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Exploring and understanding the learning needs of general practice administration support staff.

Student: Katie Jefferson
Supervisors: Prof Les Toop, Kelly Maw
Sponsor: Partnership Health Canterbury

Lay Report

Over the past 10 years we have seen an increase in the delivery of services and a shifting of roles and responsibilities within general practice. This in turn impacts on the complexities of roles within the practice teams, and greater efficiencies required for the ongoing management of the businesses and delivery of health services. As front line staff for general practice, Practice Managers and administration support staff (this includes receptionists, administrators and secretaries) make up a large percentage of our primary health care workforce. They are the staff who receive the initial phone calls, meet and greet the patients, give that first impression of the general practice team to the general public. Their job is varied and requires skills in a number of different areas such as customer service, computer programmes, finances and more. Although their positions require the use of many skills, there are currently very few training programmes in place to support this group and no structured professional development to help them increase their skills and keep informed of the ever-changing health system. Although results from a practice audit by Pegasus Health in 2010 indicated that administration support staff are identified in their workplaces by varying role titles and undertake many differing tasks daily, we recognized a gap in our knowledge and understanding of their professional development needs. There also appears to be no previous research into the backgrounds and learning needs of this group.

The purpose of this study was to explore the various titles, qualifications and position descriptions of general practice support staff. The study also aimed to establish the learning needs and levels of training required to support this group.

An initial literature review into current training and professional development programmes revealed that the only available course specific to practice managers in general practice is run by NZIM (New Zealand Institute of Management) and there are limited opportunities available specifically for receptionists in general practice. There are a few customer relations courses available through Kiwi Host as well as some general management courses available through various other institutions but nothing specific to general practice. The only professional development currently available is either organised by the practice, through PMAANZ (the Practice Managers Association of NZ) or occasional information sessions facilitated by Pegasus Health. From this review a questionnaire was designed and sent out to 349 administration support staff from Partnership Health Canterbury PHO, whose details were listed on the Pegasus database of practice staff. The responses from these questionnaires were analysed and volunteers participated in a focus group where issues that were raised in the questionnaire were explored in more depth. The focus group discussion was audio taped and transcribed so that themes could be drawn from it.

We had a 43% response rate from the questionnaire with 46% of respondents identifying themselves as receptionists, 26% as practice managers, 21% as administrators, 3% as secretaries and 5% as other. Although the survey supported our previous findings regarding various roles and titles, the research project did not explore how these roles differ. Almost all of the respondents were female and a number (23%) reported that they did not have position descriptions for their current role. The majority (66%) of respondents had some sort of formal qualification with a tertiary qualification being the most common (21%) followed by attendance at a receptionist course. 64% of respondents reported they did not have a structured orientation programme for their current position. The survey requested participants suggest fundamental content for a standardised orientation resource; the top four were a written job description including expectations from their employer, an introduction to the practice including the staff and patients, a run-through of all policies and procedures for the practice and a trial period including one on one tuition in the role with a current staff member. Surprisingly the majority of people said that they were well informed of professional development opportunities and most said that they were able to participate in professional development opportunities when and if they arose, even though lack of time was the most common barrier to participation in professional development. The second aim of this project focused on the learning needs and training required to support this group. Although only 25% responded to this question the focus group discussion centred on this area and mirrored responses from the survey. Findings from the survey identified the most common learning need was in the area of business skills, closely followed by computer programmes.

The lack of structured education opportunities was discussed at length within the focus group and the need for the development and formalization of a standardised orientation resource was highlighted. This need was also mirrored by a large number of participants from the survey who reported that they did not have a structured orientation programme in their most recent position. The formation of a standardised orientation resource would ensure that staff in all practices had opportunities to develop the same skill-set to confidently perform the tasks required. Another suggestion was to have a modular course or information sessions on a variety of “hot topics” – areas that people struggle with or have undergone recent change and require a refresher. Some suggested topics included confidentiality, the health system, finances, legislation and customer relations. It was also suggested that there could be different sessions for practice managers to receptionists and administrators as the roles require different knowledge and skills. Another suggestion that would provide this group with more support was the formation of peer group meetings where staff from different practices could meet and discuss problem-areas and through their combined knowledge come up with a solution. It was noted that this would be especially beneficial for reception and administration staff as they currently do not get the opportunity for this sort of discussion, whereas practice managers do. A theme that was consistent throughout the discussion was that some standardisation across practices would be beneficial. Of course every practice is individual and caters to its own specific needs, but it was agreed that standardisation of some policies and procedures would be a good thing and would help to support the practice managers. Along with this it was suggested that resources be available online so that practices have an easier way of communicating and sharing with each other. This would also provide a repository for framework templates and guidelines for writing policies and procedures and so help to standardise important management aspects of the general practices.

Administration staff in general practices play a very important role in the provision of care to patients, so it is important that they are equipped with the necessary skills and knowledge required to perform their roles effectively. This group is identified by varying role titles; the majority of them hold a qualification for their role and most have a position description. The survey identified that this group would benefit from the formation of a structured professional development programme including an orientation resource, modular sessions, peer group forums and improved availability of resources.