This week we’ve heard that the minimum wage is set to increase to £11.44. As a Practice Manager who knows how hard our lowest-paid staff struggle, this was music to my ears. However, as a Practice Manager who looks after a limited staff budget, this news made me anxious. How on earth are we going to fund this? We have to, of course, but it will involve some very difficult decisions for us and for many other practices.

Today, I spent my morning walk thinking about the admin staff I’ve lost to non-NHS jobs: the receptionist who went to work at a community pharmacy and the staff members who are going to supermarket and coffee shops to earn more. Then there are those who are working in high-street retail and enjoying more money, discounts and quieter days – though they do have to work unsociable hours, of course.

When you’re on minimum wage, does it matter if the pension is better in the NHS? Is the pension even that good anymore? So, what is it that keeps good people with us? Well, when I ask my team this question, they all say it’s because they want to make a difference; they want to be part of a community; they want to be in a caring role. There’s no doubt that abuse in general practice is increasing, so that sense of being in a caring role is diminishing. And, of course, the workload continues to increase… So, will the thought that they’re making a difference be enough to spur them on in the future?

There’s so much to think about! First, though, let’s consider earning £10.42 per hour. If you work 37.5 hours per week, your weekly wage is £390.75 – i.e., you’re taking home about £300 a week or £1,200 a month. What can you get for that? Well, in Central Manchester where I practise, you don’t get much. The cheapest rental rate for a one-bedroomed flat is about £800 per month – that’s one within walking distance of the practice (you’d probably get that a couple of hundred pounds cheaper if you were prepared to travel). The majority of my team live further out and catch one of our new Bee Buses to work (£2 for any journey), so let’s say they pay £600 a month for accommodation and work five days a week, so their transport costs are £80 a month. This leaves you with £520 per month for bills. What do we spend on bills roughly? I guess council tax, electricity and heating could amount to £300. Insurance would be another £50. So, you’re left with £170 per month for everything else: food, internet, phones, going out, family events… Which of these do you prioritise out of your last £170? Let’s face it, £42.50 a week is nothing! I can call into the supermarket for a loaf of bread and a pint of milk and somehow spend £20. It makes me feel so sad that we have people living in poverty who are working for us.

What can we do about it? Well, we’ll all find a way to pay the uplift, I’m sure. And the IGPM, along with our colleagues at the GPC, will lobby the government to increase our funding. But I’ve also picked up some good ideas over the years from Practice Managers around the country on ways to support our staff. For example, here at Urban Village, we always have fruit in the practice – that’s one of the things that goes when you’re on a tight budget, isn’t it?

Some of the other ideas include:

• Having a wellbeing noticeboard on display with the details of local foodbanks, community kitchens and pantries, and even cheap meal ideas
• A practice in Central London has a volunteer coming in at lunchtime to cook for the team; there’s always something cooking in the slow cooker so everyone gets a hot meal
• An emergency food cupboard in the practice containing things like pasta, rice, tinned soup, beans and cereal – all free for the team to take when they need it (and, interestingly, it’s topped up by some staff members as well as the practice)
• As part of the staff induction process, everyone gets a Blue Light Card paid for, including a list of all the places where you can get a discount by using it

We’d love to hear any more ideas you may have to support your teams.

Come April 2024, we’ll have to manage an increase in our wage budgets of about 9% for our lowest earners. We must get more funding; if we don’t, we’ll have to reduce our workforce. What do you think the answer will be?