This site is intended for health professionals only

Two fifths of practice managers considering quitting – with pay and workload top reasons, says survey

by Rima Evans and Emily Roberts
26 January 2024

Share this article

Most practice managers – 65% – are either very or fairly satisfied in their job, findings from our Practice Manager Salary Survey 2023/24 have found.

And the majority (61%) have said that leaving their job is not on their radar.

Nevertheless, the data showed that a significant 39% are thinking of quitting within the next 12 months. And dissatisfaction with pay and workload are the main factors driving that.

Practice managers who indicated they were thinking of resigning were asked to rank the main reasons why.

Two thirds (65%) said workload being too high was among their top three reasons.

Almost half – 49% – agreed that ‘practice manager pay not keeping up with the cost of living/ inflation’ was in their top three.  And a similar percentage, 46%, flagged the concern that ‘pay at my practice doesn’t reflect my responsibilities and workload’.

Other issues that were among the top three reasons for wanting to leave included:

  • Job is too stressful (44%)
  • No opportunities to progress career (25%)
  • Level of patient abuse (25%)
  • Career change (17%)
  • Wanting to become a locum practice manager or pursue a portfolio career (13%)
  • Retiring (9%).

In terms of workload, the survey of 975 UK practice managers in permanent jobs provided insight into the complexity of the role and the level of responsibility they hold.

The list of duties they cover runs to more than 20 areas and includes: maximising finances and funding streams; meeting QOF targets; purchasing and procurement; managing both non-clinical and clinical teams; HR; business planning; preparing for CQC assessment; IT and data security and more.

In addition, the report highlights the size of budgets practice managers control. More than half (51%) are responsible for practice budgets exceeding £1m, while 18% are in charge of budgets of more than £2m.

In larger organisations, this wide range of functions would be split among a number of different people or teams, yet in primary care they are often tasked to just one person – the practice manager, the survey says.  

It adds: ‘It’s easy to understand why practice managers report having overdemanding workloads. However, it also demonstrates the pressures on general practice and how critical a role the practice manager is to the effective functioning of a surgery, and in turn, to patient care.’

Comments made by respondents revealed the extent to which some are feeling pushed to their limit and overwhelmed, while still being committed to their work (see box below).

For example, one practice manager said: ‘I love my job and my team, but the job is becoming more demanding and stressful, the whole team is suffering the effects of the pressure on primary care and I fear it is not sustainable. I feel primary care is being failed by the government and unrealistic expectations.’ 

Another respondent said that ‘many colleagues are leaving the profession’ and that the problem of recruitment and retention of practice managers should be more widely acknowledged and addressed.

Full-time practice managers earn an average annual salary of £48,802, the report found.

It warned that a dissatisfaction with practice manager pay at a macro level will have serious repercussions on GPs’ ability to recruit top talent. ‘It is an area they will have to monitor and address if they want the practice manager profession to keep developing and be regarded as an attractive career choice,’ it said.

Meanwhile, respondent highlighted the upside of working in practice management, citing flexibility in the job, the variety of the role, and being able to work autonomously as reasons that outweighed concerns on pay and workload, and kept them wanting to stay in their current position.

The pay report, Practice Manager Salary Survey 2023/24: gauging the state of the profession, was launched earlier this week by Management in Practice.

You can now download a full PDF of the report here.

How are practice managers feeling?

Practice managers responding to our survey voiced their concerns about the pressures they are currently under and around levels of pay. Comments included:

‘I have over 35 years experience in general practice. I love my job but it is getting harder due to demands from patients and commissioners etc.’

[I] love practice management but the workload is increasing and the support is not there from NHSE to increase funding for more staff.

‘The job of practice manger has become so stressful over the years. We are expected to know everything, emails cascade into our inbox at an alarming rate and everybody wants a piece of you.’ 

‘Pay does not reflect the amount of work carried out, responsibilities and on call telephone calls during [the] weekend and when on annual leave.’

‘I have been a PM at the same practice for 34 years. This is the most disillusioned and pointless I have ever felt. The resources are so stretched that there is no job satisfaction left. It has become impossible to offer a consistent quality service.’

The job has changed exponentially from that which it was a decade ago. Not enough time, too much stress, isolation, lack of support.’

Reassuringly, there were some positive comments too. These included:

I love my job. Our GP partners are young, enthusiastic and devoted to their role. Together we have built up an excellent admin and nursing team and it is a pleasure to come to work.’ 

 ‘Primary care is still very rewarding – demanding but I still enjoy it.’ 

Read tips and advice on Retaining your practice manager: Valuing your secret weapon’ in Section 8 of the Practice Manager Salary Survey 2023/24 report