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Performance management in general practice
Updated: Sep 28
Watch Dr Clare Sieber join Dr Rachel Morris on the You Are Not a Frog podcast to explore performance management in general practice, constructive feedback and what to do when a colleague is not pulling their weight.
The conversation considers why these discussions can feel difficult in close working teams, and how clearer expectations, trust and regular feedback can help. It offers useful perspectives for GP partners, practice managers and others working in primary care.
Watch the full conversation
What to Do When a Colleague isn’t Pulling Their Weight
You Are Not a Frog · Episode 219 · 7 May 2024 · 49 minutes
With Dr Rachel Morris and Dr Clare Sieber. Video published by You Are Not a Frog.
Explore the discussion
Use these points to find a topic in the video:
06:28 - Giving feedback without making it personal.
12:02 - Raising concerns when you are not the manager.
12:47 - Helping colleagues feel able to speak up.
18:30 - Developing trust within the team.
22:55 - Understanding difficult reactions to feedback.
29:41 - Using feedback to improve working relationships.
35:18 - Considering a more formal approach.
40:17 - Making responsibilities and expectations clearer.
45:41 - Clare’s closing practical suggestions.
Why performance management in general practice can feel difficult
In a practice where colleagues work closely together, raising a concern can feel uncomfortable. A conversation about workload or expectations may also touch on professional confidence, fairness and long-standing relationships.
Leaving a concern unspoken can create its own difficulties. Other team members may take on additional work, while the colleague involved may not understand what needs to change. The episode explores how feedback can become part of everyday working relationships, rather than something reserved for a crisis.
Making feedback more specific
One approach discussed is the Situation–Behaviour–Impact, or SBI, framework. This gives a difficult conversation a clearer structure:
Situation: identify the particular occasion or context.
Behaviour: describe what you observed.
Impact: explain the effect on you, the work or the team.
The emphasis is on a specific concern that can be discussed, rather than a broad judgement about someone’s character. It also creates an opportunity to hear the other person’s perspective and understand what may be contributing to the difficulty.
Building trust and a culture of open feedback
Clare and Rachel also explore the connection between feedback, trust and psychological safety. Team members need to feel able to ask questions, raise concerns and acknowledge mistakes.
That openness matters alongside accountability. Clear roles and shared expectations make it easier to recognise a problem, discuss its impact and agree what needs to happen next. Feedback then becomes part of maintaining a working relationship, rather than a sign that the relationship has already failed.
When concerns become relationship difficulties
Questions about performance can become entangled with frustration, assumptions and a loss of trust. For GP partners and practice teams, the way a concern is raised and responded to can shape what happens next.
Where communication has become difficult, mediation can provide a structured space to explore the disagreement and discuss a way forward. You can read more about mediation in general practice.
About General Practice Mediation
General Practice Mediation supports GP partners, practices and PCNs in resolving disputes constructively and confidentially.
If your practice or PCN is facing relationship or governance difficulties, book a free 30-minute consultation at a time convenient for you.
Related reading: Challenging mediation myths in general practice.
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