In an NHS already under pressure, the shortage of skilled Practice Managers has become a critical but under-discussed problem. As surgeries battle rising patient demand, complex compliance requirements, and workforce instability, the person holding it all together—the Practice Manager—is harder than ever to find.
At The Practice Professionals, we see this every day. Practices across the country come to us saying the same thing: “We just can’t find anyone suitable.” So why is recruiting Practice Managers so difficult in 2025—and what can be done about it?
🧩 A Role That’s Grown in Complexity
The modern Practice Manager is no longer just an administrator. They are:
- An HR lead, handling recruitment, retention, staff wellbeing, and disciplinaries
- A finance manager, overseeing budgets, claims, payroll, and contracts
- A compliance officer, ensuring CQC standards, safeguarding, and policy updates
- A systems expert, navigating EMIS/SystmOne, online access tools, and telephony
- A strategic partner, working with GPs, PCNs, the ICB, and wider networks
All of this happens in real time, often under pressure, with limited support.
The result? Burnout, turnover, and a shrinking pool of candidates willing—or able—to take on the challenge.
📉 Why the Talent Pipeline Is Shrinking
There are several key reasons behind the recruitment struggle:
1. Retirement and Burnout
Many experienced managers have left the profession post-COVID, citing stress, long hours, and insufficient recognition.
2. Lack of Structured Training
Unlike clinical roles, there is no formal national pathway for becoming a Practice Manager. Most learn on the job, often stepping up from admin roles—meaning experience levels vary widely.
3. Mismatch of Expectations
GP partners often want someone strategic and hands-on, confident and calm, experienced and affordable. In reality, few people tick every box.
4. Geographic and Pay Disparities
In some areas, particularly rural or high-deprivation locations, it’s simply harder to attract qualified candidates—especially when private sector roles may offer more money for less stress.
⚠️ The Impact on Surgeries
When a surgery can’t find the right manager, the ripple effects are immediate:
- Team morale drops
- QOF and IIF targets are missed
- CQC risks increase
- GPs feel the pressure directly
- Recruitment and retention across the team suffer
In some cases, practices enter serious operational difficulty, requiring interim or turnaround management just to stay afloat.
🧭 What Can Be Done?
There’s no magic fix—but there are proven strategies that help:
✅ Start early – Don’t wait until crisis hits. Succession planning is essential.
✅ Be realistic and flexible – Focus on key priorities and be open to training the right person, rather than waiting for a unicorn.
✅ Use specialist recruiters – Generalist agencies may not understand the nuance of NHS operations. Agencies like ours specialise in matching the right people with the right challenges.
✅ Offer support, not just salary – Training, mentoring, hybrid options, and a clear onboarding process can help attract and retain talent.
✅ Consider interim solutions – Locum or fixed-term Practice Managers can keep the practice stable while a long-term hire is found.
🤝 We’re Here to Help
At The Practice Professionals, we work exclusively in the primary care space. Whether you need a full-time Practice Manager, a part-time Assistant, or a skilled interim to steady the ship, we’ve built a trusted network of people who understand what’s needed—and who are ready to make a difference.