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The Good, the Bad and the Ugly – What Practice Managers Really Thought of 2020

The annual Practice Manager’s Salary Survey published by FPM Group shines a light on what those at the coal face of practice management are really thinking and feeling. But 2020 was a year like no other, and for a profession who are always honest and forthright in their assessment of the year just gone, those surveyed didn’t hold back.

The results make essential reading - both for Practice Managers themselves as a community, and those who manage the funding and regulatory landscapes that practices operate in. So what were the themes that emerged over 2020, not just in terms of salary but about the hopes (and fears) for the future?

The Good

Despite the huge and profound challenges that Covid 19 brought to GP surgeries and the wider NHS, Practice Managers felt justifiably proud of what they had achieved, and many signposted what they thought had helped them to do this. ‘Adaptability is the key factor’, wrote one PM, a sentiment echoed by others who noted that ‘you need to be agile’, as well as being ‘able to say no’. Others pointed to the great variety of work, its fast pace and rewarding nature.

 

This year’s survey showed an average salary of £45,170 - an increase on last year by £2,567. When it came to salary satisfaction, the average score out of 100 was 56. Many did feel justly rewarded, noting that it was often the front of house staff who deserved an increase. Others cited different priorities, saying they had come from a commercial background where they had been paid significantly more but ‘moved to primary care to make a difference’.

Covid 19 brought a plethora of unwanted extra worries and requirements – but it also caused staff to innovate and evolve in ways they otherwise may not have. The importance of a good team remained one of the most cohesive factors cited by PMs. And some confided that they felt ‘fortunate to love what I do, despite (or because of?) the challenges’.

The Bad and the Ugly

There was little ambiguity in the majority of responses from Practice Managers – 2020 was the hardest year they had ever experienced. Some warned that unless the Government began to understand their situation more, workloads receded slightly, and they received more financial support or reward, the pressures may prove so great that retirement or resignation would be the only solutions.

One of the commonest salary complaints was the many unpaid and unrecognised overtime hours worked each week - though many also noted that constrained finances would not allow overtime payment on such a scale. For others, their move to the Agenda for Change pay scale had been delayed to save money.

Others voiced their fears for the future of primary care, as ‘so much secondary care is being handed to us’. Many had the feeling that the ‘CQC seems to have little understanding of GP practices’, and that ‘the government is underfunding GPs and the public don’t seem to care.’ The new contracting arrangements with PCNs had also brought extra complexity for some, a situation not helped by ‘flaky, woolly guidance.’

The most urgent calls for change came from those PMs who found their role ‘relentless’, ‘demoralising’, ‘incomprehensible’, and in some cases ‘soul-destroying’. A recurrent theme was the feeling that there are simply too many ‘tick-box exercises’ involved in practice management, creating an environment which felt all too often ‘lonely,’ ‘isolated’ and where it’s easy to ‘lose sight of your priorities.’ Without adequate time to plan and look ahead, many felt their time was spent mostly on ‘firefighting’ and trying to be ‘all things to all people,’ a situation they did not feel was sustainable in the long term.

What’s changed – and what needs to change?

Although they cited both good and bad aspects of their roles, those PMs who filled in the 2020 salary survey agreed that it had been a tough year for all staff, and that it had already been tough before the global pandemic it. Some flagged new roles and responsibilities as part of the acceptance that the role can sometimes be too much for one person – ‘I’m now a director of Business and Strategy and we have appointed a new PM, so we share the load.’ But in some cases, respondents reported having to take on more responsibility – such as a PCN lead manager role – with no extra financial recompense. For others, they were clear that the role deserved more recognition – just not necessarily monetary. And again this year, the gender pay gap between male and female practice managers continued, at around £3,000, despite three quarters of managers being female.

Many Practice Managers pointed out that they rely heavily on organisations like FPM Group for support and guidance. This may be particularly pertinent in light of new regulatory requirements which have recently been introduced – the extra vigilance and safeguarding issues can often seem like the work of an extra full-time role.

So the picture is mixed; as well as highlighting commonalities in the struggles that many PMs share, the findings show that Practice Managers are realistic, resourceful, and resilient - and their focus on the common goal of great patient care remains as strong as ever.


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