Salaries in a Nutshell – 2018

Practice Manager Salaries in a Nutshell

This data was collected as part of a Gender Pay Gap Survey of over 500 practices in March 2018 with the help of Practice Index (

Salary Description                           Average List                Average Salary

1. Gender Pay Gap                                           9497                            £38,625

2. Male Salaries                                                9992                            £41,445

3. Female Salaries.                                           9407                           £38,114

4. England (Salaries)                                       10047                           £39,661

5. Scotland (Salaries).                                       7215.                          £33,316

6. Wales Salaries.                                              7407                           £36,512

7 Northern Ireland                                           7096                            £30,791

8 Greater London                                           10024                           £42,159

Geographical Location

9 Urban based Practices                                10092                           £38,497

10 Semi-Rural Practices.                                  9777                           £39,101

11 Rural Practices.                                             6331                          £36,237

Number of Surgery Premises

12 One Surgery.                                                8198                           £37,088

13 Two Surgeries.                                           10870                           £39,874

14 Three Surgeries                                         20627                           £49,111

Contracted Working Week

15. 40 hours per week.                                     8838                          £37,873

16. 37.5 hours per week.                                10491.                        £41,136

17. 37 hours per week                                    10273                         £40,701

18. 35 hours per week.                                     8000                         £36,484

19 30 hours per week                                       6804                         £31,478

20 Average Working Hours

a. Average Hours Per Week                             35.38

b. Average Overtime Per Week.                        6.36

c. Average Salary with Overtime                 £45,462


Gender Pay Gap

Many thanks to Practice Index for helping me publish a striking report on the Gender Pay Gap for Practice Managers. For the detailed blog go to

Key Points

“The Royal College of Nurses is currently running a ‘Close the Pay Gap’ Campaign”

The aim of the Pay Survey was to see whether a gender pay gap was apparent amongst general Practice employers.

The Findings

There was an excellent response from our Practice Index members to our timely 2018 survey on Practice Manager Pay with 528 responses, of which 81 replies (15.3%) came from Male Managers.

The Gender Pay Gap

Gender Pay Prominence

One gender is more prominent in the Pay stakes than the other in:

England – Male
Scotland – Male
Northern Ireland – Male
Wales- Female
Greater London – Male

For detailed results, take a look at the Blog on

Length of Service and Increments

50% of Practice Managers who responded have been in post for less than 5 years. Might it be that Incremental Pay scales have not awarded sufficient increments so far to effect their salary. In the NHS it can take over 6 to 9 years to reach the top of the pay scale. Only 30% of respondents have been in post for 10 or more years.

Paying a Bonus

Interestingly 25% have in the past paid a bonus to their Practice Managers, which averages almost £1,500. 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. Few practices pay NHS Agenda for Change Pay Bands.

Workload and Commitment

The standard working week for full time staff in the NHS is 37.5 Hours, but the average contracted hours for Practice Managers is 35. Many practices still contract for a 37 hour week. One seriously questions why the average is only 35 hours when again on average Practice Managers say that they actually worked 6/7 hours extra a week. But is that paid time? A new poll on Practice Index is looking at this.

Recruitment and Retention

Recruitment problems are often cited as a reason for needing improved pay levels. But the principal duties and responsibilities of Practice Managers are common throughout the UK no matter the location or size of Practice. Certainly there is a main core of duties and responsibilities that you would expect a Practice Manager to perform. However individual PM salaries might vary in practice of a similar size as for instance one PM is paid a flat rate salary, no overtime and no bonus and another might be paid increments, overtime and a bonus. Alternatively it might be a mixture of factors including either paying or not paying a cost of living increase. The full report on Practice Index looks at this in detail.



As a New Year Approaches

From the retired perspective, I now see general Practice more from the outside than in, principally as a patient.

I have seen great variances in the promptness and quality of services offered. I have met with complications and delays caused by the Electronic Prescription Service. When it works it’s wonderful but does it go to the chosen pharmacy and if it does is that pharmacy well stocked.

