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Why are Practice Managers not valued?

by in GP Practice Management

The golden hello scheme was agreed as part of the 2020/21 GP contract deal and opened to applications on 1 July this year after being delayed by the coronavirus pandemic.  Golden hello payments are available to people taking up partnership roles in general practice for the first time after 1 April 2020, and can be claimed not only by GPs who become partners, but also nurses (including ANPs), pharmacists, pharmacy technicians, physiotherapists, paramedics, midwives, dietitians, podiatrists, occupational therapists, mental health practitioners.

A notable exception to the list is practice managers.  Odd, of course, because there has been an increasing number of practice managers made partners of GP practices in recent time (certainly more than most of the roles listed above!), yet they are not part of the list.

NHS England has stated on a number of occasions that they are hoping to expand the offer to include practice managers, but it is clear that there is opposition to this that is proving difficult to overcome.

This then raises the question of who is arguing the case for practice managers on a national level?  Indeed, is anyone?

In technical terms,  practice managers are represented as part of practices by their local LMC.  The LMCs are then represented nationally by the GPC.  But they are representing practices as a whole, and practice managers question whether the voice of practice managers really gets heard at that level.  Indeed, there are reports of resistance within the GPC to the idea of a practice manager committee operating within it.

A recent Practice Index poll found that an astonishing 55% of practice managers are considering leaving the profession in the next 12 months.  Morale across the profession, as our panel recently discussed, is at an all-time low.

The two issues are clearly linked.  General practice as a whole is under huge pressure, and much of that pressure falls directly on the shoulders of the practice managers.  At the same time, there is nobody fighting the corner for practice managers or acting on their behalf.  They feel abandoned and alone and, unsurprisingly, many are seriously considering leaving.

The time is surely now for this issue to be addressed.  Practice managers need some sort of voice, some national representation.  Without it, it won’t just be practice managers who suffer, but the whole of general practice.  Practices simply can’t afford to lose their practice managers.

But the reality is that if this change is to happen, practice managers themselves will need to make it happen.  Nearly all practice managers have come together on the Practice Index site.  It is time to build on this unity and work together to establish a national body, whether this is a new one or part of an existing organisation.

It can be done.  It will inevitably require a small number of individuals to put their heads above the parapet and take this on.  More importantly, it will need everyone else to rally behind them.  It may well require the profession to introduce its own accreditation.  But it will be worth it because it will create a legitimacy and a national voice that to date has been sadly lacking.

Let’s hope we reach a point soon where practice managers start to be valued and recognised for the work they do, and stop being treated as second class to the clinical roles working in general practice.

Listen to our latest podcast, ‘Professional recognition of practice managers’ here.

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Ben Gowland

Ben Gowland

Director and founder Ockham Healthcare, presenter of The General Practice Podcast, supporting innovation in General Practice

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11 Responses to “Why are Practice Managers not valued?”
  1. Avatar
    Will Menzies Says:

    A PM body has been discussed for ages. I would support it and happy to be involved in the setup. Who leads?


  2. Avatar
    Andrew Whincup Says:

    Hi, This is a great article. I came to Practice Management late in my career and have been one for just over 3 years. I am very lucky as I work in a practice where I am valued by the GP Partners. However I am well aware of the issues mentioned in this article and disgusted that PM’s are not considered for the partnership help that others are getting. I would be very interested in looking at forming a body to represent PM’s but unsure of how to go about that. I’m used to sticking my head above the parapet.


  3. Avatar
    Ceri Chaplin Says:

    I think that this article sets out the issue very succinctly.

    If I’m honest, up to now, I have not been a real fan of a PM organisation or voice, but the ommission of PMs from the golden hello scheme is just one example of why we might need an organisation to argue on our behalf.

    We also need to make our voice heard about the issues caused by ‘announcement by media’ e.g. the confirmation this morning of the over 50s being eligible for flu from 1st December – still not seen anything official in my inbox about this!

    I have no idea where to start…but would be happy to be involved with others to get something off the ground!


  4. Avatar
    Michele Petrie Says:

    This article succinctly indicates the position practice managers currently find themselves in.

    PMs have always been under pressure but this has substantially increased even before covid and this is rarely recognised appropriately.

    Notwithstanding the golden hello fiasco, the recent trial by media and now the relaying of information concerning flu and covid vaccinations again via the media, PMs are regularly required to provide information to PCSE on a whim deadline of 24 or 48 hours. Systems are changed in the best interests of PCSE without any discussion or thoughts on how this affects the PM and her workload.

    Anyone would think someone somewhere wants to make it so hard for PMs they will all disappear!!!

    There is no ability to challenge and this needs to change. I would very much welcome any form of recognised affiliated group to be at the discussion table to address our concerns. Count me in.


  5. Avatar
    Robert PM Says:

    All sorts of words and phrases spring to mind to describe the plight of Practice Managers and with the advent of PCNs it might be appropriate to use the word ’hierarchy’ or the phrase ‘splitting the pack”. In the Practice I might use the phrase ‘pecking order’ and I would ask the question where does the ‘poer’ Really lie? ‘Power is certainly not defined by the job title ‘Practice Manager’. You could use another title ‘Business Manager’ but what if that person works part time and earns less. You might enjoy the role of a non-clinical Partner, which might give you a say and a vote.

    Every Practice I have worked in (6 of them) worked in a different way. One thread running today talks about lead roles. I do wonder what mine was. My job satisfaction came from my achievements and from my successes and whether or not I was simply listened to. I needed to remember throughout my career that I was not the boss. I was an Employee; just one of the staff.

    There is much talk of a trade union or organisation to represent Practice Managers. But the problem is really with the independent nature of general practice and the unlikelihood of Practices speaking with one voice. It really is a case of each Practice to his or her own. There’s no consistency. There’s a mixture of good and bad pay and terms and conditions of employment.

    You have to ask yourself the question as to why salaried GPs and Trainee GPs can enjoy NHS rates and conditions. Why? You have to ask yourself whether being a Practice Manager is still a viable career. It was for me but now I’m nearly 70 I think if I was younger I would want better!


  6. Avatar
    Ben Gowland Says:

    Thanks for all your comments! The best place to start I am sure is attending the webinar on Wednesday at 12.30 that the NAPC are holding. You can register here for the webinar: https://us02web.zoom.us/meeting/register/tZUkfuytpz0tGtf5-aKq1n1BM86aQKzsLe0W

    There are several hundred already registered, and the more that attend the more seriously practice managers will be taken


  7. Avatar
    Kay Keane Says:

    Thank you Ben for a wonderful article, describing so many of our struggles.

    So that we are reacting to the climate positively there is a web event planned for Wednesday 25th where we can plan how we as Practice Managers help Practice Managers. We have support from many of the national general practice organisations.

    To join follow this link



  8. Avatar
    Christine Says:

    It is clear that there is no real support for Practice Managers out there. Although the LMC is portrayed to represent us, they don’t. Whenever anyone talks about burnout in general practice it always relates to clinical staff and not to us PM’s who have a very different but demanding and varied role.

    I support a PM body and would help set up such an organisation.


  9. Avatar
    Will Menzies Says:

    Would love to but I have a flu clinic to run at this time. Apologies.


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