Resilience Support for GP Practices in Islington

A number of GP practices across Islington were facing increasing pressure due to workforce shortages, rising demand, and the ongoing complexity of delivering care in a dense urban setting. The impact of staff burnout, long-standing vacancies, and fragmented systems was starting to affect both patient access and internal operations. With support available through NHS England’s General Practice Resilience Programme, the local commissioning group engaged PCMS to provide structured, practical support to help stabilise and future-proof practices across the borough.

PCMS began the programme with a diagnostic phase, working closely with each participating practice to understand their unique pressures. This included a combination of interviews, system reviews, and on-site observations. Through this process, PCMS identified a number of shared challenges, including administrative backlogs, inconsistent use of clinical systems, poor rota coordination, and leadership fatigue.

Following the diagnostics, each practice was provided with a tailored improvement plan, focusing on priority areas such as appointment management, staff structure, patient flow, and system use. Where immediate operational risks were identified, PCMS provided hands-on support to help stabilise the situation.

A key element of the support involved embedding experienced consultants into practice teams for short periods. This allowed urgent issues to be addressed directly, such as overdue correspondence, system errors, and communication breakdowns between clinical and administrative teams. PCMS also helped reintroduce clarity around roles and responsibilities, particularly where gaps had developed due to sickness, turnover, or unfilled posts.
At the same time, PCMS worked with practice managers and partners to strengthen core management systems. This included workforce planning, rota development, and the use of digital tools to track appointments, referrals, and recalls. Practices were supported to make better use of available funding streams, such as PCN roles and local enhanced services, and to embed routine monitoring systems that could alert teams to emerging risks.

Leadership support was also a focus. Many practices had been led by long-standing partners or PMs who were carrying multiple responsibilities with limited support. PCMS offered coaching, peer support, and guidance on how to delegate more effectively and manage change within teams. In several cases, PCMS supported practices in restructuring their admin teams or introducing new middle management roles to ease the burden on senior leaders.

By the end of the programme, practices across Islington reported greater stability in their day-to-day operations, improved team communication, and a clearer view of their workforce and service planning. In many cases, internal confidence had returned, and practices felt more in control of their operational environment.

This programme demonstrated PCMS’s ability to deliver both practical, front-line resilience support and strategic management consultancy within a diverse group of practices. By tailoring support to the specific needs of each practice while maintaining a consistent framework across the borough, PCMS helped re-establish a sense of control, confidence, and forward momentum.