This plan gives you a systematic approach to admin workforce planning that fixes system problems, not just fills gaps. You'll identify what's actually broken in your practice, prioritize improvements by risk and ROI, match people to high-value problems, and present a business case partners will approve.
Instead of reactive firefighting ("we need more bodies"), you'll demonstrate organizational thinking: diagnose problems, quantify costs, design solutions, calculate return on investment, and track results.
Implementation timeframe: 8-10 weeks for full diagnostic, business case, and approval; ongoing quarterly reviews for continuous improvement
Why This Matters
For Your Practice
Stop treading water: Most practices spend years firefighting the same problems. Strategic workforce planning lets you actually make progress because you're adding capacity where it creates system change, not just spreading existing team thinner.
Self-funding improvements: Problems that cost money (lost claims, excessive locum spend, inefficient processes) can be solved by admin resource that pays for itself through savings. When the investment demonstrably reduces costs or captures lost revenue, the business case becomes compelling.
Risk mitigation: Systematic problem diagnosis reveals what's putting patients at risk or could get you shut down by CQC. These problems need fixing regardless of cost—identifying them early prevents crisis.
Partner confidence: Business cases with clear ROI get approved. Vague requests for "more admin support" get rejected. Strategic planning shows you understand practice economics and organizational design.
Staff retention and development: Internal talent often goes under used. Giving existing staff stretch assignments with development support improves retention, builds capability, and de-risks new initiatives.
Sustainable improvement: Quarterly review cycles mean you're continuously adjusting resource to emerging problems, not locked into outdated staffing structures.
For Your Professional Development
By leading this improvement, you'll demonstrate:
Strategic workforce planning capability: Designing staffing solutions based on system diagnosis and organizational needs, not reactive gap-filling
Problem diagnosis and root cause analysis: Identifying what's actually broken (not just symptoms), understanding why problems persist, and designing interventions that address causes
Business case development and financial modeling: Quantifying current costs, projecting savings, calculating ROI, and presenting compelling cases for investment
Risk management across multiple domains: Assessing patient safety risks, regulatory risks, and financial risks; prioritizing interventions appropriately
Talent development and succession planning: Identifying internal capability, creating development opportunities, and building organizational capacity
Change management and system thinking: Understanding how organizational problems are interconnected and designing staffing interventions that create system-level improvement
Add these achievements to your year-end evaluation: "Led strategic workforce planning initiative that identified £X in annual savings opportunities, secured partner approval for [role/project], and implemented quarterly review system maintaining continuous organizational improvement over [X] months."
Prerequisites and Preparation
What You Need Before Starting
Approvals: Partner agreement to conduct strategic review (this isn't threatening—frame as "understanding where we need to strengthen the practice"). Some finance access (payroll, locum spend, rejected claims data) to quantify problems.
Stakeholders: GP partners, clinical leads, senior admin staff, finance manager/accountant (if separate from your role)
Resources: Time to conduct diagnostic (8-10 hours over 2-3 weeks), access to compliance status, financial reports, operational metrics. Budget will come later—you're building the case for it.
Current state data: Whatever you can gather—CQC inspection reports, QOF achievement, appointment access metrics, staff turnover, locum spend, claims rejection rates, patient complaints themes. Imperfect data is fine; you're looking for patterns, not precision.
Estimated Time Investment
Total implementation: 8-10 weeks from diagnostic kick-off to approved business case
Your time commitment:
Weeks 1-3: 8-10 hours (diagnostic, problem categorization, data gathering)
Weeks 4-6: 6-8 hours (solution design, role definition, ROI calculation)
Weeks 7-8: 4-5 hours (business case preparation, partner presentation)
Ongoing: 2-3 hours per quarter (review cycle, reassessment)
Senior team time: 3-4 hours total across meetings
Partner time: 2 hours (initial buy-in meeting, final business case presentation)
The Implementation Plan
Phase 1: Kick-Off and the "What's Broken?" Diagnostic (Week 1-3)
Meeting 1: Initial Kick-Off
Attendees: Practice Manager, GP Partner (or senior partner if multi-partner), clinical leads, senior admin staff
Duration: 45 minutes
Agenda:
Present the strategic approach — Explain that you want to understand what's not working well in the practice so you can build targeted solutions, not just request "more staff." Frame as proactive improvement, not criticism.
Review scope — Establish you'll audit key operational areas (compliance, access, finance, clinical governance, HR), categorize problems by risk and ROI, design solutions, and present business case.
Set expectations — This will reveal problems (that's the point). Some will need resource; some will need process change; some need external help. Partners don't commit to anything today—just to seeing the findings.
Assign responsibilities — Practice Manager leads diagnostic; clinical leads provide input on their domains; partners provide financial data access and approve final business case.
Agree timeline — Week 3: diagnostic complete; Week 6: proposed solutions; Week 8: business case presentation
Outputs:
Partner agreement to proceed with diagnostic
Access to necessary data (finance reports, operational metrics)
Commitment to review findings in Week 6
Cultural permission to surface problems without blame
Action: Conduct the "What's Broken?" Diagnostic
This is the heart of the entire process. You're looking for what never gets done properly and why.
