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Nearly half of practice managers considering quitting within the year, report finds

by Nora Elias
27 March 2019

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As many as 47% of practice managers may leave the profession in the next 12 months, new research published today reveals.
A report published by Management in Practice publisher Cogora shows that 30% of practice managers are contemplating leaving the profession in the next year for reasons other than retirement.
Reasons given by the 424 practice managers taking part in the survey, presented in the Primary Concerns 2018: The State of Primary Care report, included ‘exhaustion’, ‘far too much pressure and bureaucracy’, ‘huge unrealistic workload’, ‘can’t tolerate the daily stress levels’ and feeling ‘burnt out’.
This was the highest percentage of any of the primary care professions in the annual report, which this year features responses from more than 2,300 practice managers, GP partners, salaried GPs, pharmacists, nurses and healthcare assistants.
The number of practice managers stating they may leave their job for non-retirement reasons was closely followed by pharmacists on 29%.
Coupled with the 17% who said they might retire in the next 12 months, the report reveals that a significant 47% of practice managers may leave their role within the year.
The report also found low work morale to be a theme. Asked about their current work morale, 42% of practice managers rated it as ‘low’ or ‘very low’, while just 21% said it was ‘high’ or ‘very high’.
The most significant contributor was ‘unrealistic demands from patients’ with 55% citing this as a very important reason why they feel demotivated at work.
This was followed by ‘too much bureaucracy’, referenced as very influential by 50% of practice managers, ‘workload dumping’ from other sectors at 39%, ‘unfair NHS criticism from the media’ at 34% and ‘unfair NHS criticism from politicians’ at 33%.
Practice Managers Association spokesperson Loretta Outhwaite said:
‘Given the increasing challenges frontline healthcare providers are facing, the results of the survey are unsurprising and reflect what we have been hearing from practice managers.’
Practice managers were also among the primary care professionals most likely to work unpaid overtime, with 52% stating that they do this on a daily basis.
This was the highest figure in the survey, equalled by salaried GPs – 52% of whom also said they work additional hours every day.
Co-chair of the Practice Management Network Steve Williams said: ‘You only have to look at the immediate demands created by the new contract, to see the operational pressures that are being placed upon practices.
‘They will manage, as they always do, or they will leave – as the survey suggests.’
He added: ‘Recognition of the value contributed by our profession both by NHS England and employers would go a long way towards addressing this potential problem. The right investment into the workforce will be critical to future success.’
Despite the long hours and the high levels of stress referenced by practice managers, the overwhelming majority, 65%, had not had time off for stress or burnout in the 12 months preceding the survey, and did not expect to.
However, a quarter, 26%, said they expected to need time off for stress or burnout in the upcoming year.
Comments on this topic included: ‘I don’t have time to be ill or take annual leave’ and ‘I have considered [taking time off for stress] but who would do the work if I was away? I would come back to more work.’ 
One practice manager said: ‘It would just put more pressure on my staff which would have a spiralling effect. I will just keep going until I drop’.
Some practice managers also made it clear they were taking the option or retiring early instead.
Feedback included: ‘I am taking early retirement next year as I have had enough,’ and ‘I have been in the practice for 30 years but have decided to take early retirement early next year. I have always been able to cope with pressure and stress but no longer at this level.’

Somewhat surprisingly, given the low levels of work morale, 60% of practice managers said they had requested a pay rise or improved working conditions while in their current role.
Of those who had asked the overwhelming majority, 76%, had been successful in their request.
This was the highest percentage of any of the professions in the report, with the average pay rise granted to practice managers being 7%.
Asked for their views on the current state of primary care, practice mangers were scathing, with some of the feedback including: ‘A mess: bureaucracy gone mad’, ‘at absolute breaking point’, ‘broken’, ‘battling bureaucracy’ and ‘badly funded and overworked’.
One practice manager replied: ‘A complete shambles and an embarrassment to the country. It breaks my heart to see what has become of a service I love and have given the best years of my life to.’