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Do you feel as though you work for the National Health Service?

Over the last ten years, I’ve worked for a number of practices, helping them out during difficult times, and have been involved in the recruitment of new practice managers. So, during that time, I’ve come across a variety of situations, which on reflection make me think about the salaries offered for the job in hand.

Does your practice use the NHS pay system?

The NHS is one of the biggest single employers in the world with over 1.3 million staff, and at times like this, with a raging pandemic going on, it receives applause from all quarters for the way in which it provides a first-class service. From a personnel perspective, the NHS has a structured pay system (Agenda for Change) and applies strict staffing policies and employment standards throughout the service. I’ve often asked why this isn’t the case in general practice, only to be met with the argument that general practice is independent of the mainstream NHS and can set its own salaries and contracts, which of course it does.

Does your practice use the NHS Employer’s Handbook?

I do have some sympathy with the view that the NHS pay system is too complicated, but then what about the terms and conditions of service for employees? I wonder what’s wrong with the NHS terms and conditions, which means that practices are forever writing their own policies. Having said that, Practice Index has taken up the cudgel of providing an excellent library of the three Ps: policies, protocols and procedures. The NHS Terms and Conditions Handbook can be found here

Moving on, are you happy with your salary?

I have to admit that during my NHS and general practice career, I’ve always been very lucky. I’ve had good employers, who always awarded staff with a cost-of-living increase each April. In the mainstream NHS, it was always automatic and has continued to be so. But in general practice, it took a bit of persuasion – and negotiation – but something was always paid. I’m not sure that can be said of all practices, even today. Often responses to threads on Practice Index confirm non-payment of a cost-of-living increase. Are staff going to get a £500 bonus this year, I wonder?

What was your predecessor paid?

I don’t know about you, but over my working life I’ve always looked for career progression. I only once recall applying for a job on the same grade. Usually it was the next NHS grade upwards or for a job in general practice that paid a higher salary. I’m somewhat intrigued to find that even ten years on, one job I once held is still being advertised at a similar salary to the one advertised ten years ago. Career-minded practice managers will be looking for a better salary to move on to, even though it might be a smaller practice. So, if there’s been a change in the job content, a lower salary might be reasonable – but I doubt it. I’ve come across practices wanting to advertise jobs at a significantly lower rate of pay than the retiring manager earned.

I’ve always felt that there should be more structure to salaries in general practice and I do wonder whether the movement to pay a national living wage has really helped. So as a parting shot, I can understand why again on Practice Index we read about the unhappiness of colleagues who are doing their best but not being rewarded.

Author: Robert Campbell

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Robert Campbell

Former GP Practice Manager with over 25 years experience working in Upton, near Pontefract, Seacroft in Leeds, Tingley in Wakefield, Heckmondwike and more recently Cleckheaton, West Yorkshire. www.gpsurgerymanager.co.uk

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