Practice managers have written an open letter to health secretary Matt Hancock and senior NHS leaders calling for their immediate inclusion in the ‘new to partnership’ scheme.
The golden handshake-style scheme, which offers up to £20,000 for eligible participants taking on practice partnership roles, opened to applications from clinical staff only on 1 July.
Practice managers said in the letter that their exclusion from the scheme comes on the back of ‘prolonged underrepresentation/appreciation for the essential work they perform’.
NHS England and Improvement (NHSE&I) has said it is ‘working on a plan’ for practice managers to be included, but the body has not yet suggested a timescale for this.
‘Stress and burnout’
Practice managers said in the letter that they appreciated the scheme was still in draft form, but their exclusion spoke volumes to ‘an already demoralised group of professionals’.
The letter made reference to Cogora’s 2018 report on the state of primary care, which found 47% of practice managers were looking to leave their posts within a year, due to workload pressures, burnout and unrealistic workloads. That figure had increased to 70% in the 2019 survey.
‘We are aware of the tragic loss of practice manager colleagues, who have felt so desperate they have taken their own lives,’ the letter said.
The practice managers added that the ‘clear focus on the impact of the workload, stress and burnout of clinicians in the NHS’ has not been extended to include appreciation or recognition for the thousands of practice managers, ‘who dedicate their lives to the running of their practices’.
The inclusion of other roles in the scheme, such as podiatrists and pharmacy technicians, sends ‘a very clear message’ that practice managers are not valued and are ‘not even seen as relevant’ by NHSE&I and the Department of Health and Social Care, the practice managers suggest.
‘We understand the political motivation to show increased clinical partnership, and to attract these newer roles into general practice, but practice managers have a complex, high workload, [and] they have led the response to Covid-19 in primary care, plus the workload of primary care networks alongside the day job, with very little recognition or thanks,’ they said.
The scheme also offers a £3,000 training fund for partners to develop non-clinical partnership skills. The letter said this shows how important skilled management and leadership is, but to not include practice managers suggests they ‘are not valued’ because they ‘are not clinical’.
‘Many of us are very highly qualified and experienced, but announcements like this set the tone for the whole health service,’ it added.
Practice managers also said in the letter that they are already working as partners in primary care, adding that their exclusion from the scheme is ‘discrimination and denies the opportunity to many bright, capable and skilled individuals’ to be at the centre of innovation in the sector.
They added that many practice managers have led mergers and developments, but final pay controls have meant that they have not been ‘fairly recompensed’ for their expertise and work.
The letter called on health and social care leaders to immediately include practice managers in the ‘new to partnership’ scheme and review final pay controls to ensure practice managers are paid fairly for the workload and extra responsibilities that come with working at scale.
Jane Dawes, Practice Manager at Blackmore Vale Surgery and one of the signatories of the letter, told Management in Practice that the letter has been signed by 120 practice managers in England so far, and has also received backing from GPs and other clinicians.
Dr Nikki Kanani, Medical Director for Primary Care at NHS England, said in a webinar on 3 July that the scheme had been limited to clinical staff initially to get it ready in time for 1 July.
She said: ‘But what we do want to do is extend the scheme and make sure our practice managers can be part of it as well, so we are working on how to do that. We’ll get those details out as quickly as possible.’
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