Leadership in primary care:

Achieving the best from

teams (study day B)

A CPPE workshop Workshop book

PC/MOD4SDB/HO
February 2020
 CPPE programme developers
Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

Faiza Ali, education supervisor

Joanne Lane, regional manager
Project team
Shannon Nickson, senior pharmacy professional
Karen Wragg, regional manager
External reviewers
Anne Child, pharmacy and dementia specialist lead, Royal Mason Benevolent Institution Care Company
Cherise Howson, care homes pharmacist, Croydon CCG and Guy’s and St Thomas’ NHS Foundation Trust
CPPE reviewers
Hayley Berry, regional manager
Karen Wragg, regional manager
Piloted by
Bianca Glavin, senior pharmacy professional, medicines optimisation in care homes training pathway
Clare Smith, senior pharmacist, national pathways for primary care education, programme lead, foundation
pharmacist training pathway
Edited by
Bethan Wilkes, assistant editor, CPPE
Brand names and trademarks
CPPE acknowledges the following brand names and registered trademarks mentioned throughout this
programme: Myers–Briggs Type Indicator®
Disclaimer
We have developed this learning programme to support your practice in this topic area. We recommend
that you use it in combination with other established reference sources. If you are using it significantly after
the date of initial publication, then you should refer to current published evidence. CPPE does not accept
responsibility for any errors or omissions.
External websites
CPPE is not responsible for the content of any non-CPPE websites mentioned in this programme or for the
accuracy of any information to be found there.
All web links in this resource were accessed on 11 February 2020.
Published in February 2020 by the Centre for Pharmacy Postgraduate Education, Division of Pharmacy and
Optometry, The University of Manchester, Oxford Road, Manchester, M13 9PT.
www.cppe.ac.uk
Production
Design and artwork by Gemini West Ltd

© Copyright controller HMSO 2020

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Contents

Leadership in primary care: Achieving the best from teams (study day B) – Workshop book
Learning with CPPE 4

About this CPPE workshop resource 5

Overall aim 6

Learning objectives 6

Workshop activities 7

Activity 1 – Revisiting MBTI 7

Activity 2 – Leadership skills dilemmas in a primary care setting 8

Activity 3 – Feedback practice 12

Activity 4 – GROW model 14

Next steps 16

Appendix 1 – GROW questions 17

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 Learning with CPPE
Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

The Centre for Pharmacy Postgraduate Education (CPPE) offers a wide range of learning opportunities
in a variety of formats for pharmacy professionals from all sectors of practice. We are funded by Health
Education England to offer continuing professional development for all pharmacists and pharmacy
technicians providing NHS services in England. For further information about our learning portfolio,
visit: www.cppe.ac.uk

1 2 3

We recognise that people have different levels of knowledge and not every CPPE programme is suitable for
every pharmacist or pharmacy technician. We have created three categories of learning to cater for these
differing needs:
1 Core learning (limited expectation of prior knowledge)
2 Application of knowledge (assumes prior learning)


3 Supporting specialties (CPPE may not be the provider and will direct you to other
appropriate learning providers).

This is a 2 learning programme and assumes that you already have some knowledge of the
topic area.

Revalidation
You can use this programme to support revalidation and your continuing professional development
(CPD). Consider what your learning needs are in this area. For more information about revalidation and
to record your entries, visit: www.mygphc.org

Keeping up to date
To ensure this learning resource is up to date we will review it every year. A CPPE programme manager
will check through the material to ensure the content is current and relevant, and that the quality of the
learning experience is maintained. You will find the latest version of this resource on the CPPE website.

Feedback
We hope you find this learning resource useful for your practice. Please help us to assess its value and
effectiveness by completing the feedback form at your event, or by emailing us at: feedback@cppe.ac.uk

4
About this CPPE workshop resource

Leadership in primary care: Achieving the best from teams (study day B) – Workshop book
You are about to take part in training to complement your learning as part of the Leadership in primary
care module.

