Workforce Planning

-  Large / Urban / Multi-Site Practice / 20000+ List Size, England

-  March - June 2014


This practice is a large, urban practice across three different surgeries. It is a well respected practice that consistently delivers high quality care and experience for its patients. A large proportion of its 20000 + patients are registered to its university surgery. This adds a layer of complexity and variation on demands to its services. Its other surgeries offer services to a more typical demographic spread, facing the pressures from the increasing prevalence of lifestyle related conditions and an ageing population. 

The staff at the practice were feeling under pressure on delivering their services. Working days felt very, very busy and staff were having to work late to catch up as clinics overran. The senior team felt that they had to do something to alleviate the pressure and that the way they organised their team was one area to look at. 


During this sense checking stage, observations about the analysis were listed, as were some potential new working principles that came from the observations. While these observations and principles were not a ‘solution’ they would help structure and speed up the discussion with the senior team so that decisions could be made when they met later in the day. 

Observations from data gathering exercise:

In only one week in the past year did our actual hours match the planned hours we set out with.

  Many of the points where we had the lowest levels of the available resource happened at our busiest times (term time etc).
  We loose approximately 1/4 of our planned resource through natural processes such as holiday, training, meetings and sickness.
  We require 2604 sessions to operate our practice(s). 
  We plan 2652 sessions. 
  With the above natural losses, we only have 2121 sessions available. 
  With planned new GP team members, the sessions will rise to 2588 sessions.

Ongoing working principles from the data gathering.

For equity we need a transparent and fair process for planning our rotas, training and holidays
We need to plan our availability around the practice, not the practice around our availability.
We need to smooth out our holiday and training over the year.
We need to consider our staff planning as planning for once practice - not three.
We need to limit the numbers of the staff who can be off at certain times.
We need to alternate who has first priority for booking in certain periods (to be equitable over extended period of time)
We need a shorter holiday booking window so the practice can respond to changing priorities more rapidly.




The decision making process, on a complex area, was achieved in a short timeframe - while still being inclusive. 


The proposed contracts for new GP recruitment have been changed to better suit the practice requirement. Previously they would have just repeated the pattern of spreading sessions evenly over the year rather than when the practice actually needed them.


Agreement was made on new ways to manage holidays and sickness. 



The senior team are now more aware of the impact of individual actions on the whole practice’s staffing.


New visual staff availability planner has been put into action. Pinch points have been identified for the coming year. The practice manager has since rolled out the new planning methods to the nurse and reception team.

6 A new ‘standard’ level for sessions has been calculated to take into account natural fluctuations such as sickness, holiday and training.