Structured diagnostic framework across key domains:
1. Compliance and Regulatory Risk
Policies: Are they current? Last reviewed? Evidence of implementation?
Audits and SEAs: Are they completed on schedule? Quality adequate? Action plans followed through?
Training: Compliance rates by category (statutory, professional, role-specific)? Induction completion for new starters?
Record-keeping: Clinical records quality? Documentation standards met? Evidence trails for CQC?
DSPT: Current status? Outstanding actions? Data security incidents?
Red flags (illustrative—assess based on your practice risk profile): Role-appropriate training gaps, policies 3+ years out of date, audits not done, SEAs backlog, DSPT standards not met
2. Access and Appointment Management
Appointment availability: What percentage of patients get appointment within target timeframe? DNA rates?
Telephone access: Call abandonment rates? Queue times? Patient complaints about access?
Locum reliance: How many locum sessions per month? Annual locum spend? Why do you need locums (gaps, demand, or poor appointment design)?
Triage effectiveness: Is total triage working? Are patients getting right care at right time?
Capacity planning: Do you know your actual demand? Is capacity matched to need?
Red flags (illustrative thresholds—benchmark against your baseline): Significant locum reliance without planned absence, high call abandonment, extended appointment wait times, appointment system feels chaotic to staff and patients
3. Finance and Revenue Capture
QOF achievement: Projected performance? Historical trends? Money left on table?
Enhanced services: Are you delivering what you're contracted for? Billing accurately?
Claims and reimbursements: NHSBSA prescription services rejection rates? Claims submitted via PCSE Online on time? Claims backlog?
Cost control: Prescribing spend? Wastage? Supply chain efficiency?
Budget management: Do you know your monthly financial position? Forecast accuracy?
Red flags (illustrative—assess against your targets): QOF significantly below potential, NHSBSA rejection rates elevated, claims backlog >3 months, no monthly financial reporting
4. Clinical Governance and Safety
Prescribing safety: Error rates? CD compliance? High-risk medication monitoring?
Safety systems: Are protocols followed? Escalation pathways clear? Incident reporting working?
Clinical audit: Planned audit schedule? Completed on time? Action plans implemented?
Information governance: Confidentiality breaches? Subject access requests handled on time? Record security?
Red flags: Prescribing incidents, CD discrepancies, SEAs revealing system failures, information breaches, audit backlog
5. HR and Workforce Management
Staff turnover: Annual turnover rate? Exit interview themes?
Sickness absence: Rates by staff group? Long-term absence? Wellbeing support?
Supervision and appraisal: Compliance with supervision schedule? Appraisals completed? Development plans followed?
Recruitment: Time to fill vacancies? Successful probation completion rates? Onboarding quality?
Morale and culture: Staff survey results? Supervision themes? Visible stress or burnout?
Red flags (illustrative benchmarks—compare to your trends): Elevated turnover, absence rates significantly above baseline, supervision not happening, staff reporting feeling overwhelmed
6. Premises, Equipment, and Operations
Maintenance: Planned maintenance schedule? Backlog of repairs? Equipment calibration current?
Health and safety: Risk assessments current? Fire drills done? Incidents investigated?
Systems and IT: Clinical system optimization? Integration working? Downtime managed?
Administration efficiency: Repeat processes that cause delays? Bottlenecks? Manual work that could be automated?
Red flags: Maintenance backlog affecting operations, H&S non-compliance, manual processes consuming significant staff time
How to gather this information:
Document review: Last CQC report, QOF performance, financial reports (P&L, locum spend), compliance tracker, training records, HR reports (turnover, absence)
Data analysis: Appointment wait times, DNA rates, call metrics, claims data, prescribing reports
Staff conversations: 15-minute conversations with 5-8 staff across roles asking: "What never gets done properly? What do we always struggle with? If you had a dedicated person to fix one thing, what would it be?"
Partner input: "What keeps you up at night about this practice? What problems do we keep discussing but never solve?"
Patient feedback: Recent complaints themes, Friends and Family Test comments, online reviews
Using My Practice Manager Email Assistant to help with the diagnostic:
Email mypm@automate.mypracticemanager.co.uk with queries like:
"What are the typical compliance gaps that indicate need for additional admin support in GP practices?"
"What financial metrics suggest revenue capture problems that could justify hiring?"
"What locum spend levels typically justify investing in appointment system improvement?"
"Generate a diagnostic framework for identifying workforce planning priorities in a 5-GP practice"
You'll get informed responses within minutes that can guide your data gathering and help interpret findings.
Outputs from diagnostic:
List of 15-25 specific problems across the domains
For each problem, note: What's not happening? Why? What's the impact? What's the cost (approximate)?
Raw notes from staff conversations (themes and quotes)
Data snapshots (locum spend, QOF %, claims rejection rate, turnover %, training compliance %, etc.)
Action: Create Your Document Package
While this plan focuses on strategic diagnosis rather than compliance documentation, you'll benefit from having structured templates and frameworks to support your workforce planning process.