This book will help to support your learning during the workshop and provide you with a useful reminder
of the notes and plans you make to develop your everyday practice in this subject area. We have included
activities at the workshop to stimulate your thinking and support you in developing the skills and attitudes
required to demonstrate a range of leadership skills.

This workshop will last six hours.

A note about web links

Where we think it will be helpful we have provided web links to take you directly to an article or specific
part of a website. However, we are aware that web links can change. If you have difficulty accessing any
web links we provide, please go to the organisation’s home page or your preferred internet search engine
and use appropriate key words to search for the relevant item.

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 Overall aim
Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

The aim of this workshop is to support pharmacy professionals with the application of knowledge covered
in section two of the e-course for Leadership in primary care. It will also include a briefing on the practice-
based quality improvement project that learners need to plan, implement and present in Module 5.

Learning objectives
You can use our programmes to support you in building the evidence that you need for the different
competency frameworks that apply across your career. These will include building evidence for your
Foundation pharmacy framework (FPF) and supporting your progression through the membership stages
of the Royal Pharmaceutical Society (RPS) Faculty.

As you work through the programme, consider which competencies you are meeting and the level at
which you meet these. What extra steps could you take to extend your learning in these key areas?

After completing all aspects of this programme, you should be able to:

n explore the leadership skills required when involved in challenging situations within a primary care
setting
n practise giving and receiving feedback
n use the GROW model to coach a colleague through a work-related issue
n reflect on the impact of understanding Myers–Briggs Type Indicator (MBTI) personality traits upon
your practice
n share ideas with colleagues regarding a practice-based project that drives quality improvement
initiatives for the benefit of people you care for.

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 Leadership in primary care: Achieving the best from teams (study day B) – Workshop book 2

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Workshop activities
Activity 1 – Revisiting MBTI
Notes
 Activity 2 – Leadership skills dilemmas in a primary care setting
Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

Dilemma A: Poor nutritional care

It’s lunchtime and the catering staff are busy delivering food to the people living in the care home. Carole,
a care worker, is helping Angela, a resident who has dementia and doesn’t speak, to eat her lunch.

Angela requires one-to-one support during mealtimes and needs to be spoon-fed. She has her meals in
her room as she is not mobile enough to eat in the restaurant downstairs.

You observe Carole shoving food into Angela’s mouth in large morsels, trying to stuff a spoon in her
mouth before she has swallowed her previous mouthful. Carole is distracted and looking at her phone,
providing no eye contact or conversation with Angela for the entire duration of her meal. Angela looks
distressed.

After observing for a while, you step in to the room and tell Carole what you have seen. Carole looks
shocked as she didn’t think anyone was watching her. She then breaks down in tears, pleading with you
not to tell her manager as this is a new job and she desperately needs it. She is a single mum with a five-
year-old daughter and is at risk of losing her home if she does not pay the rent.

1. What are your next steps?

2. What are the risks with your approach?

3. What outcome are you looking for?

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Dilemma B: Falls risk

Leadership in primary care: Achieving the best from teams (study day B) – Workshop book
Ethel is an 82-year-old woman living in a care home. She is frail, has limited mobility and is at risk of falls.
She is unsteady on her feet and needs support to balance herself. A falls risk assessment was carried out
two years ago that stated Ethel should mobilise with a walking aid (rollator) and the support of a member
of staff. Ethel has the capacity to make her own decisions.

Jorden is the care worker supporting Ethel today. She last received training for the management of falls
five years ago. She feels frustrated about this as she wants to keep up to date with her training but her
manager rebuffs her when she tries to discuss it.

You approach Jorden’s manager and enquire about falls training for the staff. The manager is very abrupt
and tells you that she will look into it but is too busy at the moment.

The following week, Ethel has a fall and is now in hospital. You discover that she tried to get to the toilet
using her walking aid but without the support of a care worker and was wearing poorly fitted footwear.

