• What are the main steps that must be taken to recruit the extra staff that is needed across the health and social care sectors in the short, medium and long-term?

NHS Jobs and Careers to provide stronger marketing messages to promote practice management as a worthwhile NHS career, leading and developing general practice provision in the NHS.

Inclusion in the ‘Golden Hello’ initiative currently only offered to clinical partners at GP Practices.  Inclusion of Practice Managers as Lead Partners and Partners in GP practices, would also demonstrate parity of esteem from the centre.

• What changes could be made to the initial and ongoing training of staff in the health and social care sectors in order to help increase the number of staff working in these sectors?

Investment in practice management training and career development and the workforce in general i.e. the speciality of practice management as part of the NHS Graduate Management Scheme as well as a funded PM Vocational Training Scheme.  Recognition of accredited practice managers would be a positive step for those currently accredited and encourage others to formalise their role within the profession.

Investment and recognition of PMs acting as mentors as demonstrated during the pandemic offering pastoral care and well-being support both to colleague PMs, practice team members and GPs.

• What are the principal factors driving staff to leave the health and social care sectors and what could be done to address them?

NHS HR departments to collect intelligence from staff exit interviews.  This should be system-wide and include general practice and primary care.

One of the unforeseen impacts of working through the Pandemic is that staff members want a better work life balance and say they want to live in the here and now.  They are choosing to vote with their feet to earn similar or better wages for less stressful positions outside healthcare.

For established staff, the goodwill has often gone, so they don’t want additional stress for the wages offered, and are more likely to retire early or move on.

The lack of professional recognition for Practice Managers, despite many years of requesting this to be considered, so Practice Managers are fed up with no action regarding this.

• Are there specific roles, and/or geographical locations, where recruitment and retention are a particular problem and what could be done to address this?

Snapshot of current staffing situations facing GP practices across England.

Hertfordshire: possible oversupply of potential GP partners within a limited number of flexible training practices, which bucks the national picture, compared with 75% of administrative staff leaving or planning to do so.  One practice, in a relatively deprived area where many staff do not have the use of cars, is a big employer locally and has a depth of GP Partners, many of whom train.  The practice pays above the Agenda for Change rate and still has difficulties recruiting management and administrative staff. Nurse shortages have been filled previously by long-term links with local University.

North East: having to use sponsorship licence to recruit overseas GP knowing that is just a temporary marriage of convenience fix and the GP is unlikely to stay at the practice once the year is done. Practice nursing shortages as practices and the Primary Care Networks are in competition for a very small pool of trained nurses.  The NHS is competing against itself for key workers, with the bigger organisations able to offer better pay.

Teesside: Practice Managers due to retire in the next few years are retiring early due to the stresses of the job and there are few responses when advertising vacancies across the entire North East.

Surrey: Difficulty recruiting administrative staff as many in the area do not have to work and can pick and choose from a buoyant employment market.

Solution. Reduction in the top down approach nationally, demonstrated by support and trust in GP Practice Managers and practice staff to provide a quality service without the extensive reporting processes and the demands of the wider health network.

Solution. Career paths for Deputies, Assistants with locally funded training schemes and led by established Practice Managers, concentrating on the fundamentals of Practice Management, which should possibly provide a pool of Practice Managers to grow into experienced Practice Managers (who will always need support depending on NHSE&I, DHSC or government changes and expectations).

Solution. Informing patients about how best to utilise resources especially staff/the practice/the NHS. 

Solution. Working with primary care patient organisations such as the National Association for Patient Participation (NAPP) and Patient Participation Groups (PPGs) to understand the skill mix available and being kind when patients do not get what they want! 

• What should be in the next iteration of the NHS People Plan, and a people plan for the social care sector, to address the recruitment, training and retention of staff?

Ensure that roles in general practice and primary care have equal standing and promotion in any future iteration of these plans.

Have one unifying plan for both sectors to send clear messages about integration as the future for the sectors and more employment opportunities.

Parity of esteem and support and career development for primary care management roles. 

Take responsibility to audit and measure the impact of the NHS People Plan and publish the results. This will ensure that practices and the public are aware how many GPs/staff are employed and being trained as this is for the long term.

• What is the role of integrated care systems in ensuring that local health and care organisations attract and retain staff with the right mix of skills?

To ensure Occupational Health services are available for all staff.  Pastoral care for non-GP partners appears to be an after-thought.

To provide resourced Management and Clinical supervision and mentors at a local level for nurses and managers as part of their role.

To reduce the training barriers across the NHS system.  So just as there are funded GP trainee places and funded backfill for GP Trainers, there should be funded Primary Care Management placements and funded time for senior practice managers to undertake training roles.

To develop some hub and spoke working across practices to ensure best practice and best use of resources.

To ensure publicly funds are equitably and transparently allocated and the ICS is accountable. Engagement with general practice from the outset.

The Practice Management Network Board

Jan 2022