Our practice has recently conducted a patient survey as part of the patient participation LES. The freehand section for comments contained more than a dozen remarks about the conduct of a particular longstanding receptionist, who is competent but has an abrasive manner that is not popular with the patients. We would like to use this as a starting point to re-educate her, but our otherwise excellent practice manager, who is a close friend of the receptionist, says that he will not head up any disciplinary proceedings, and has threatened that if she goes, he goes too. What should we do?
A GP's response
Dr Alison Glenesk is a GP trainer in Aberdeen
As the practice manager is responsible for staffing issues he could be in breach of contract and is certainly acting extremely unprofessionally. You need to explore his unusual emotional response to this situation, and point out that personal relationships must not encroach on professional obligations. Further discussion may reveal other areas of dissatisfaction with his job, which need to be addressed, or perhaps a relationship with the receptionist which is more than just friendship. He will hopefully concede that he is acting unprofessionally, and explain why he is unable to fulfil his obligations. You are unlikely to wish to undertake disciplinary procedures as he is otherwise excellent; further advice can be obtained from the BMA.
Comments from the survey must now be fed back to the staff member by one of the partners, perhaps as part of an appraisal process, while also emphasising her positive qualities.
She may be unaware that her manner is seen as unfriendly. She should be given some specific help to improve her interaction with patients and some mentoring, then undergo re-evaluation. She may find this acceptable, or become upset or even decide to leave. If she fails to improve her behaviour you may need to consider disciplinary action.
Following this incident, the practice should hold a significant event analysis, with one of the objectives being to decide how to take action on any future surveys before they take place.
A medico-legal view
Dr Rachel Birch is a medico-legal adviser at MPS
Feedback from patients has raised concern about the manner and attitude of this receptionist. Although she is good at certain aspects of her job, the patients' concerns should be investigated. You may wish to invite the receptionist to discuss the issues as part of a learning exercise, perhaps bringing her appraisal date forward accordingly. If the concerns are greater, the most appropriate method might be to hold an investigatory meeting under the practice's disciplinary policy. You should discuss the patient survey results and any feedback from other staff members with the receptionist and give her an opportunity to express her thoughts.
As the practice manager has asked not to be involved in the disciplinary process it may be more suitable for the senior partner or the partner with responsibility for complaints to conduct the investigatory meeting. However, you should make clear to the practice manager that he must maintain boundaries between his professional and personal life and the outcome will not be influenced by his threats.
After investigating the concerns you may feel that the receptionist requires further training in customer service and communication skills. After this training you should agree to hold a review meeting to ensure that there has been improvement in her performance.
A patient's opinion
Antony Chuter is an expert patient
The survey has identified a big issue for patients, which is damaging the practice's reputation in the community. I think there are two ways of dealing with this situation.
It strikes me that a good manager would put the care of patients and the reputation of the practice before friendship, so perhaps there is more of an issue with the practice manager than first believed.
All reception staff need regular ongoing training. I suggest the partners talk about the training opportunity for both the manager and the reception staff. After the training there should be some ongoing performance review. Any member of staff who is then not up to scratch can be put on a performance management process if they have not improved.