Templates and tools you'll need:
Workforce Diagnostic Framework — Structured template for assessing problems across domains
ROI Calculation Worksheet — Financial modeling template for business cases
Role Specification Template — Standard format for defining new roles or stretch assignments
Business Case Template — Structured format for partner presentations
90-Day Project Plan Template — Implementation milestone tracker
Quarterly Review Agenda — Structured format for ongoing workforce reviews
You may also need supporting HR/Management policies:
Recruitment and Selection Policy — Framework for hiring decisions
Staff Induction Policy — Onboarding standards for new roles
Performance Management Policy — Appraisal and development frameworks
Supervision Policy — Structured support for stretch assignments
Three ways to get these documents:
Email Assistant (Fastest): Email your request to mypm@automate.mypracticemanager.co.uk:
"Generate a workforce diagnostic framework template for a GP practice with [size]. Include domains for compliance, finance, access, clinical governance, HR, and operations."
"Create a business case template for workforce investment with ROI calculation, risk assessment, and implementation plan sections."
Response in 1-2 minutes with document attached as PDF or Word
No login required
Web AI Tools: Use our AI document generators for visual editing and customisation (~1 minute generation time)
Compliance Library: Browse and customise HR/management templates manually at our library
For manual implementation: You can create similar documents yourself using spreadsheet software for diagnostic frameworks and word processors for templates. Ensure they capture the key elements: problem identification, cost quantification, solution design, ROI calculation, and implementation planning.
Phase 2: Problem Categorization and Solution Development (Week 3-5)
Action: Customize Your Diagnostic Framework
Now that you have raw diagnostic data, refine your analysis framework to suit your practice context.
Customisation steps:
Review your diagnostic notes — Look for patterns and themes across the six domains
Add practice-specific context — Include your practice size, patient demographics, service mix, staffing model in your analysis
Tailor risk categories — Adjust RED/AMBER/GREEN thresholds based on your partners' risk appetite and practice priorities
Refine cost estimates — Use your actual financial data (payroll, locum invoices, claims reports) to ground cost calculations
Using My Practice Manager Tools:
Email Assistant (recommended): Email mypm@automate.mypracticemanager.co.uk with:
"Review my attached diagnostic findings and help me categorize problems by risk and ROI for a [practice size] practice"
"Help me estimate the annual cost of [specific problem description] in my GP practice"
"What are typical ROI timeframes for [type of workforce intervention]?"
Web AI Tools: Generate customized analysis frameworks at https://app.mypracticemanager.co.uk/ai-tools with:
Visual, step-by-step framework development (~1 minute)
Real-time editing and refinement based on your data
Export analysis frameworks in Excel or PDF formats
This allows you to move from raw data to structured prioritization quickly while ensuring the framework reflects your specific practice context.
Action: Categorize Problems by Risk and ROI
Now analyze your diagnostic findings using a three-tier risk framework.
Tier 1: RED - Immediate Risk (Patient Safety or Regulatory Shutdown)
These problems could directly harm patients or trigger CQC enforcement action. They need fixing regardless of cost.
Examples:
Role-appropriate training gaps for clinical staff (note: CQC doesn't prescribe mandatory training lists, but assess based on role requirements and patient risk)
Controlled drugs reconciliation not happening (risk of theft/diversion)
No system for safety alerts (risk of missing critical clinical updates)
Serious compliance gaps that could result in CQC rating downgrade or registration restrictions
Policies critically out of date (3+ years, major regulatory changes missed)
For RED problems, ask:
How immediate is the patient risk?
What's the regulatory consequence if discovered?
Can we fix this with our current team or do we need additional resource/expertise?
Tier 2: AMBER - Problems Costing Money (Lost Revenue or Excessive Spend)
These are the self-funding opportunities. Problems costing more than the admin resource needed to fix them.
Examples (illustrative—actual results depend on your specific context and implementation quality):
Locum spend: £80k/year on locums because appointment system is chaotic and GPs are overwhelmed → Solution: Hire appointment systems coordinator (£30k), implement total triage, optimize capacity → Target: Reduce locum reliance, improve access metrics
Claims backlog: £15k/year lost to rejected NHSBSA claims due to poor quality checking → Solution: Senior dispenser with dedicated claims quality time (0.5 FTE, £15k) → Target: Reduce rejection rates, capture lost revenue
QOF underperformance: Achieving 92% QOF (£340k) when could achieve 98% (£363k) with better recall and chronic disease management → Solution: Clinical admin lead for recalls (0.5 FTE, £14k) → £23k additional revenue in year 1
Enhanced services not delivered: Practice could deliver £25k worth of enhanced services (diabetes, frailty, learning disabilities) but lacks admin coordination → Solution: Enhanced services coordinator (0.3 FTE, £9k) → £16k net gain year 1
Staff turnover costs: 20% turnover costing ~£8k per replacement (recruitment, training, lost productivity) = £32k/year → Solution: Invest in supervision system, staff wellbeing, development opportunities → Reduce turnover to 10% = £16k saved + improved morale
For AMBER problems, calculate:
Current annual cost of the problem (hard costs: lost revenue, locum spend, wastage; soft costs: staff time, rework, stress)
Proposed solution cost (salary, training, any external support needed)
Expected savings per year
ROI = (Annual Savings - Solution Cost) / Solution Cost x 100%
Payback period = Solution Cost / Annual Savings x 12 months (how many months to recover the investment from savings?)
