Editorial Comment

New Practice Managers Be Warned

You may have applied for or been offered a job as a GP Practice Manager. Working in a medical practice you are a key worker. You will be carrying out essential work. Practice Managers carry out many management functions on behalf of their employers, but of course, may not have the final say. A small minority of Practice Managers are non-clinical members of the ‘partnership’ and as such will be part of the decision making process, but the vast majority of managers are employees of a medical practice and will only enjoy the powers that are delegated to them but on many matters as I have said they may not have the final say.

Are you Part of the NHS?

It must be understood from the outset that staff are employed in general practice who are non-clinical are unlikely to have employment contracts based on the National Health Service salary system or enjoy the same terms and conditions of service offered to mainstream NHS staff. However, Salaried doctors and Practice Nurses will probably enjoy the same pay rates and contractual terms and conditions that they would have enjoyed in the hospital service. The only certain link with the mainstream NHS is that since 1997 Practice Staff become members of the NHS Pension Scheme, unless they opt out.

The Interview Journey

The journey to become a Practice Manager all starts with an interview and as a candidate I am sure you will soon get the message as to where those interviewing you are coming from. It may be a very well organised interview and involve a Human Resources Adviser who takes the lead. The other side of the coin might be simply the ‘Partners’ who struggle along asking questions with no structure or forethought. Most interview panels ask questions from a set list and score candidates. You will probably be asked to make a presentation about 10 minutes long. I think it has to be said that GP Practices may have little experience of interviewing candidates for a highly paid managerial position. So don’t expect too much!

Consider a job offer very carefully

After the interview you might be the lucky one who gets the phone call – we’d like to offer you the job. You should wait until you receive the offer letter before you accept the job, and certainly don’t give in your notice unless you are satisfied with the content of the contract offered. You should look at it very carefully. Here are some elements to consider.

Salary – For the size of the Practice you need to consider whether the salary offered is both fair and reasonable. Is it on a fixed salary point or will it increase incrementally each year. NHS Pay scales tend to have at least two annual increments. Is an increase in your salary to be judged by your performance and achievements. Is it performance related pay? Will there be an annual cost of living increase? Will you be paid overtime. The standard working week in the NHS is normally 37.5 hours. What happens if you consistently work longer. You might be allowed to work less than a five day week, but be mindful that the salary might be adjusted, pro-rate.

Annual Leave – In the mainstream NHS annual leave entitlement reaches a maximum of 33 days plus bank holidays, whilst in general practice the tendency is to stick to the Statutory entitlement of 28 days sometimes inclusive of bank holidays and sometimes not. So the generosity of the leave entitlement may give you a hint of how the employer might behave in the future. Working in a medical practice can be extremely stressful so it important to use whatever annual leave is awarded to you. You may find that there are objections to you carrying forward leave to the next Leave year.

Sickness – Similarly, some GP Employers only pay Statutory Sick Pay when an employee is absent. For mainstream NHS staff, the Employers Sick Pay Scheme is generous to say the least with at six months full pay and six months half pay after completing a period of service. If offered a Practice Managers job, you will really need to look at what’s on offer on Sick Pay and decide whether you can live with it.

Notice and Probation – Normally employee’s are expected to work one months notice if wishing to leave an employment. Some employers look for longer periods of notice, for say three months. It seems to me that to expect a lengthy period of notice from the start of a contract is at odds with the idea of expecting a new employee to work a probationary period. Added to that in my experience it would be unusual to set a period of probation for a senior post, particularly when a rigorous recruitment process has taken place.

Professional Development and Training – Another important area to consider is what support you might be given for your professional development and training. Are you to be allowed any form of study leave and the associated expenses. Are you to be encouraged to take part in say, a local Practice Managers Group, or become involved in the local Primary Care Network

As a final comment, pay levels for Practice Managers can vary significantly so it is worthwhile doing your research before you contemplate accepting a job offer. Find out if you can what the outgoing Manager was paid. It could be more or it could be less. There are numerous factors which might affect the level of salary offered, such as the list size, numbers of clinical and non-clinical staff, number of Surgery premises, and the type and extent of services offered. The Practice might be a training Practice and have educational interests. It might form a hub for out of hours services. There may be many reasons why arguably the salary offered should be enhanced. New Practice Managers be warned.

Robert Campbell
March 2021


Robert Campbell

By Robert Campbell<br><img src="" alt="Robert Campbell" class="avatar" width='50' height='50'/>

Started work writing medical cards in 1966 at Staffordshire Executive Council. Have worked at Inner London Executive Council, Hertfordshire Executive Council, Lambeth Southwark and Lewisham FPC, Birmingham FPC, Dudley FPC and Wakefield FPC and Family Health Services Authority. I was seconded to the NHS Appeals Unit and have worked as a full time GP practice manager since 1992 until 2010. I was also an AMSPAR trainer at Park Lane College, Leeds. Now I work as a freelance author.