1. What are your next steps?

2. What are the risks with your approach?

3. What outcome are you looking for?

2

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 Dilemma C: Project presentation
Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

Due to a significant event, you have been working within the practice identifying, reviewing and contacting
patients who are on a medicine that requires frequent blood tests. The practice does not have a system in
place to recall patients and you have found that there are several patients who could be at risk. You discuss
this issue with a number of the GPs and decide that this would be a good quality improvement project to
implement in the practice.

You spend the next few weeks conducting root cause analysis and collating data, then put together a
proposal to present to the GP partners in the practice. You have been made aware that the senior partner,
Dr Brady, has been making comments about the project behind your back and does not ‘see the point’ in
this piece of work. Dr Brady has commented that the project won’t change anything in the practice as they
won’t be changing the systems that they already have. You haven’t been able to speak to Dr Brady about
this.

The following week, you present your proposed project to the partners during their lunchtime meeting. You
articulate the project to the partners and ask for their comments and feedback. Dr Brady, who you know is
not ‘on board’ with the project, does not offer any comments. You are aware that the proposed changes will
require a practice-wide agreement so if the senior partner does not agree, the project will not work.

1. What are your next steps?

2. What are the risks with your approach?

3. What outcome are you looking for?

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Feedback Models

Leadership in primary care: Achieving the best from teams (study day B) – Workshop book
There are many models for giving feedback – here are four examples:

SBI

Situation: You gave the GP information about the wrong patient.

Behaviour: You didn’t check the patient’s name.
Impact: 
An error could have affected the patient’s health, affected the reputation of you and
the organisation and created extra work for those who would need to sort it out.

AIID

Action: In the meeting yesterday, the data you provided about the waste audit was wrong.
Impact: I felt embarrassed as there were a number of senior people there and I’m worried it
might affect the team’s reputation.
Input: What do you think about the comments I have made? Could I have done it
differently?

Desired outcomes: Next time, I will ensure that the figures are up to date and accurate.

BOOST

Balance: Ensure you cover positive and negative points

Observed: Based on what you’ve seen
Objective: Based on facts
Specific: Relate to specific examples
Timely: As close to the event as possible

Pendleton’s rules:
n get permission to give the feedback
n briefly clarify the facts
n learner identifies what has gone well
n observer(s) identify what has gone well
n learner says what could be improved and how
n observer(s) says what could be improved and how.

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 Activity 3 – Feedback practice
Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

In pairs, spend two minutes each role playing giving feedback using different models (perhaps starting with
a model you have never used before). Then, the other person should give three minutes of feedback on how
it went before you swap over. You can make notes on the next page.

Work through three or four of the scenarios on the handout.

1. Y
 ou are currently working as part of a multidisciplinary project team within your organisation. The
project has just finished and Sam, one of your teammates, has taken the initiative to write up a final
report incorporating the work of the rest of the team. The result is impressive. It is accurate and puts
everyone’s work together in such a way that the whole is greater than the sum of the parts.

2. I t is Monday. Last Monday you asked Leanne, an experienced care home pharmacy technician, to
pull off some figures for an audit of the number of patients on a certain drug and have them to you by
Friday. However, she still hasn’t provided them and now you need the data urgently as your meeting is
this afternoon.

3. Y
 esterday you had two members of staff off sick, leaving you very short to cover all the care home
medication reviews. Emma, a newly-appointed pharmacy technician on the Medicines optimisation in care
homes pathway, offered to work through her pre-arranged protected CPPE pathway study time, allowing
you to continue with a piece of work that had a very short deadline.

4. Y
 ou have just overheard Mohammed, a care homes pharmacist, dealing with an angry relative of a
resident in a care home. In your opinion, he did not handle the situation very well and the relative
threatened to make a complaint.

5. Y
 our colleague, Adam, presented the results of an audit to the medicines safety committee today. His
presentation was clear and succinct. He focused on the benefits to patients and how adopting the
recommended changes in practice would comply with local and national guidance and improve patient
safety.

6. N
 ina, the pharmacy technician, is a little disorganised and tends to get distracted easily. She forgot to
visit a care home today and has not informed anyone at the care home about this.