I have had the unfortunate need to use hospital services and have been knarked to see huge numbers of ambulances idle outside a major hospital yet I paid an enormous sum to park my car in the multi-storey car park.

Having said that I have been impressed at the promptness I have been seen at an out-patient appointment even in one occasion almost an hour early. The consultants were information, thorough and did not rush. There are good experiences in the NHS even though you are ill.

I have both experienced long delays for a GP appointment and very prompt consultations – again I was made to feel that I had not wasted anyone’s time and a prompt referral was made.

I also have to comment that some NHS services can be lacking – Physiotherapy in general Practice can be left wanting offering patients instruction sheets to read and exercises to do rather than hands on effective treatment.  Private physios working either in the NHS or independently can be relied on for a much better service.

So what can we expect in 2017, fewer GPs, linger waits to see a GP and to see a consultant. Longer distances to travel for out of hours care and hospital services. What about more charges not just the hospital car park. Buy your own routine medicines over the counter. Do it yourself consultations using the NHS Choices web site or any reputable site. The only thing is that your symptoms might match both the most serious and least serious medical events in your life and have you paid into that funeral plan.

A happy and and healthy new year to one and all.


How on earth do Practices Afford it?

We Employing additional staff in new, special and unusual roles in general Practice always begs the serious question as to who pays for it. For example, in a Practice that was a ten mile round trip to the nearest hospital pathology department I always thought that it was an important service to offer phlebotomy at the surgery. But this post was not funded by the Practice. It was initially funded by the GP fundholding initiative and after the demise of fundholding the hospital continued the service until the hospital accountants stepped in to stop the service. After that funding was intermittent as PCGs and then PCTs offered various degrees of funding for a phlebotomist.

The basic Practice budget allows for reception staff, medical secretaries and practice nurses and you could argue that is all that it is for. Any additional posts come from either the Practice or any special funding initiatives that have taken place over the years. Newly appointed Practice Managers may not be aware of the history of funding ancillary staff. Fundholding practices received growth money and this was used to fund posts such as a salaried GP or a nurse practitioner. There were also savings but the money would be a one off income not a permanent one. There have been other funding initiatives. But what if that money is clawed back. Who pays then. Beware too of the cost of redundancy and the rising cost of pensions. Be aware too of the potential employment tribunal costs of terminating staff unfairly!

Practices of course are free to use their budgets as they see fit, but to make a long term commitment to fund say a nurse practitioner instead of a GP still assumes that the fund will be consistently available. What if the list size is falling? What is QOF income is reducing? What if MPIG has bitten harshly. What if the scope to increase Enhanced Services Income is minimal and unreliable? I have to say that having run five medical practices over 25 years I do wonder why Practices get into financial scrapes and do not cut their cloth accordingly. That said there are disasters that beset Practices, such as theft, and fraud. Since 2004, the staffing element of the budget never matched the original cost once you factor in superannuation. The need for Locum cover presents a major headache for those trying to balance the books. Cutbacks in budgets, the MPIG and changes to QOF all add up to a financial nightmare.

I also found that moving to privately built premises which were under a lease to the Practice became a burden. The leasing companies seem to keep a tight reign on maintenance costs and insist on their own contractors providing services, whereas Practices that own their own premises would be unlikely to set up high cost maintenance services for their buildings. So when it comes to funding ‘new’ staff posts one can understand the desire to employ two health care assistants instead of a nurse practitioner. But let the buyer beware.

Here are ten keys points to bear in mind:

Is funding guaranteed for the post or posts you propose?

Have you assessed the actual full costs, including superannuation, national insurance, professional fees and medical indemnity?

Are you getting value for money?

Would the money be better spent on something else (Opportunity Cost)?

Are you going to be tied in to a long term commitment that is difficult to get out of?

What happens if funding reduces or is withdrawn?

Beware of ‘flavours of the month’!

Listen to your accountant not the CCG idealists!

Always have reserves and know you can pay the bills, particularly Inland Revenue?

Beware of GPs too keen to take high drawings!