Tier 3: GREEN - Efficiency and Quality Improvements
These don't have immediate financial ROI or critical risk, but improve operations and staff experience.
Examples:
Manual processes that waste staff time (e.g., multiple handovers, unnecessary duplication)
Communication breakdowns between teams
Poor information flow causing repeated queries
Training and development opportunities that improve capability
For GREEN problems, ask:
Would this make staff significantly more effective?
Does it reduce stress and improve morale?
Could it prevent future problems (proactive vs reactive)?
Is it quick win or long-term investment?
Action: Quantify Costs and Estimate Solutions
For your top 5-8 problems (focusing on RED and high-ROI AMBER), work out:
Current state cost (annually):
Hard costs: £X lost revenue, £Y locum spend, £Z wasted on errors
Soft costs: Estimate staff time consumed (hours/week x hourly rate x 52)
Risk costs: What could this cost if it goes wrong? (CQC enforcement, patient harm claim, professional body sanctions)
Proposed solution:
What capability/skills are needed to fix this?
System/organizational thinking (e.g., redesigning appointment system)
Specialist expertise (e.g., pharmacy first implementation, IT optimization)
Dedicated admin capacity (e.g., clearing claims backlog, managing compliance tracker)
Project management (e.g., leading staff training system implementation)
Is this a permanent role, fixed-term project, or internal stretch assignment?
Could existing internal staff take this on with support and development?
Do we need external consultant/support for part of it?
Solution cost (annually or project total):
New role salary: £X (include NI, pension, training budget)
Internal stretch assignment: Backfill cost for their usual role while they work on project
External support: Consultant fees, training costs
Implementation costs: Any technology, materials, training needed
Expected savings/value (annually):
Quantified savings or revenue gain
Risk mitigation value (harder to quantify but note it)
Efficiency gains (hours saved per week across team)
Example calculation (illustrative—your actual figures will vary):
Problem: Excessive locum spend due to chaotic appointment system and poor demand management
Current cost: £80k/year locums, plus £10k GP stress-related absence, plus patient complaints about access = £90k total
Proposed solution: Appointment Systems Coordinator (£30k + £7k on-costs = £37k total cost) + external support for total triage implementation (£8k consultant), plus practice manager time for oversight (10% = £5k)
Total solution cost Year 1: £50k
Expected savings Year 1 (conservative estimate): Reduce locum reliance by 60% = £48k savings, plus reduce GP absence by 50% = £5k savings = £53k total
ROI Year 1: (£53k - £50k) / £50k × 100% = 6% positive return
Payback period: £50k / £53k × 12 months = 11.3 months to recover investment
Ongoing Years 2+: £37k cost, £53k savings = 43% ROI annually
This demonstrates a financially viable business case, though actual results depend on implementation quality and practice-specific factors.
Meeting 2: Review Findings with Senior Team
Attendees: Implementation team (Practice Manager, senior GP, clinical/admin leads)
Duration: 90 minutes
Agenda:
Present diagnostic findings — Walk through what's broken across domains. Use factual data (numbers, staff quotes, examples) not blame.
Show categorization — Present your RED/AMBER/GREEN framework with specific problems in each tier.
Share quantified costs — For top problems, show current annual cost and impact.
Discuss root causes — Why do these problems persist? Usually: lack of dedicated ownership, no system, competing priorities, capability gaps.
Test proposed solutions — For 2-3 high-priority problems, present your draft solution ideas and get feedback. Are these realistic? Would they work?
Identify internal talent — Ask: "Is there anyone in the team who's looking for development opportunity and could take on one of these with support?" Often there's someone eager to step up.
Outputs:
Validated problem list with senior team agreement on priorities
Refined solution concepts with feasibility checked
Potential internal candidates identified for stretch assignments
Partner approval to proceed to business case development
Phase 3: Solution Design and Role Definition (Week 5-7)
Action: Design Solutions and Define Roles
For your top 3-5 priority problems (mix of RED and high-ROI AMBER), create detailed solution specs.
For each solution, document:
Problem statement (2-3 sentences): What's broken, why it matters, what it's currently costing
Proposed solution (paragraph): What role/capability is needed, what they'll do, expected outcomes
Role specification (if hiring or internal assignment):
Purpose: Why this role exists (the problem it solves)
Key responsibilities: 5-7 specific activities
Success metrics: How you'll know it's working (KPIs, targets)
Skills/capabilities needed: What type of person? (System thinker? Detail-oriented? Change management skills? Clinical background needed?)
Time commitment: Full-time, part-time, fixed-term project (12 months), or ongoing?
Development opportunity (if internal): What will this person learn? How does it support their career progression?