7. A
 member of your team, Shabana, is a very hard worker. You have just observed her consulting with a
resident and think she used too much jargon and too many acronyms.

8. M
 aya, a GP new to the practice who visits some of the care homes you cover, organised a charity bake
off last week and invited the pharmacy team to take part. Not only did it raise a large amount of money
for the chosen charity, but it also raised the morale of your team at a very busy time of year.

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Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

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2
Notes
 Activity 4 – GROW model
Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

In your group, work to identify and agree which section of the GROW model each prepared question fits
underneath.

Notes

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 Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

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2
Peer discussion
Notes
 Next steps/Action plan
Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

Spend some time reflecting back on what you have covered today.

Identify one thing you will stop doing, one thing you will continue to do and one thing that you will start
doing as a result of what you have learned and practised during Module 4.

Share your ideas with the person next to you. Remember that you can follow up with each other via the
discussion forums too.

Write down three actions you will take in your practice as a result of completing this workshop.

1. Stop

2. Continue

3. Start

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Appendix 1 – GROW questions

Leadership in primary care: Achieving the best from teams (study day B) – Workshop book
These are some examples of the types of questions that can be asked in a mentoring session.

This is not intended to be a checklist of the exact number, type and sequence of questions to be used. You
also do not have to use these questions strictly at the suggested stage of the GROW model.

London Pharmacy Education & Training developed these questions for the Royal Pharmaceutical Society
(RPS).

Goal

n What is the issue that you would like to work on today?

n What would you like to achieve by the end of this mentoring session?
n How far and how detailed would you like to get in this session?
n To what extent is your longer-term objective related to this issue?
n Can we achieve what you want today in the time available?

Reality

n What do you wish to accomplish?

n What do you wish to change or improve?
n What is the issue or challenge you are facing at work?
n Can you tell me more about this?
n What is happening at the moment?
n How sure are you that this is an accurate representation of the situation?
n What and how great is your concern about it?
n Who, other than yourself, is affected by this issue?
n Who knows about your desire to do something about it?
n How much control do you personally have over the outcome?
n Who else has some control over it and how much?
n What action steps have you taken so far?
n What stopped you from doing more?
n If I could grant you one wish related to the issue, what would it be?
n Imagine being really successful in this venture. What does this look like? How will you measure success?

Options

n What are some possible ways of doing this?

n What are the different ways in which you could approach this issue?
n What are the alternatives to these approaches?
n What strategies do you need to achieve this?
n What options and opportunities are available to you?
n What else could you do?
n What would you do if you had more time, a large budget or if you were the boss?
n What would you do if you could start again with a clean sheet or a new team?
n Would you like a suggestion from me?
n What are the advantages of each of these?
n What are the risks and benefits for each of these ideas?
n Which would give the best result?
n Which of these solutions appeals to you most or feels best to you?
n Which would give you the most satisfaction?
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n How do you think you might achieve these development needs?

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 Will
Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

n Which option(s) will you choose?

n What will be your first step to achieve your objective?
n What are your next steps?
n What challenges do you anticipate?
n What will you do to address these challenges?
n What resources (time, skills, money and equipment) are required to complete your action steps?
n What is within your control and authority?
n When would you like to achieve this by?
n What are your target dates?
n How realistic are the dates?
n What are your criteria and measurements for success?
n When precisely are you going to start and finish each action step?
n What could arise that would hinder you in taking these steps?
n What personal resistance do you have, if any, to taking these steps?
n How will you overcome this resistance?
n What commitment do you have on a scale of one to ten to taking these agreed actions? What prevents
this from being ten?
n Who needs to know what your plans are?
n What support do you need and from whom?
n Do you feel confident to tackle these issues?
n Please can you summarise what you plan to accomplish and by when?
n How will you maintain the necessary confidence, determination, and momentum to make this happen?
n What will you do to celebrate the completion of this project (and realisation of your dream)?
n Is there anything else you want to talk about?
n When would you like to meet again?

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Leadership in primary care: Achieving the best from teams (study day B) – Workshop book

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Notes
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info@cppe.ac.uk

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