Workload and remuneration of medical managers in primary care
May 2007
The changes to the consultant and GP contracts and increasing workload have highlighted the fact that pay arrangements for medical managers need to be formalised. At present remuneration for medical management work varies considerably between organisations. In 2005, the Clinical and Medical Directors Subcommittee conducted a survey of clinical and medical directors’ pay in the hospital sector. This reinforced the impression of the Subcommittee that the circumstances in primary care were quite different and that a separate survey needed to be undertaken.
In 2006, the Subcommittee worked with the BMA’s Health Policy and Economic Research Unit on a survey of medical managers in primary care. The questionnaire was sent to the medical director/Professional Executive Committee chair/clinical governance lead in all PCTs across England. This report presents the results of the survey.
Download the report as a PDF here or by using the link on the right.
Summary of the results
- Two in five respondents are currently employed as medical director and almost half are employed as PEC chairs. The majority of respondents are GPs. Three quarters of respondents are male and the vast majority are of white ethnic origin.
- Respondents were asked to quantify the time contracted to undertake management duties. A third of respondents reported this in terms of hours: average of 27 hours. The remaining respondents reported their contract commitment to management duties in terms of sessions: average of 5 sessions.
- The majority of respondents report that they work extra hours in addition to their contract hours on management duties. In most cases these extra hours are worked every week, or at least most weeks.
- Three quarters of respondents are currently responsible for managing poor performance in general practice and three out of five are responsible for performance management of GMS/PMS quality and outcomes framework. More than half are responsible for performance management of GMS/PMS quality and enhanced services and 60 per cent of respondents are currently responsible for GP appraisal. Three out of five respondents are currently responsible for clinical governance, largely in relation to general practice.
- Around a third of respondents report having a job plan, which, on the whole, covers management duties. Less than two-thirds of respondents have had or expect to have an annual job plan review.
- Half of respondents are on contract for their management work only and a fifth have an additional contract for management work. Of those respondents on a management contract, half are based on an NHS management contract.
- Three-quarters of respondents report that their management pay has been increased annually. This increase is largely on the basis of the general NHS pay award. The basis for remuneration has not changed in the last 12-24 months for the majority of respondents.
- The average estimated gross pay for management duties is £46,758, but varies from an average £37,747 for PEC chairs to an average £56,000 for medical directors. Two-thirds of respondents continue to have clinical responsibilities in a GP practice, in addition to their current management duties.
- Two out of five of respondents report that their management responsibilities have an impact on the partnership agreement. Such impacts include shared income with the practice and management work undertaken in practice time, resulting in reduced clinical sessions.
- In half of cases, locums are required to cover absences from the practice whilst respondents undertake management duties. In two-thirds of cases, locum costs (average is £603 per week) are met by the organisation for whom the management duties are being undertaken.
Download the report in PDF format here (65 KB)
To view and print PDF files, you must have Adobe® Acrobat® Reader installed.Download Adobe here