Foundations of general practice standard

F7 – Practice team culture, safety and involvement

Standards for general practices (6th edition)
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      8. F7 – Practice team culture, safety and involvement

F7 | Practice team culture, safety and involvement

Consumer expectation statement: I expect that this practice fosters a culture that supports the health, safety and wellbeing of the practice team and consumers, and enables open communication for the team to work together effectively.

F7.A The practice fosters a positive culture by supporting the safety, health, and wellbeing of the practice team.

The practice:

  • has a work health and safety policy
  • manages and reduces the risk of occupational exposures
  • supports the practice team during emergencies or other traumatic events
  • supports staff involved in significant clinical incidents, including patient safety incidents
  • educates the practice team in its work safety, health and wellbeing requirements
  • has systems in place to protect members of the practice team from violence and aggression
  • monitors and adjusts the workload of members of the practice team to support their wellbeing
  • collects and analyses workforce data on staff sick leave and reasons for staff departures to inform improvements that support team wellbeing and retention.

F7.B The practice leadership group actively seeks the involvement and input from all members of the practice team.

The practice leadership group:

  • has a systematic approach to obtaining feedback from the practice team on their experience of working for or engaging with the organisation to implement improvements based on this feedback
  • actively seeks input from all members of the practice team
  • maintains a process for members of the practice team to escalate and resolve issues
  • has processes for the practice team to discuss administrative matters.


Practice owners and managers are responsible for creating a safe, healthy, and supportive working environment, in line with the quintuple aims of:

  • advancing population health
  • enhancing people’s healthcare experience
  • supporting healthcare providers’ work life
  • promoting health equity
  • reducing healthcare costs(1).

Supporting staff involved in clinical and patient safety incidents improves psychological wellbeing and reinforces team trust. Practices support team resilience and promote shared responsibility for safety by offering structured debriefs, access to mental health resources, and opportunities to contribute to system improvements.

The practice owner/manager is obliged to meet their responsibilities as an employer by complying with relevant federal and state/territory workplace health and safety (WHS) laws, including those relating to equality, diversity, inclusion, and equity.


Actively seeking input from all members of the practice team helps to embed safety and wellbeing initiatives into daily operations. Encouraging open communication and shared decision-making supports:

  • effective two-way communication
  • shared responsibility for improvements
  • collaborative identification and resolution of workplace issues
  • alignment with practice values and goals
  • continuous quality improvement through team feedback.


A cohesive, positive and strong team culture is crucial for providing high-quality patient care and ensuring patient safety. It also fosters:

  • the wellbeing of the practice team
  • open communication
  • collaboration and mutual respect, which promotes provider and consumer satisfaction.

When members of the practice team have a strong sense of belonging and shared goals, they are more likely to:

  • work together seamlessly
  • make informed decisions collectively
  • deliver consistent and coordinated care.


Table 5 provides areas of focus and actions that the practice could adopt.

Table 5 Strategies to support the safety, health and wellbeing of the practice team

Theme

Focus area

Actions
Safety Safety features in the practice
  • Install adequate external lighting around pathways, entrances, and carparks.
  • Record emergency contacts for all team members and establish clear emergency protocols.
  • Install duress alarms or security cameras to monitor and respond to threats.
  • Develop and regularly review emergency exit plans.
  • Prioritise safety-focused room design when planning renovations or fit-outs.
Managing and reducing the risk of occupational exposures
  • Implement a documented exposure management protocol, including steps for prevention, identification, reporting, and post-exposure follow-up.
  • Provide training on safe handling of sharps, bodily fluids, hazardous materials, and the prevention of manual-handling injuries.
  • Provide access to appropriate PPE and hand hygiene facilities.
  • Maintain staff vaccination records and offer immunisations relevant to occupational risk (see CG8 – Immunisations).
  • Conduct regular risk assessments and update procedures accordingly.
  • Provide access to counselling or debriefing following exposure incidents.
Patient aggression and patient-initiated violence
  • Have a clear, visible zero-tolerance policy (on signs, websites, phone systems).
  • Facilitate staff training in de-escalation and incident response. Whole-of-practice training could be used to facilitate a collective approach to the prevention, identification and early response to violence and harassment.
  • Record incidents for review and risk assessment.
  • Know when it is appropriate to discontinue care for a violent patient.