90-day plan (if project-based):
Month 1: Onboarding, problem deep-dive, stakeholder engagement, initial quick wins
Month 2: Core implementation (new system, process improvement, backlog clearance)
Month 3: Embedding change, training others, measuring results, preparing handover or ongoing maintenance
Example: Appointment Systems Coordinator Role
Problem: £80k annual locum spend driven by poor appointment management, reactive booking, capacity not matched to demand, resulting in GP overwhelm and patient access complaints.
Solution: Hire Appointment Systems Coordinator (or internal stretch assignment for senior receptionist) to lead appointment optimization, implement total triage, match capacity to demand, reduce locum reliance.
Role specification:
Purpose: Transform appointment management from reactive firefighting to strategic demand and capacity matching
Key responsibilities:
Implement total triage system with structured clinical decision-making
Analyze demand patterns and optimize session templates
Monitor access metrics and capacity utilization weekly
Lead reception team on appointment management best practice
Manage relationship with external support (if using consultant)
Report monthly on locum spend, access metrics, patient feedback
Continuously improve system based on data and staff feedback
Success metrics: Reduce locum sessions by 50% within 6 months, appointment wait times <48 hours for routine, call abandonment <5%, patient satisfaction with access >80%
Skills needed: Organizational thinking, data literacy, change management, reception experience, confidence to challenge current ways of working
Time commitment: 12-month fixed-term project (full-time) with review at 9 months for permanent role consideration
Development opportunity: Project leadership, system design, practice-wide impact, management experience
90-day plan:
Month 1: Analyze current demand data, map current appointment flows, engage GPs and reception on vision, quick wins (remove obvious bottlenecks), engage external consultant for total triage training
Month 2: Implement total triage protocols, retrain reception team, optimize session templates, monitor daily and adjust
Month 3: Measure impact (locum sessions reduced? access improved?), refine system based on data, train backup staff, prepare sustainability plan
Action: Identify Internal Talent for Stretch Assignments
Review your current team: Who's ready for more?
Signs of high potential internal talent:
Consistently high performance in current role
Shows initiative (makes suggestions, spots problems, volunteers for extra)
Good stakeholder relationships (trusted by colleagues)
Curious and willing to learn
Looking for career progression but no immediate opening
Benefits of internal stretch assignments over external hiring:
De-risked: If they don't succeed, you haven't hired someone permanent. If they excel, you've developed a star and can create permanent role or succession pipeline.
Faster start: They know the practice, relationships, culture. No 3-month onboarding.
Retention: Development opportunities improve morale and reduce turnover. Staff see you invest in them.
Cost-effective: Backfill their role temporarily (often easier than recruiting senior) while they prove capability on project.
How to propose a stretch assignment:
Private conversation: "I've identified a high-priority project that would really benefit the practice. I think you have the capability to lead it. Are you interested in a development opportunity?"
Clear brief: Give them the role spec, 90-day plan, success criteria. Don't assume—be explicit about expectations.
Support structure: Weekly check-ins with you, senior sponsor (GP partner), training budget if needed, clear escalation if stuck.
Safety net: "This is a development opportunity. Worst case, it doesn't work out and you return to your role—no judgment. Best case, you excel and we create a permanent opportunity for you."
Recognition: If they succeed, reward it (pay increase, job title change, permanent role, public recognition with partners).
Example: Senior receptionist with 8 years' experience, proactive, well-respected, looking for progression but no management vacancy. Give them the "Implementing Staff Training System" improvement plan project as a stretch assignment. Outcome: They successfully build the training matrix, audit compliance, implement tracker system. Practice gains systematic training compliance (prevents £30k crisis if CQC found gaps). Staff member demonstrates project management capability. Create permanent role: Training and Development Lead (£3k pay rise). Win-win.
Phase 4: Business Case Development and Partner Approval (Week 7-8)
Action: Prepare Business Case for Partners
Structure for compelling business case:
1. Executive Summary (1 page)
Current situation: Brief problem statement
Proposed solution: Role/project summary
Financial case: Current cost vs solution cost vs expected savings
ROI: Payback period and ongoing annual savings
Risk mitigation: Patient safety, CQC, financial protection
Recommendation: Approval for [specific role/budget]
2. Problem Analysis (1-2 pages)
Detailed diagnostic findings for this specific problem
Data: Current costs quantified, impact documented
Why it persists: Why we can't solve it with current team (capacity, expertise, system design)
Consequences of inaction: What happens if we don't fix this? (escalating costs, increasing risk, staff burnout)
3. Proposed Solution (1 page)
Role specification or project brief (as per Phase 3 work)
Why this will work: Evidence from similar practices, expert recommendations, internal capability
Implementation plan: 90-day timeline with milestones
Success criteria: How we'll measure results
4. Financial Analysis (1 page)
Current state cost: £X annually (break down: locum spend, lost revenue, staff time, risk)
Solution cost: £Y annually (salary + on-costs, or project budget)
Expected savings: £Z annually (conservative estimate)
Net benefit Year 1: £Z - £Y = £[positive number]
ROI Year 1: (Z - Y) / Y × 100% = [percentage]
Payback period: Y / Z × 12 months = [months to recover investment]
Ongoing benefit Years 2+: Show continued savings with lower ongoing costs (typically no consultant/setup costs)
Visual: Simple table or chart showing current state, solution cost, savings, and net benefit
5. Risk and Mitigation (1/2 page)
Risk: Investment doesn't deliver expected results
Mitigation: 90-day review points, clear KPIs, senior sponsor oversight
Risk: Internal candidate doesn't succeed in stretch role
Mitigation: Return to substantive role, no long-term commitment, alternative solutions prepared
Risk: Problem is more complex than anticipated
Mitigation: External expertise available if needed, phased approach allows adjustment
6. Recommendation and Decision (1/2 page)
Request: Approval for [specific role/budget/project]
Start date: [Realistic timeline]
Review point: 3-month progress review, 6-month results review
Alternatives considered: Brief note on why this is best option (vs doing nothing, vs other approaches)
Using My Practice Manager Tools for business case development:
Email Assistant — Get help structuring and refining your case:
Email mypm@automate.mypracticemanager.co.uk:
"Help me build a business case for hiring an appointment systems coordinator. Current locum spend is £80k/year. Expected savings from better demand management?"
