Written evidence submitted by The Practice Management Network (FGP0295)


The Practice Management Network (PMN) is the recognised collaborative of senior practice managers, practice manager partners and experts in strategic practice development. Founded in 2005, their Board members provide expertise and advice, with the benefit of organisational memory, to a variety of NHS organisations including NHS Digital and the National Association of Primary Care.  PMN has a strong patient focus thanks to a memorandum of understanding with the National Association for Patient Participation.


What are the main challenges facing general practice in the next five years?

There is a well-documented workforce crisis in practice management which over the next five years, will impact the viability of many general practices and patients, carers and communities ability to receive locally based general practice services. 

Practice managers are the leaders, lynchpins and organisational continuity of many GP practices.  This critical management role is often undervalued or unrecognised by the wider NHS.  Given that the GP workforce is shifting to be flexible, the consequence is that someone has to hold it all together.  Practice managers are the system glue and safety net, offering value for money within the NHS and across social care too, with demonstrable impact on referral management and support for carers etc.

Practice managers are the single point of access to the GP practice, the organisational continuity within the Primary Care Network.  They are under increasing pressure to deliver new and more complex services to their patients, plus filter and action multiple requests from CCG, NHSE, DHSC all asking to some extent for the same thing but slightly different wording. It is timely to remember the numerous additional staff roles being introduced into primary care with the practice manager acting as the conduit for both the patients and staff to introduce the new roles and service.

Practice leadership is now increasingly provided by this cadre of managers who are increasingly taking on Partner status as leaders of their practices, without the benefit of the NHS golden hello’ incentive offered to clinical colleagues who become partners.

These factors make an already challenging role unsustainable and increasingly unattractive to new recruits. Retention is increasingly difficult as demonstrated by increasing numbers leaving due to burn out and earlier than planned retirement.  There is no clear pipeline of replacements for those with planned retirements. 

As a management role within the NHS family, practice management is the forgotten part of the profession.  There has been little system investment in formal training, no clear career path, career development unlike other NHS management rolesPlus there has been a brain drain’ of senior practice managers into strategic roles at Primary Care Network and Integrated Care System level.

What can be done to reduce bureaucracy and burnout, and improve morale, in general practice?

Practice management is the system architecture in general practice and needs strengthening.  This requires:

Dec 2021

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