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Independents' Day

Practice managers pushed into sick leave amid rising work pressures

Rising workloads are pushing experienced practice managers to take time off work or even think about resigning, with CQC registration being described by one LMC as ‘the final straw’ for some strained practice managers.

Somerset LMC said that it has been ‘shocked by the number of calls it has received from PMs and the numbers taking sick leave or even resigning’. The LMC has opened up its GP pastoral services in response so that PMs are now able to access anonymous advice or mentoring services on how to cope with pressures.

The measures may be followed elsewhere in England, with Norfolk and Waveney LMC set to embark on a practice survey to identify how it may be able help struggling PMs and to be able to raise concerns on a national level.

Writing in the LMC newsletter, Norfolk and Waveney LMC chair Dr Tim Morton said: ‘The LMC is aware of an increasing number of practice managers feeling the strain of the exponentially increasing workload they face. Practice managers are an integral part of running a practice and the sudden loss of one would most likely destabilize any practice. The LMC is therefore keen to extend its GP pastoral support to Practice Managers and will be putting an item in the LMC Practice Managers’ Newsletter asking for thoughts on how this could best be delivered.’

‘We therefore ask you to please fill in the survey to help the LMC ensure it is able to share its concerns nationally and provide the necessary support to practices. If individuals have suggestions and thoughts on this matter not covered by the survey we would be keen to hear from you.’

Jill Hellens, executive manager of Somerset LMC, said: ‘This is something that has evolved over time. You start to notice more stress coming in, more work coming in and experienced practice managers starting to take time off sick, think about resigning, and I’ve had one experienced practice manager who has actually resigned. They resigned because the workload was just too huge. For GPs it has become very large, for practice managers it has become equally large, an increasing workload comes across their desk, in their email inbox, and probably the CQC was the final straw for a lot of them.’

‘They’ve tried to delegate, they have done all they could do but like everything there comes a point when the practice is just saturated. It is just a symptom of what is going on in primary care.’

‘Concerns over future practice funding is another concern that adds to the pressure on practice managers.’

Readers' comments (7)

  • This comes as no suprise to me, I have been a PM for the last 17-18 years and this is the most stressful time I can think of. 20-30 plus emails a day constantly moving targets, fluid CCG's its just demand, demand, demand, with very little patient centred care we are all good at delivering. Something has to give and I am already starting to bail out before I fall over.

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  • For many PM's they have no one to delegate to. Significant numbers of administrative staff are mature ladies who work for 'pin' money, with little or no incentive to go an 'extra' mile, as they don't need the money or the hassel! (Makes appraisal virtually pointless - some just happy to be alive in 5 years time!) It's not just the increase in admin tasks that the PM's have, it's staff unaware/ not wanting to know what is going on and then feeling isolated, with a sudden comment such as,"Can you get the Xmas decorations down" emphasing the fact that no one seems to care! Of note my GP's do understand and fully support me, if it wasn't for their appreciation I would have resigned by now.

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  • The workload for PM's has been becoming more and more unmanageable over the past few years. Too many changes in the NHS and the goalposts ever shifting. I decided to take early retirement a month or two back after 22 years in the job. Whilst I enjoyed it for most of the time, there comes a point... and probably CQC was one of the final straws. Of course the demands on GP's have become enormous too, but usually they have Partners with which to share the burden. PM's can often feel quite isolated in their role.

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  • Totally agree with both of the previous comments. I have only been in the role 4 years but I am seriously considering resigning in the New Year. I feel very isolated and the CQC is a burden that I am having to manage virtually on my own.

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  • My question is what are the PM employers doing to manage their staffs workload.

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  • Most employers are the GP's who are just as busy with the 'worried well' , Daily Mail readers, targets, pathways et al. Mine are fully supportive and we drown our sorrows together! I owe them my loyalty and they appreciate it. The patients have no idea and the staff don't want to know and are tired of 'there's no money' they just expect the money to continue to flow in but are oblivious the real world. Though to be honest mine fill me with tea and cake so I don't leave!

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  • This is a really difficult one and it is not actually very easy to come up with a workable solution. Most GP Practices are a small business where by necessity the payroll is kept small - not here the grand designs for role expansion and grade inflated salaries we see in the wider NHS. Because the payroll is small the management function is kept lean and efficient (normally only one person and sometimes part time) and it is only in the largest Practices where some assistance can be afforded.

    The organisation is a management guru's dream - small. lean, efficient and FLAT (no hierarchy). The PM is at the hub of the organisation but without the scope or capacity for delegating tasks. Remember GPs are an expensive asset - they should be beavering away at what they have been trained for - delivering clinical service.

    PMs are victims of their own success - able to cope and manage the business in 'normal times' with the capacity to surge in times of exceptional but time limited demand - they are now faced with an onslaught of change, uncertainity and with very little support from the PCT (in its death throes). PMs are at the limits of that surge capacity and that has become the new level of working the exceptional has become the norm - it is frankly unsustainable.

    For all those PCT Managers who think that there may be a PM job open to them think of this:

    1. Have you got the range and span of skills required (No HR dept or Payroll dept to go running to).
    2. Can you translate talking about work to actually doing it (yourself).
    3. Can you absorb a reduction in salary of between £15 to £20K?

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