"What are typical ROI timeframes for admin investment in GP practices?"
"Review my attached business case and suggest improvements for partner presentation"
Meeting 3: Business Case Presentation to Partners
Attendees: All GP partners, Practice Manager, relevant clinical/admin leads
Duration: 45-60 minutes
Agenda:
Recap strategic approach (5 min) — Remind partners this was about diagnosing problems systematically
Present findings (10 min) — High-level diagnostic results (RED/AMBER/GREEN categories, key themes)
Present top 3 priorities (15 min) — For each: problem, cost, proposed solution, ROI
Detailed business case for #1 priority (10 min) — Walk through full financial case, implementation plan
Q&A and discussion (15 min) — Address concerns, test assumptions, discuss alternatives
Decision (5 min) — Ask for approval to proceed with priority #1, agreement to review others if successful
Tips for effective presentation:
Lead with numbers: "We're spending £80k on locums" gets attention immediately
Show ROI clearly: "£50k investment targeting £53k savings in year 1, with potential for ongoing annual benefit"
Address "why now?": "Problem is escalating" or "We have opportunity to prevent crisis"
Acknowledge uncertainty: "Projections are conservative estimates—actual results depend on implementation quality" (honesty builds trust)
Provide options: "We could hire externally, promote internally, or use fixed-term contractor"
Show you've thought it through: 90-day plan, KPIs, review points demonstrate thoroughness
Outputs:
Partner approval for at least one priority investment
Budget approved and timeline confirmed
Agreement on review points (3 months, 6 months)
Permission to proceed with recruitment or internal assignment
Phase 5: Implementation and Quarterly Review Cycle (Month 3+)
Action: Implement Approved Solution
Once approved:
Recruitment or internal assignment: If hiring, write JD and recruit. If internal stretch, have formal conversation with chosen staff member, confirm their agreement, arrange backfill.
Onboarding and induction: Even for internal staff taking new role, provide proper onboarding—role clarity, stakeholders, resources, support structure.
90-day milestones: Work with the person to set clear 30/60/90-day milestones from the plan.
Weekly check-ins: Practice Manager has 30-minute check-in weekly for first 3 months—progress, blockers, support needed.
Senior sponsor support: GP partner is visible sponsor—shows organizational commitment, removes blockers, provides clinical input.
Using My Practice Manager Task Management:
Set up recurring tasks to maintain accountability and momentum:
Weekly: "Check-in with [role/project lead] - progress, blockers, support needed" assigned to Practice Manager (30 min)
Monthly: "Review KPIs for [project] - on track? adjustments needed?" assigned to Practice Manager (30 min)
Quarterly: "Full review of [project] - present results to partners, assess ROI, identify next priorities" assigned to Practice Manager (2 hours prep + meeting)
This creates clear audit trail and prevents projects drifting.
Key metrics to track (specific to your priority problem):
Financial: Actual cost reduction (locum spend, claims captured, QOF improvement)
Operational: Process metrics (appointment wait times, training compliance %, backlog clearance)
Quality: Patient feedback, staff satisfaction, error rates
Efficiency: Time saved (hours per week), process cycle times
Action: Quarterly Workforce Review Cycle
Don't stop at one problem. Set up recurring quarterly reviews to maintain continuous improvement.
Quarterly Workforce Review Meeting (90 minutes):
Attendees: Practice Manager, senior GP, relevant leads
Agenda:
Review current initiatives (30 min)
Progress on approved projects
KPIs achieved vs targets
ROI realized vs expected
Challenges and adjustments needed
Scan for new problems (30 min)
What's emerged since last review?
Any new risks (RED)?
Any new cost problems (AMBER)?
Staff feedback on pressure points
Prioritize next actions (20 min)
Based on current state, what's next highest priority?
Do we have capacity to tackle it or need more resource?
Is current initiative ready to close (successful) or expand?
