Editor Rima Evans offers a round-up of the main events and developments – the highs and the lows – as reported in Management in Practice during the last 12 months
2025 has been a decisive and dynamic year for practice managers.
There’s been tireless lobbying and campaigning going on to raise the profession’s profile and influence – and get a better deal for general practice. But this year it’s actually spurred a hugely significant change…
Back in January, practice managers participated in a parliamentary event to launch a white paper (which Management in Practice contributed to) that placed a spotlight on the ‘stark’ workforce and funding crises facing GP surgeries.
In March, the Institute of General Practice Management (IGPM), expressed its disappointment over the 2025/26 GP contract funding settlement and strongly urged the Government to boost its investment and reverse the National Insurance increase that took effect from April 1.
The professional body was also vociferous after the launch of the 10-year health plan in July pressing MPs and ministers to stop overlooking managers’ critical role when it comes to implementing policy, and demanding ‘a seat at the table in strategic decisions to help turn plans into real change’.
There’s been lots more activity that goes unreported behind the scenes, of course. And this year, as I mentioned earlier, the hard work has paid off.
In early December, we reported that the IGPM had been invited to have an official role in the negotiation of the GP contract for 2026/27, as NHS England announced it was overhauling the usual arrangement for negotiations and putting in a place new ‘stakeholder model’ so the BMA isn’t the sole body involved.
The IGPM will be consulted on the new contract alongside health and patient bodies, the RCGP, the National Association of Primary Care (NAPC), Healthwatch England, National Voices and the NHS Confederation.
Kay Keane, chair of the IGPM, described this was an ‘important moment for our profession’.
While the profession is making waves at Government level, the last 12 months has seen practice managers on the ground have to contend with a dizzying amount of change and uncertainty (probably the only certainty in general practice).
The year started with surgeries being involved in collective action in protest against contractual terms and funding and though it was paused in around March, by December it was back on the cards (though possibly for next spring).
The Leng review, published in July, recommended the physician associate role essentially be retained although with a new job title of physician assistant, new training requirements and altered job description for primary care. Since these were accepted by the Government, a list of instructions was promptly issued by NHS England to ensure practices were compliant with the changes.
However, it was never going to be that straightforward. HR experts warned practices to ‘tread carefully’ and that simply following the guidance could put them at risk of legal claims from PAs or in breach of insurance policies. Instead they were urged to take a robust HR approach and be ‘compassionate’.
The Publication of the 10-year health plan also in July saw the launch of the Neighbourhood Health Service, which brings bigger health teams together under one roof. Since 43 sites went live in the Autumn in deprived areas, ahead of a national roll out in 2026, ‘GP teams had to take time out in the summer to attend an intensive coaching programme to prepare for the changes.
The AI agenda started to make its presence felt more widely this year too although this also became a source for confusion. In June, an NHS England letter building on previous guidance around the use of I-enabled ambient scribing products – transcribing tools used during consultations – left practices unclear as to what software packages they could use that meant they weren’t exposed to liability for clinical safety issues or data breaches. Leicester, Leicestershire and Rutland LMC ended up issuing its own guidance to support practices,
Meanwhile, the biggest frustration for practices in England this year – and increasing their work demands inexorably – has to have been the mandated reforms to changes to online access implemented from October 1 which means surgeries, which has required to keep their online consultation tool open during core hours as a minimum for non-urgent queries.
Although health secretary Wes Streeting thanked practices for rolling it out (as of start December 3, 98.7% were doing so), Management in Practice’s exclusive survey revealed that GP teams are spending the time equivalent of almost 210,000 appointments a week managing the extra requirement.
The same survey highlighted how the online request system was risking patient safety, as practice managers reported how some patients are flagging urgent clinical problems, including breathing difficulties, severe vomiting, acute abdominal and chest pain, and feverish children through online forms. One patient even used the online tool to report they had drilled through their finger!
The list goes on. Practice managers had to digest the news that NHS England was being axed and the ICB workforce being cut in half, triggering ICB mergers to cut running costs; they have had to tackle ongoing complex pensions issues and errors; and they have had faced challenges with the CQC, including IT glitches that caused delays to reports and problems with scoring. ( In May, the CQC also saw a new chief inspector of primary care appointed, GP Professor Bola Owolabi).
Will 2026 be less complex or demanding? Unlikley. But look out for a piece on the new year setting out the main challenges facing practices and tips for managing and preparing for them.
I want to take the opportunity to wish you a peaceful and health new year. And to thank you for another 12 months of exceptional hard work.
