When I joined the Oakwood Team almost two years ago, I had no idea of how a general practice ran. I brought with me a wealth of leadership, coaching, training and performance management experience. Unfortunately, I had zero knowledge or experience of the NHS and so I had a lot to learn.

After a short orientation period, I set out my stall to learn the practice inside out. I did this through a range of activities but predominantly by observing every role within the practice, a back to the floor exercise with the admin team where I spent time performing each role alongside somebody else, and by asking literally hundreds of questions.

What did I learn?

What was apparent from the start was that our patients loved us and that as a training practice, we left a lasting impression on the people that trained with us. We were quite forward thinking in terms of using telephone triaging, meaning that the majority of our patients could access an appointment on the day that they requested it.

However, patients didn’t like our telephone system as it was often engaged. Admin staff in particular, couldn’t carry out all aspects of the role so there were gaps in tasks if the relevant person was absent. Some of our processes were long winded meaning that there were many points where errors could be mad. We banked  and produced our accounts “the old fashioned way”!

Actions taken

After the initial back to the floor exercise, I spent time “on the job” with each member of staff and talked to them about our processes, what worked, what didn’t and what they would do differently. We also used the opportunity to highlight individual strengths and also identify what people’s training needs were.

  • Created a training plan from the information above
  • I ran an anonymous employee survey. This included questions specifically relating to the current and future running of the practice. We asked for ideas on how to be more efficient. All of the common themes from this survey were incorporated into our business plan
  • Conducted a review of practice processes and where required, updated them
  • Met with the accountant and bank manager to discuss ways of improving the way we worked
  • Shared our telephone challenges with our phone company and asked them to work out a solution


Admin staff are now multi skilled meaning that workloads are more easily managed in the absence of a staff member or a vacancy and that the team are able to quickly adapt to practice demands

Staff members feel valued, listened to and involved in the running of the practice, resulting in negligible turnover.

Improvements to our telephone system and a significant reduction in the number of patients complaining that they couldn’t get through

New on-line banking and accounting systems which greatly reduced monthly costs and made paying bills, raising invoices and producing accounts much quicker.

Our processes are user friendly and have been written by the people using them. They are easy to change/adapt based on feedback from the team and changes from the wider area.  

Staff members have been empowered to present solutions rather than problems and they are then involved in putting that solution into practice.

Every practice is different, and will each have its own strengths and development areas. As a relative new-comer to the NHS and General Practice, I would challenge you all to exercise your curiosity, ask questions and look at the way your practice runs with an open mind – you’ll be amazed at what you see and hear by taking time out to get back to the floor and feel it!

About the author

Allison Edgeler

Business Manager – The Oakwood Surgery