The RACGP’s Preventing and managing patient aggression and violence provides detailed guidance on dealing with violence and aggression.
Health Healthy workload
  • Encourage regular breaks during consulting time.
  • Support team members attending GP appointments and taking preventive care.
  • Provide access to support services for those experiencing workplace stress.
  • Offer flexible work arrangements during crises or emergencies.
  • Provide changing rooms, showers, staff toilets, and bike racks.
Healthy lifestyle
Healthy physical environment
  • Maximise natural lighting and introduce green spaces, plants or natural design elements to boost mood and productivity.
  • Encourage sustainable transportation options, such as biking or walking, to improve staff fitness and mental health.
  • Reduce the use of harmful chemicals and promote eco-friendly alternatives.
Wellbeing Wellbeing and inclusion
  • Facilitate training on topics such as unconscious bias, cultural sensitivity, and diversity.
  • Provide access to gender-neutral bathrooms.
  • Foster a culture that celebrates diversity and open dialogue.
  • Use software and tools that are compatible with assistive technology.
  • Offer career support for staff on parental leave.
  • Designate clean, private spaces for breastfeeding or pumping.
Feedback and reflection
  • Conduct surveys or structured feedback activities to assess team culture, wellbeing, communication, and psychological safety.
  • Share results transparently and use them to inform team discussions, training needs, and quality improvement initiatives.
  • Encourage anonymous feedback to support psychological safety and honest reflection.
Cohesive, positive and strong team culture
  • Display the practice values and ethics electronically and physically.
  • Provide opportunities for learning and professional development.
  • Have regular team discussions or check-ins (formal or informal, individual or as a team).
  • Celebrate achievements, positive feedback and milestones.
  • Host social activities and informal gatherings.
Supporting staff in emergencies or after traumatic events
  • Debrief as a team after a traumatic event.
  • Adopt trauma‑informed principles by promoting safety, trust, choice, collaboration and empowerment in team communication and debriefing.
  • Use support services such as:
    • Employee Assistance Programs (EAP)
    • the GP Support Program – a free service for RACGP members that provides access to professional advice on personal and work-related issues
    • the Nurse and Midwife Support Service – a support service for nurses that provides access to confidential advice and referral
    • services offered by the local Primary Health Network.
Supporting staff involved in significant clinical incidents, including patient safety incidents
  • Acknowledge that clinical incidents, including patient safety incidents, can be distressing and may affect the emotional wellbeing of team members involved.
  • Use support services (as listed above).
  • When reviewing incidents, apply a fair and just approach that avoids individual blame and focuses on improving the system.
  • Involve affected members of the practice team in reflective discussions and in the process of identifying changes to prevent a recurrence.
  • Foster a culture of openness and trust where members of the practice team feel safe, supported, and encouraged to:
    • speak up about incidents
    • contribute to understanding what happened and why it happened
    • contribute to identifying how the practice can improve systems and processes to prevent similar issues in the future.


A culture of open communication, regular workload review, and access to mental health resources supports the mental health of the practice’s team members. Professional organisations that offer support include:


To foster a culture that values individual contributions and promotes whole-of-team involvement in decision-making, the practice could: 

  • use communication tools, such as digital message systems and notice boards, to collect feedback, ideas, or concerns
  • facilitate feedback about staff experiences by having clear processes for escalating and addressing issues raised by team members
  • invite all team members to participate in and contribute to regular meetings and discussions, noting that in smaller practices these discussions may occur informally
  • keep and share records of meetings for transparency and follow-up
  • during recruitment and induction, clearly communicate that all staff are encouraged and expected to provide input on how the practice operates
  • conduct staff satisfaction surveys
  • offer exit interviews to staff leaving the practice.

The feedback gathered from the practice team needs to be analysed for trends and used by the practice management to plan and implement improvements. Practices could consider trends in absolute numbers, as percentages alone can mask meaningful changes in staff wellbeing. Areas that might need improvement could include communication, staff training and support, technology, and the practice’s processes.

 
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