The evolving role of practice managers: Challenges and opportunities in the UK

A key member of every GP Partnership is the Practice Manager (PM). They fulfil a central role in ensuring smooth operations across finance, HR, compliance, and strategic planning. The role has certainly grown in scope and complexity over recent years. They are the lynch pin of the practice and can often be a primary reason as to whether a GP partnership is “successful” or not.

In the modern-day medical environment, as well as looking after the traditional area of finance, a Practice Managers role has evolved to include leading the partnership, looking after the staff, liaising with the PCNs and other groups, as well as trying to ensure that the patients are well cared for and that there are enough Doctors working. They need to be resourceful, adaptable, innovative and (of course) be able to work all the computer systems!

They face a number of challenges and opportunities which require all these skills.

Key challenges for practice managers

Financial pressures

Practice Managers are facing rising costs, changing NHS contracts, and workforce constraints. This means Practice Managers need to be able to plan and be highly skilled in financial management, and cost-saving strategies. At this time of year they need to be working with the Accountants to complete the Class 1 Superannuation certificates. They must budget for any catch-up of contributions which may potentially need to be paid by the end of March (to obtain tax relief at the earliest time). They have to consider the impact of minimum and living wages on their staff salaries, and calculate the impact in the increase in employers National Insurance contributions from April 2025. They also need to consider whether the Practice can consider pay rises and the impact this will have on staff morale and retention.

Regulatory compliance

Traditionally the Practice Management team can be very small – often just the Practice Manager themselves. This is increasingly a lonely position to be in, especially with increasing CQC requirements, data protection laws, and NHS policy changes. These levels of increased workload, mean that Practice Managers need to ensure that they are on top of their policies and compliance and governance.

Workforce management

Another major challenge is the recruiting and retaining staff, managing wellbeing, and navigating HR complexities at all levels. This includes ensuring that minimum and living wage legislation are adhered to, considering using ARRS staff, and the mix between partners and salaried GPs and the use of locums. Other issues they need to consider are IR35 and flexible working.

Technology & digital transformation

It often feels that the Practice Manager also needs to be an IT genius! This ranges from ensuring that all the correct templates are filled in by the GP Partners to maximise QOF points, all the way through to implementing electronic patient records. They also oversee the need for a well designed Practice website, the design and maintenance of an efficient booking in and recall system for patients, and ensuing the safety and security of sensitive patient data at all times.

Patient expectations & access

At the heart of GP practices is the patient. At all times the Practice Manager must balance the cost and efficiencies of running the practice with the demands and needs of the patients. Great care needs to be taken in balancing the demand for services with resource constraints. A Practice Manager must manage an effective appointment and triage system and communicate clearly with the patients, as well as to the GP partners and staff.

Opportunities for the modern practice manager

As well as being challenging, the role of the modern day Practice Manager does offer many opportunities.

• Strategic Leadership – If they haven’t always been, it is very much the case that Practice Managers are key decision-makers, who are helping to shape the long-term sustainability of GP partnerships.
• Collaboration & PCNs – The Practice Manager now has the opportunity to work with Primary Care Networks (PCNs) and Integrated Care Systems (ICSs). This gives the GP partnerships and partners access to shared resources and funding opportunities.
• Data-Driven Decision-Making – The importance of technology and innovations has led to the greater use of financial and operational data to drive efficiencies and improve patient outcomes.
• Training & Development – It is imperative that the GP practices and Practice Managers invest in leadership training, finance skills, and digital expertise to help to ensure that the GP practice is run as efficiently as possible, offering a safe and enjoyable working environment for the GP Partners and staff, whilst offering a modern day health service to the patients.

Many Practices have recognised the importance of the Practice Manager and have appointed them as Partners of the Practice.

Conclusion

The role of the Practice Manager is certainly more demanding then ever in the modern day health care environment. GP Partnerships are facing an ever increasingly difficult mix of navigating financial, regulatory, and technological changes, and the Practice Managers ability to adapt, innovate and lead/guide can be crucial to the long-term success, and even survival of the Practice. It is important that every GP Practice invests in and supports this role.

Ballards, specialise in supporting practice managers and GP surgeries with tailored financial and operational solutions designed to ease the burden.

Whether it’s handling bookkeeping, streamlining payroll, resolving pension discrepancies, or providing real-time financial insights, our team of experts is here to help. We provide a full range of services to advise the individual Partners, the GP Partnerships (and the Practice Manger), as well as the larger PCN/Federation/ICB. We also offer website design and digital transformation advice to our clients. We are more than accountants. Get in touch to speak with our specialist medical team about how Ballards can support your practice.

Ballards are very proud of the support and advisory role which they fulfil for the Practice Manager and the GP Partnership as a whole. Please don’t hesitate to reach out if you require assistance to perform your difficult role.

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