(Time to read: 6 minutes)

By Robert Campbell

Gender pay gaps are never far from the headlines. Whether it’s the BBC, the sporting world, Hollywood or the NHS, where we’ve recently heard about disparities in pay amongst consultants, the problem is widespread. But what about Practice Managers? Is there a gender pay gap in our profession? If so, what’s causing it? And, are there any regional variations? Together with Practice Index we set out to find the answers to these questions and more.

The survey

To get to the root of the subject, Practice Index surveyed its database of Practice Managers to see whether a pay gender gap was apparent amongst GP Practice Managers, or if there was quite simply just a pay gap between Practice Managers carrying out the same or similar range of duties but working in similar sized practices. We received a total of 528 responses – many thanks to everyone who helped.

 Is there a gender pay gap?

The responses received highlighted some interesting points. Overall, 15% of the Practice Managers that responded to the survey were male, reflecting the gender split within the profession. While male PMs were not necessarily the top wage earners overall, a general gender pay gap did emerge.

National variations

Analysing the results further, focusing on specific regions, the stats become even more interesting:

England: Based on 427 responses, the average salary for Practice Managers is £39,661 with an average practice list size of 10,047 patients. The average male Practice Manager’s salary is £42,334, while the average female salary is £33,421, a pay gap of around 21%.

Scotland: In Scotland the average practice list size is much lower, standing at 7,215. The average male salary is £38,902 based on an average list size of 9,056, while the average female salary is £32,081 and the average list size is 6,871, a gap of 17%.

Wales: In Wales the situation is reversed with female managers earning more on average than male managers. This may be because Welsh practices tend to be on average smaller, with an average list size of 7,407 and an average salary of £36,512. Female managers average salaries of £37,047 (list average 7,913), while male managers average a salary of £34,965 (list average 5,946). That’s a female-positive gender pay gap of 6%.

Northern Ireland: The sole male Practice Manager to respond from Northern Ireland is the top earner amongst our respondents, but the sample is too small to accurately assess whether there is a pay gap or not. The average salary is Northern Ireland is £30,791 but the average practice list size is 7,095.

Greater London: Looking at Greater London in isolation, the average salary for a Practice Manager is £42,159. However, the average male salary is £47,000 whilst the female salary is £41,097. That equates to a gender pay gap of around 13%. The average practice list size is 10,000 patients.

Worrying variations in pay

More worryingly for budding Practice Managers wanting to maintain or develop a career in general practice, the differential between comparable practice list sizes highlights an even wider pay gap.

Whilst no two practices are alike, that level of difference is hardly justified. Admittedly, there are many reasons why one manager might earn more than another. The practice might have more than one surgery. It might be a high earning practice, scoring well on QOF and providing a full range of enhanced services. It might also be a training practice. It might provide a whole range of additional services, such as an out of hours or extended hours centre. But what if the practice occupies leased premises? Are the running expenses higher? Is it a rural practice with a dispensary and high running costs?

Reasons why pay might differ

Here are ten reasons why practice staff pay might differ from one practice to another:

1. Fixed salary versus incremental salary
2. Overtime or time off in lieu
3. Payment or not of bonuses
4. Cost of living increases or not
5. A mixture of the above
6. Self-employed, non-clinical partner, profit sharing paid drawings
7. Payroll and accounts delegated to outside agency
8. Authorises payments and expenditure, signatory to bank accounts (no prescribed limits)
9. Appoints administrative staff, right to dismiss
10. Represents practice externally (CCG, etc)

Here are another five reasons why one Practice Manager might earn a higher salary than another:

1. Multi surgery venues and property management, including the rise of ‘super practices’
2. Location: urban as opposed to rural practice
3. Training practice
4. Extended or out of hours centre
5. Pharmacy management

Whilst it can be argued that the ‘core’ work of a Practice Manager will be common to all practices, there may well be variations in the extent to which individual practices allow their managers to act independently of decisions by the doctors, partners or owners of the practice.

Length of service

Another factor that may affect Practice Manager pay is length of service. It is interesting to note that 50% of the Practice Managers who responded to the survey have been in post for less than five years. Might it be that incremental pay scales might not have provided sufficient increments to affect their salary? In the NHS it can take over six to nine years to reach the top of the pay scale. Only 30% of respondents have been in post for 10 or more years.

It may also be the case, that many practice managers in post today are not familiar with NHS pay system and the history of Whitley Council pay grades.

Bonus payments

Practice Manager salaries might also be enhanced by the payment of a bonus. Overall, 25% of respondents have received a bonus, averaging almost £1,500 per payment, but payments are not always made annually. The question arises as to whether the payment of a bonus is used instead of increments (or a cost of living pay rise). Previous pay surveys have highlighted the lack of adherence to NHS pay grades and salaries.

Factors or excuses

There are many factors that could explain the variances, but the core duties and responsibilities of a Practice Manager are common to all practices. The same skills and knowledge are required. Practices are all organised differently, and no two staffing set-ups are alike.

Nevertheless, some level of consistency would have been expected and it would be understandable if a manager of a larger practice was paid more. Our results show that this isn’t always the case.

You are valuable

In conclusion there remains the question, what is a GP Practice Manager worth? How can such variances in salary paid be fair and reasonable?

Existing and budding Practice Managers should look very carefully at any salary paid or offered. They should look for incremental progression and assurances of an annual ‘cost of living’ review. A solid salary that truly reflects the size of the practice, the extent of responsibility and the actual workload should be the goal. Time is valuable and so are you.

By Robert Campbell

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