Only 7% of practice managers are partners in their practice, although more than eight in 10 think they should be given the opportunity, research has shown.
The study, carried out by the London School of Hygiene and Tropical Medicine in 2017 and funded by the Health Foundation, found that only 95 of 1,285 practice manager respondents were business partners.
However, 82% thought they should be able to become one.
The report also found that male practice managers are almost twice as likely to be partners than their female colleagues, at 11% and 6% respectively.
This follows the news that practice management has a significant gender pay gap, with more than twice as many male practice managers in the UK earning over £50,000 a year compared to their female counterparts.
Larger practices were also more than twice as likely to have a practice manager serving as partner than smaller practices, according to the study.
In practices with a list size of over 10,000, 11% of practice managers were partners, while in practices with under 5,000 patients only 4% had this role.
‘Face of the practice’?
Study author Dr Jennifer Gosling said: ‘With changes to primary care and shifts towards part-time working among the GP workforce, perhaps it is time to recognise the practice manager as a full member of the leadership team running the business and give them a real investment in its future.
‘It’s time to stop seeing only the GP as the face of the practice.’
Earlier this month, it was revealed that practice managers provide strategic leadership and management within their practices and are increasingly involved in organisations outside the practice.
Dr Gosling recommended that practice managers work across organisations to negotiate and liaise with their peers ‘rather than the default being to contact the GP’.
Primary care networks (PCNs) may provide an opportunity to do so, with the BMA’s PCN handbook suggesting networks include a board of practice managers from member practices to share ideas and best practice.
Earlier this year, the first cohort of practice managers completed a new primary care at scale diploma that aims to prepare them to run networks.
Dr Gosling added that practice managers are ‘beginning to challenge the primacy of GPs as practice leads’.
One anonymous respondent said: ‘This role has fundamentally changed over recent years, so much so that it can no longer be treated as a basic administrative post but is required to sit as part of the senior management team [and] also include organisational leadership and financial responsibility.’
Gareth Thomas, business manager at West Quay Medical Centre in Barry, Wales, said that if partners value practice managers highly, they should offer them the opportunity to take on the partnership.
He said: ‘Practice managers are vital in ensuring the day-to-day running and development of the practice and it would allow them to feel personally involved and recognised, be rewarded and more importantly be retained.’
Mr Thomas added that practice managers may now be more interested in a partnership opportunity due to the increasing ‘reluctance of GPs’ to take on the role in recent years.
The GP Partnership review, published in January, found that ‘workload is the major factor that is causing GPs to leave the profession and discouraging GPs joining partnerships’ and recommended greater support for practice managers to help ease this.
Co-chair of the Practice Management Network Steve Williams suggested giving practice managers the opportunity to become partners could alleviate GP workload.
He said: ‘It would allow the existing partners – typically GPs – to focus on their chosen career and deal with the clinical aspects of the practice, while a managing partner could concentrate on the organisational and strategic objectives.
‘Practice managers can offer another skillset and their contribution could make a significant difference to the success of the practice.’
‘A risky proposition’
However, Practice Managers Association advisory group member Mairead Roche said she didn’t believe partnership should be ‘a right’ for practice managers although they may be invited to take on the role if they have shown ‘exceptional service and a commitment to staying at the practice’.
Research has shown that nearly half of practice managers have been in the job more than a decade and more than a third have been at their current practice for the same length of time.
Ms Roche added that practice manager partners would be ‘outnumbered and out-gunned when it came to decisions regarding staff rises and recruitment’.
She said: ‘It’s a risky proposition – I’d never contemplate it.’