Update workforce plan (10 min)
Adjust 12-month rolling plan
Identify any budget implications for next financial year
Note any succession/development opportunities
Outputs:
Updated workforce plan with current initiatives, next priorities, parking lot (future)
Budget forecast for next quarter/year
Recognition of successes (celebrate wins with team and partners)
This rhythm prevents returning to reactive firefighting. You're continuously assessing, prioritizing, acting, and reviewing. Practice evolves with changing pressures.
Common Problems and Solutions
Problem 1: "Partners say we can't afford extra staff—budget is too tight"
Why this happens: Partners see salary as pure cost, not investment. Don't understand ROI. Fear committing to ongoing expense when practice finances feel uncertain.
How to address it:
Start with self-funding problems: Present AMBER tier problems first—"This investment pays for itself in 6-12 months, then generates ongoing savings." Much easier sell than "we need more people."
Fixed-term projects, not permanent roles: Propose 12-month fixed term with review. De-risks the commitment. If it works, make permanent; if not, natural end point.
Show current hidden costs: "We're already spending £80k on locums—I'm proposing spending £37k to reduce that by £48k." Reframe as cost reduction, not cost increase.
Quantify inaction cost: "If we don't fix this, we'll continue losing £15k/year to rejected claims indefinitely." Sometimes cost of doing nothing is more frightening than cost of acting.
Prevention: Build track record. Deliver on first small project, demonstrate ROI, then partners trust you for larger investments. Start small, prove value, scale up.
Problem 2: "We don't know what's actually broken—everything feels chaotic and overwhelming"
Why this happens: When you're firefighting constantly, you can't step back to diagnose root causes. Everything feels urgent and important.
How to address it:
Use structured diagnostic framework: Force yourself to look at each domain systematically (compliance, finance, access, HR, etc.). Written framework prevents reactive "whatever's on fire today" thinking.
Gather data, not just feelings: Numbers reveal patterns. "We feel overwhelmed by appointments" becomes "42% call abandonment rate, 8-day wait for routine appointments, £80k locum spend." Data clarifies priorities.
Ask staff directly: 15-minute conversations with 5-8 staff: "What never gets done properly here?" They know. They've been saying it for years. Someone needs to listen and document it.
Review external feedback: CQC reports, patient complaints, exit interviews—outsiders often see patterns you're too close to notice.
Prevention: Quarterly review cycle built into calendar. Even when things feel calm, check: "What's not working well? What's emerging as a problem?" Catch issues before they become crises.
Problem 3: "We give someone a project and it goes nowhere—they get pulled back into daily work"
Why this happens: No protected time, no clear accountability, competing priorities, lack of senior support, unclear brief.
How to address it:
Clear role specification and 90-day plan: Give them written brief with specific deliverables and timeline. Vague "improve X" fails; specific "implement Y by date Z" succeeds.
Protected time: If it's 0.5 FTE project, backfill their usual role for that time. Don't expect people to do project "on top of" usual work—it won't happen.
Weekly check-ins: 30 minutes with you, every week. Accountability, support, unblock barriers, adjust plan if needed.
Senior sponsor: GP partner is visible sponsor. Shows project is practice priority, not just PM's idea. Sponsor can remove political blockers and provide clinical input.
Celebrate progress: Monthly updates to partners, public recognition when milestones hit. Demonstrates you value their work and holds everyone accountable.
Prevention: Treat projects like real work, not extra work. Proper brief, protected time, accountability, support, recognition.
Problem 4: "We fix one thing and two more problems pop up—it feels endless"
Why this happens: It is endless. Practices are complex adaptive systems. Solving one bottleneck reveals the next. That's normal, not failure.
How to address it:
Reframe expectations: Strategic workforce planning isn't "fix everything once and we're done." It's continuous improvement—always working on next highest priority.
Celebrate progress: You've fixed the first problem! That's success, even though more remain. Acknowledge what's working now that wasn't before.
Prioritize ruthlessly: You can't tackle everything. Focus on RED (patient risk, CQC risk) and high-ROI AMBER (self-funding). Let GREEN items wait.
Quarterly review rhythm: Build in regular reassessment. Problems change. Priorities shift. Workforce planning adapts to current reality.
Prevention: Set expectation up front that this is ongoing practice. "We'll identify top 3 priorities, tackle those over 6-12 months, then reassess. This is how we continuously improve, not a one-time project."
Problem 5: "Internal staff aren't interested in development opportunities—they just want to do their job"
Why this happens: Maybe the opportunities aren't compelling. Or staff don't trust you'll support them. Or they're already maxed out and "development" sounds like "more work for same pay."
How to address it:
Make opportunity attractive: Frame as career development, not extra work. "This is project leadership experience. It would position you for [next role]. We'd provide training budget, weekly mentoring, and if successful, permanent role with pay increase."
Provide real support: Not "go figure it out"—give them training, mentoring, protected time, budget. Show you're investing in their success.
Protect them from failure: "This is development. If it's harder than expected, we adjust plan or bring in help. You won't be blamed for system problems."
Reward success visibly: If someone steps up and delivers, reward it publicly. Pay increase, job title change, recognition in partner meeting. Shows others that development opportunities are real pathway to progression.
Choose the right person: Not everyone wants stretch assignment. Look for the 10-20% who are hungry for growth, not the 80% who are content in current role.
