Reimagining General Practice: The Power of Team Culture

Dr Natalie Jones and GP Ben Allen

General Practice is under extraordinary pressure.

Rising demand, workforce shortages, and increasing complexity mean many teams are operating in survival mode. National plans often focus on funding, structures, and targets, these matter. But our experience suggests something equally powerful and often overlooked, sits much closer to home.

Organisational culture.

Over the past five years, we have seen first-hand how focusing on the human foundations of teamwork, trust, leadership, communication, and shared purpose can transform not only staff morale, but patient experience and organisational performance.

This work has now been published in BMJ Leader:

https://doi.org/10.1136/leader-2025-001379

For those without journal access, the full paper is available here:

https://eprints.whiterose.ac.uk/id/eprint/236941/

In the paper, we describe what we call the “social determinants of team health”,  the cultural and relational conditions that allow teams to move from surviving to thriving.

We are familiar with the idea that social determinants, such as housing, education, and income, shape individual health. In the same way, there are social determinants that shape the health and performance of teams. These are not technical factors like staffing numbers or buildings. They are the human conditions that determine whether people feel safe, valued, and able to do their best work.

We identified seven key determinants.

1.       Psychological safety and trust are the foundation. When people feel safe to speak openly, share ideas, and admit uncertainty, teams learn faster and make better decisions.

2.       Distributed decision-making ensures that leadership is not concentrated in a few individuals. When people have a voice, they feel ownership, commitment, and pride in their work.

3.       Purposeful communication builds clarity, alignment, and connection. Regular, open communication prevents problems from becoming entrenched and strengthens cohesion.

4.       Relational connection and empathy remind us that healthcare is delivered by humans, not systems. Teams that invest in relationships develop greater resilience and mutual support.

5.       Inclusive, empowering leadership focuses not on control, but on creating the conditions for others to succeed. These leaders listen, act with humility, and bring out the best in their teams.

6.       Values-based recruitment and role design ensure we bring in people not just with the right skills, but with the right mindset, curiosity, and compassion.

7.       Finally, wholehearted patient partnership reconnects teams with their purpose. When patients are truly listened to, it strengthens meaning and improves care.

What we learned was simple but profound.

• When teams feel safe, valued, and empowered, performance improves naturally.

• This is not about heroic leadership or quick fixes. It is about consistent, humble, people-centred leadership that unlocks the potential already present within our teams.

• At a time when primary care is facing unprecedented challenges, this offers something important, not just critique, but hope. Change is possible, not through working harder, but through working differently.

• If you are a GP, Practice Manager, or NHS leader, we hope this paper offers encouragement and practical ideas for building healthier, more resilient teams.

• The future of General Practice depends on the health of its teams, and that is something within our power to change.

But we’re keen to hear from others.

What does team culture look like in your practice? What helps your team thrive, and what gets in the way?

If this resonates, we’d really welcome your thoughts, experiences, or challenges. The conversation about how we build healthier teams in primary care is only just beginning…