Business, Practice management

Surviving the loss of key personnel

Temp staff or locums can fill the void of an absent staff member, but only offer a short-term solution. KAREN CROUCH explains how succession planning can be beneficial to a business and its staff.

Karen Crouch.

In a recent article, I emphasised the importance for practices to have a comprehensive Business Continuity Plan. This involves the development and maintenance of a meaningful Risk Management Plan which often focuses on major catastrophes or business-threatening incidents.

Sadly, in less vigilant practices, risk management is sometimes overlooked or downplayed. After all, critical, business threatening incidents are rare, such as loss of entire premises.

However, an important element of risk management and day-to-day practice operations relates to a practice’s most important resource: employees – whether that’s clinical or administrative, casual or permanent.

The most effective way to ensure continuity of healthcare under less than optimal conditions is meaningful and effective succession planning.

In most practices, particularly those with relatively small staff numbers, each person is a virtual ‘specialist’, focused on specific duties documented in individual position descriptions and KPIs (key performance indicators).

For example, the practice manager will invariably possess specific knowledge, experience and skills applicable to their position. Likewise, clinicians often operate as single work units on which much reliance is placed for patient care.

So what happens when one of the key personnel is absent for planned or unplanned reasons, such as vacation, extended sickness, or even resignation? Of course, there will always be access to agency temps and locums, but that invariably results in temporary reductions in efficiency and effectiveness, not always due to lack of personal ability.

For the temporary staff member or locum clinician to operate as an effective service provider, they must meet the basic requirements of becoming familiarised with the practice’s clinical and administrative protocols, including compliance with cultural and behavioural expectations of the owners.

While agency temps or locums provide a convenient stop gap, they are merely ‘temporary’ fixes as their titles denote. However, despite the transitory nature of this option, the problem could remain unaddressed if it was caused by absence of ‘internal relief’, i.e. another employee of similar status, but perhaps less technically qualified, who could continue to perform duties of the unplanned vacancy.

For example, a practice manager exits the practice on short notice for personal reasons, and other reception staff are incapable of filling in, albeit at a less competent level, for sheer lack of experience or exposure to the PM’s duties.

Recently, one of my relatively self-sufficient clients had expanded her practice in a short period of time to the point where she required advice on how to manage the sudden growth.

Among other challenges of a rapidly growing business, she could not even consider a relaxing three to four-week holiday because some of her vital tasks required daily attention; a clear sign of the absence of a trained successor! In some cases, succession planning is frustrated by the lack of willingness to ‘let go’ for fear of becoming less valuable or even more dispensable.

We commonly assume another staff member will simply absorb the extra workload of an absent colleague but the aforementioned reduction in efficiency/effectiveness, not to mention increase in stress levels, is the inevitable result. So, how do you mitigate the impact?

The following points are useful in developing a meaningful plan:

Ensure all employees appreciate the importance of a succession plan to cater for absences, whether planned or unplanned. An effective approach could be to highlight the benefits of acquiring skills and experience by performing duties of higher ranked personnel. A ‘higher duty allowance’ can also be a form of recognition/incentive.

Ensure each staff member has a comprehensive position description listing roles and responsibilities, including key deliverables.

Identify main tasks that must be performed to ensure proper job performance or at least to avoid errors or omissions, particularly if they relate to patient healthcare.

Implement an ‘upskilling program’ e.g. receptionist periodically performs tasks of the practice panager.

Staff numbers permitting, identify a staff member who could ‘understudy’ each person (more difficult for clinicians but equally important to try) during a period of absence.

Apart from mitigating impacts of planned or unforeseen absences, staff generally appreciate the opportunity of performing different tasks and, where applicable, acquiring new skills. Job rotation also results in greater job satisfaction and wider absentee cover.

These measures should render a practice more self-sufficient and reduce hiccups when employing agency temps or locums.

ABOUT THE AUTHOR: Karen Crouch is Managing Director of Health Practice Creations Group, a company that assists with practice set ups, administrative, legal and financial management of practices. Contact Karen on email or visit

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