Prevention: Build culture where development is valued and supported. Staff see that people who take opportunities are recognized and advanced. Creates positive cycle.
Success Criteria and Evidence
You'll Know You've Succeeded When:
Clear problem diagnosis documented: 15-25 specific problems identified across practice domains, categorized by risk/ROI, with quantified costs
Prioritized workforce plan: Top 3-5 priorities with detailed solutions, ROI calculations, and implementation plans ready
Approved business case: Partners approved at least one investment with budget, timeline, and review points confirmed
Implementation underway: Role filled (hired or internal assignment), 90-day plan in progress, KPIs being tracked
Early results visible: Within 3-6 months, seeing measurable improvement in targeted problem (reduced costs, improved compliance, better access, staff feedback positive)
Quarterly review cycle established: Regular review meetings scheduled, workforce planning embedded as ongoing practice (not one-off project)
Partner confidence: Partners see you as strategic thinker who understands practice economics and organizational design, not just reactive manager
Evidence You Can Show (to Partners, CQC, or for Your CV):
Documentation:
Diagnostic report with problem analysis and categorization framework
Business cases for priority investments with ROI calculations and implementation plans
Role specifications and 90-day plans for approved initiatives
Meeting minutes showing partner engagement and approval decisions
Quarterly review reports showing progress, results, and evolving priorities
Performance data:
Financial: Actual savings achieved vs projected (locum spend reduced, claims captured, QOF improved)
Operational: Process improvements measured (training compliance up from 68% to 96%, appointment wait times down from 8 days to 2 days)
Staffing: Turnover reduced, staff satisfaction improved, internal promotions/development
For your CV/professional development:
"Led strategic workforce planning initiative across [practice size], conducted comprehensive diagnostic identifying £Xk savings opportunities, developed and presented business cases achieving partner approval for [specific investments], delivered [quantified results] within [timeframe]"
"Demonstrated strategic planning, financial modeling, ROI analysis, stakeholder engagement, change management, and talent development capabilities"
Maintaining the Improvement
Quarterly workforce review (scheduled every 3 months, 2-3 hours):
Review current initiatives: progress, KPIs, results, adjustments
Scan for emerging problems: what's new since last quarter?
Prioritize next actions: based on current risk/ROI analysis
Update 12-month rolling workforce plan
Communicate to partners: brief report on status, results, upcoming priorities
Annual workforce planning cycle (4-6 hours):
Comprehensive diagnostic refresh: full review of all domains
Financial review: compare actual costs to last year, project next year
Review all roles and responsibilities: still fit for purpose?
Succession planning: identify development needs, future capability gaps
Budget planning: forecast training, recruitment, development costs for next financial year
Strategic alignment: do staffing and priorities align with practice strategy?
Embedding the change:
Make it business as usual: Workforce planning becomes regular partner meeting agenda item, like finances and QOF
Build capability: Train senior team in problem diagnosis, ROI calculation, business case development—share the skills
Celebrate successes: When initiatives deliver results, recognize the people who made it happen publicly
Learn from failures: Some initiatives won't deliver expected results—that's OK. Analyze why, adjust, try differently.
Additional Resources
My Practice Manager Tools
Email Assistant Get instant support throughout your planning:
Answer questions about typical problems and solutions
Help calculate ROI and build financial cases
Review your draft business cases and suggest improvements
Generate templates for diagnostics, role specs, business cases
No login required—just email your request
Example queries:
"What are typical self-funding admin workforce opportunities in GP practices?"
"Help me calculate ROI for hiring an appointment systems coordinator if current locum spend is £80k/year"
"Review my business case for [attached] and suggest improvements"
"Generate a diagnostic framework for identifying workforce priorities in a [practice size] practice"
Task Management Keep your initiatives on track:
Weekly check-ins with project leads
Monthly KPI review reminders
Quarterly workforce review schedule
Implementation milestone tracking
Never miss a review point or let projects drift
Compliance Library Use compliance status to inform workforce priorities:
Policy review schedules reveal if governance is systematic
Training compliance gaps may indicate need for training coordinator
Audit backlogs suggest need for compliance lead
Documentation quality issues point to supervision/capability needs
Related Improvement Plans
Use these improvement plans as stretch assignments for internal talent development:
Implementing Staff Training System — Perfect project for senior admin staff member wanting management development
Improving Controlled Drugs Management — Could be led by senior dispenser with medicines lead support
Additional improvement plans covering compliance, access, governance topics—many suitable for internal project assignments
Regulatory and Professional Guidance
CQC expectations on workforce planning:
CQC Regulation 18: Staffing — Sufficient numbers of suitably qualified, skilled staff
CQC Well-Led Framework — Strategic workforce planning as evidence of effective leadership
Workforce planning resources:
NHS England: General Practice Workforce Planning Guidance
This improvement plan is provided as practical guidance for GP practice managers implementing strategic workforce planning. Adapt recommendations to your practice's specific circumstances, financial position, and organizational context. For HR legal advice, employment law questions, or practice-specific financial modeling, consult appropriate professionals.