Another resignation can send a practice owner straight back to recruitment: cover the schedule, rewrite the advertisement and find someone quickly. Those tasks may be necessary. There is also a question worth asking before the next person arrives: which parts of working here have we actually examined?

Repeated departures justify a closer look at the workplace. They do not prove that every employee left for the same reason, or that the latest explanation is an excuse. A useful review holds both ideas together: respect what the person says, and inspect the conditions the practice can influence. Replacing a judgement about a generation with an equally sweeping judgement about one manager does not produce a better explanation.

Begin with the account you have, and mark what is unknown

If someone says they are leaving to study, relocate or change their hours, record that as their stated reason. Do not translate it into “really unhappy with management” without evidence. Personal circumstances and workplace experiences can both matter, and the practice may never have a complete account.

Keep a small, restricted review record: role, start and departure dates, the explanation the employee chose to share, and relevant support or work arrangements. Separate a documented fact from an interpretation. “The scheduled training session was cancelled” is different from “the cancellation caused the resignation.”

Give the review a defined period and use a consistent way of counting departures. If you compare roles, include the size of each team and how many people joined during that period. In a hypothetical comparison, two departures from a growing team cannot be interpreted simply by placing them beside one departure from a much smaller team. Small counts are a reason to ask focused questions, not to assign a cause with confidence.

Check whether the job delivered what recruitment described

Read the advertisement, interview notes and role description alongside the work the person was actually asked to do. Were hours, responsibilities, supervision and development opportunities described accurately? If the role changed, when was that discussed, and what support changed with it?

Replace a broad explanation such as “poor fit” with a question about the work. Which responsibility was unclear? Which decisions could the person make? Was a promised learning opportunity available during working time, with cover for their usual duties? An interview cannot compensate for a role that is presented one way and managed another.

Use what you find to improve the next recruitment brief. Describe the demands honestly, prepare questions linked to the role and make training expectations specific. Do not decide what kind of person an employee is because one task went badly. Check what was explained, taught and observed before drawing a conclusion about capability or willingness.

Check how the training plan was carried out

A named trainer and an induction document are useful starting points. Check whether the trainer had time, whether a substitute was available and whether the new employee knew what to do when instructions conflicted. A plan marked complete tells you little if completion means only that a document was handed over.

Choose a few ordinary tasks from the role and trace the learning sequence. Was the task demonstrated? Did the person practise it with appropriate support? Was there feedback before they were expected to do it independently? Keep clinical responsibilities and supervision within the practice's established arrangements; a staffing problem is not a reason to improvise clinical delegation.

The first ninety days can be a convenient review period, but they do not determine everyone's future. Someone may need support later when the role, software or team changes. Ask current staff where they still have to guess. A specific answer about an unclear process is more actionable than a request to “be more proactive.”

Examine what happens when someone reports a problem

Look at a recent administrative problem from the moment it was raised. Who received it, what was checked and how did the person who raised it hear the outcome? Review the sequence rather than starting with a judgement about who is difficult or careless.

Making it possible to report a mistake does not remove responsibility for standards. The team still needs to establish what happened, address immediate risks through the appropriate process and decide what should change. Keep that fact-finding separate from public criticism or speculation about motives.

If staff say they hesitate to raise concerns, ask what makes the route difficult. The answer might concern time, an unclear contact point or an experience of being dismissed. Do not promise that every issue will stay entirely confidential if it may need further handling. Explain how the concern will be used, who needs to know and when an update can realistically be given.

Patient safety concerns require the practice's clinical process. This workplace review must not postpone that response until the next management meeting. For everyday operational issues, a visible record of the agreed action and owner can help the team check whether the response actually happened.

Review pay, workload and recognition together

Do not dismiss a pay concern because the practice offers learning opportunities or friendly colleagues. Equally, do not assume that a pay change answers a concern about conflicting instructions or a workload that cannot be completed in the available time. Ask which issue is being raised and examine its actual terms.

For performance feedback, identify the standards communicated beforehand and the examples used to discuss them. Were comparable situations handled consistently? Could the employee correct a misunderstanding? If a development step was promised, was there a person responsible for arranging it?

Recognition can be specific and ordinary: name the contribution you observed and why it mattered. It should not be used to make up for an unresolved concern about hours, pay or support. Avoid promising a promotion, qualification or pay outcome that the practice has not agreed or cannot deliver.

Keep patient choice outside staff sales targets. An employee should be able to respect a patient's decision to wait or decline without being described as insufficiently committed. When reviewing performance, consider the quality and accuracy of the work, not just whether a booking or treatment acceptance resulted.

Invite useful feedback without demanding a confession

An exit conversation is an invitation to learn, not a test of whether the employee will reveal a hidden “real reason.” Offer practical questions: “What would you want a new colleague to know before joining?” “Where did the job differ from what you expected?” and “What support was difficult to obtain?”

Let the person decline to answer or choose an available way to give feedback. Explain who will see the notes and how they will be used. Do not promise anonymity in a small team if the circumstances would identify the speaker. Keep private personal details out of a general staff presentation.

Ask current employees about the same work arrangements without asking them to speculate about a colleague's departure. Listen for concrete examples and differences in experience. Several similar accounts can guide an investigation, but they are not a substitute for checking schedules, responsibilities or whether an agreed change was carried out.

Turn a possible pattern into one practical correction

Consider a fictional practice reviewing two recent departures. Both employees had joined reception, and both had a named trainer. The records also show that protected training sessions were repeatedly cancelled when the desk became busy. One person gave a personal reason for leaving; the other mentioned unclear instructions. This is an invented administrative exercise, not evidence about an actual practice or a claimed cause of resignation.

The useful finding is that the promised training time did not consistently happen. The owner can investigate that fact without deciding that it explains both departures. A practical correction could be to name a backup trainer, confirm cover before each session and record when a session must be rearranged. The change needs time and staffing support, not another instruction to the new employee to cope.

Write a short action record:

At the next review, check whether the sessions took place and whether staff could use the instructions. Do not label a short period without another resignation as proof that the change solved turnover. Keep what is known distinct from what is hoped for.

The owner's responsibility is to make this inquiry possible and act on the parts the practice controls. Start with one gap between a promise and daily work, close it with the team, and check it again. That creates a concrete improvement even while the reasons behind individual departures remain partly unknown.