The survey of 216 UK practice managers found that over the last two years 95.7% reported increased workload complexity, with rising intensity (94.8%), stress (90%) and hours (79%).
Recent workload had prompted 67.3% to contemplate quitting their job, the poll found. A total of 64% had thought about moving out of work in general practice, 42% about leaving the NHS and 35.3% had contemplated either retiring or reducing their hours.
One respondent said: ‘When I’m not working I spend time worrying about all the things I’m not doing. I have to prioritise work that is compulsory (CQC) or paid. I just try to fit in all the other stuff when I can.’
Another said: ‘I’m a practice manager of a small single-handed surgery. I should only be working part-time but the workload is increasing and I feel that my health is suffering as a result.’
Another added: ‘I’m totally stressed and I have no work/life balance. I love my job but practice funding has been reduced. We can’t employ staff to make the job easier.’
Carole Cusack, Wessex LMCs' director of primary care, said: ‘The LMC has been shocked by the number of calls it has received from worried and stressed practice managers together with the high numbers taking sick leave or resigning.
‘The lack of support and sense of isolation can even mean that practice managers feel unable to attend practice manager groups and other meetings where assistance for some of these problems can be found, which leads to further isolation.’
She said many practice managers report the lack of support from their partners who are also struggling with the increase in workload due to the complex medical needs of their increasing elderly populations and the sometimes unreasonable demands and aspirations of patients fuelled by the media.
Wessex LMCs has developed a variety of projects to assist with workload, stress and burnout including holding briefing sessions on federating, merging and collaboration which are open to both practice managers and GPs where specialist advice can be obtained from medical solicitors and accountants.
Ms Cusack added: ‘Our practice manager supporters scheme is going from strength to strength and we now ensure that all new practice managers are assigned a supporter from day one as well as advertising the supporters to all existing practice managers who may just need clarification on a particular issue or a discussion with someone who knows what they are going through. We will continue to do everything we can to support these highly skilled managers.’
BMA deputy chairman Dr Kailash Chand said: ‘Practice managers are working harder than ever before to meet the needs of the practice. We are seeing a morale dip to a level that I cannot remember in my 35 years as a GP.
‘This could lead to a serious workforce crisis. The cause is that practice managers along with GPs are facing an unprecedented combination of rising patient demand, unnecessary targets and duplication of paper work for various quangos like the CQC. The government is also asking practices to provide more services, including many involving the transfer of hospital care into the community, without the resources required to successfully deliver them.
‘We need politicians to realise that in order to meet the challenges facing general practice, we need to value the hard work managers are undertaking by supporting them properly. Most importantly, the government needs to work with all healthcare professionals and patients to find practical solutions to a crisis that is threatening to overwhelm general practice. The recruitment and retention crisis in general practice is getting worse by the day.’
Tom Brownlie, chief executive officer of AMSPAR (Association of Medical Secretaries, Practice Managers, Administrators and Receptionists) said: ‘Sadly this reflects what we are hearing throughout the country. Much of the focus has been on the GPs but the practice cannot function without the administration staff. There is little prospect of improvement in the near future as resources are likely to be reduced at a time when greater access is being expected. We are receiving ever greater numbers of enquiries for our qualifications as staff seek to develop their skills to work as efficiently and effectively as possible.’