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Pursuing a portfolio career: a guide for practice managers

3 November 2023

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An increase in opportunities across primary care mean that practice managers’ valuable skills are in demand. Tracy Dell explains why practice managers may wish to consider a portfolio career alongside or instead of the traditional role within a GP practice

One of the main attractions of the practice manager (PM) role is the variety. But increasingly managers are struggling with the volume of work. The PMA’s State of Practice Management survey 2022 found that many practice managers feel overwhelmed with nearly 83% admitting to working longer hours than contracted and almost 80% feeling exhausted by their work in general practice. 

The worry is that burnout may force some of these experienced PMs out of primary care altogether. But there is another option – a portfolio career. 

A portfolio career refers to a working arrangement where an individual combines multiple part-time roles or projects to create a diverse and fulfilling professional life. For practice managers, it can offer exciting opportunities to contribute to the healthcare industry in different capacities. It allows practice managers to use their expertise and experience across various roles in different organisations. Some might choose to become a Practice Manager with Special Interest (PMwSI) whilst others will see it as a way to broaden their horizon.

I know firsthand how well a portfolio career can work. I work in general practice for a couple of days a week as a practice business manager and the rest of the time I’m a freelance consultant, trainer, guest speaker and mentor to new primary care managers. 

There is a breadth of options available to PMs who are interested in taking a similar route. What roles can they consider, what responsibilities do they involve, and what skills are required?

Managing Partner

As a managing partner, a PM takes on a leadership role in a medical practice or a group of practices. They are responsible for strategic decision-making, financial management, and overseeing the overall performance of the practice.

This role requires strong leadership skills, business acumen, and the ability to collaborate with clinicians and other healthcare professionals.

Experience as a practice manager, along with additional training or qualifications in business management, can be beneficial for those considering this career path.

Managing partners typically have self-employed status. They can have a fixed or profit share of the business depending on the partnership agreement.

Locum practice manager

A locum practice manager fills temporary management positions in medical practices during periods of absence or transition. This role involves stepping into various practice environments, adapting to different systems and teams, and ensuring continuity in practice operations.

Locum PMs need to be adaptable, flexible, and possess strong problem-solving skills. While experience as a practice manager is valuable, additional qualifications in areas such as change management or project management can enhance the prospects of a locum practice manager.

Locum PMs are typically self-employed or work as contractors.

Consultants or associates

A practice manager with the right expertise might choose to work as an associate or consultant with primary care networks (PCNs), integrated care boards (ICBs), local medical committees (LMCs), or federations. Consultants can work as independent contractors or be employed by healthcare organisations.

In this role, they offer support with practice management, workforce and financial planning, service development and operational efficiency. This career path requires in-depth knowledge of the healthcare system, strong analytical skills, and the ability to work collaboratively with different stakeholders.

PMs interested in becoming consultants may benefit from gaining experience in diverse practice settings and seeking advanced education in healthcare management or consultancy. It would also be advisable to network widely within the healthcare community.


This career path would suit practice managers with a passion for education and training. They can contribute to the development and delivery of training programmes for PMs, administrators, and other healthcare professionals.

This role requires excellent communication and presentation skills, as well as a solid understanding of practice management principles and regulations.

Practice managers interested in becoming trainers can enhance their prospects by gaining teaching or training qualifications, participating in continuing professional development (CPD) programmes and collaborating with other specialists. Those who have coaching or mentoring skills could provide this as a service to practices or PCNs. Likewise, a practice manager could be an appraiser. This type of role would be focusing on developing primary care managers and staff.

Making the leap to a portfolio career  

Transitioning into alternative career paths is exciting, but it can feel like a huge step for practice managers. However, one of the advantages of a portfolio career is flexibility, so practice managers can make changes in the way that suits them.

For example, PMs could take on a training role for a half or full day a week alongside a role in a practice if they did not want to commit to full-time consultancy.

A potential obstacle, though, is that GP partners may be unwilling to support managers who are keen to explore new ways of working despite it bringing benefits to the practice.  These benefits are significant. For example, practices and PCNs often deliver the same contracts but work differently to achieve this. Exposure to how others operate can provide valuable insight and knowledge that can be taken back to the practice. Equally, practice managers’ involvement with LMCs, ICBs, training hubs and GP federations can provide opportunities to pilot new programmes.

In the absence of a GP partner offering support, it may be wise to consider other sources of assistance to facilitate a successful transition.

For example, practice managers may need access to specialised training programmes and professional development opportunities. These can include courses on leadership, business management, consultancy skills, project management, or specific industry certifications.  On a practical level, practice managers will also need to think about platforms or resources that connect them with suitable job opportunities.  

Finances will be another area of support needed by some. Transitioning into a portfolio career may involve a shift in employment status, such as becoming self-employed or working on a contract basis. So, PMs managers may benefit from financial advice and support in navigating the complexities of tax obligations, managing income variability, and planning for retirement. This is available from a variety of sources such as Locum PM (see box) or different conferences and events.

Importance of peer support

CPD is crucial for practice managers looking to broaden their scope. Opportunities for CPD, such as conferences, workshops, webinars, and online resources, will enable PMs to stay updated on industry trends, best practices, and regulatory changes.

The importance of emotional and peer support cannot be understated. Transitioning into new career paths can be challenging and feel daunting and uncertain. Practice managers will find it very helpful to access peer support groups, forums, or communities where they can share experiences, seek advice, and find emotional support from other individuals who understand their professional journey (see box).

On the same theme, mentorship programmes that connect experienced practice managers with those exploring new career paths can be invaluable. Mentors can offer guidance, share their experiences, and provide insights into different roles.

Additionally, facilitating networking opportunities within the healthcare community allows practice managers to expand their professional connections, learn from others, and explore potential job opportunities.

In conclusion, practice managers have a wealth of career options open to them outside the traditional role within a GP surgery. By understanding the possibilities and support available, they can discover new avenues for growth and professional fulfilment. 

Exciting new opportunities are there for the taking.

Peer support

The Locum PM community is a joint venture I have created with Daniel Vincent, an ex-practice manager based in Somerset who now runs his own prescription reconciliation company. It is a vibrant and supportive community to support practice managers who want to explore a portfolio career.

Accessing our Facebook group – Portfolio Careers for Practice Managers – is free. It provides valuable insights, tips, and resources no matter what stage of the career transition.  

Locums who want more support can sign up to the higher level of subscription to access advice from specialists in areas such as HR and finance.

We plan to hold further retreats, workshops, webinars, network groups and one-to-one sessions in future.

Tracy Dell is Practice Business Manager at Cleckheaton Group Practice, West Yorkshire