The government's "Fit for the Future: 10-Year Health Plan for England" signals a seismic shift for the NHS. For UK GP Practice Managers, this isn't just another policy update; it's a fundamental rewiring of the environment you work in. The plan’s vision is to move from a system of small, reactive practices to one of large-scale, digitally integrated community hubs focused on proactive population health.
This transformation presents both an existential challenge and a significant opportunity. The traditional role of a Practice Manager is set to evolve dramatically, moving from the operational lead of a single business to a strategic leader within larger, more complex networks.
For busy managers, the key question is: what does this mean for me and my career? What skills do I need to simply keep up, and what capabilities will I need to thrive and secure a senior role in this new landscape?
This roadmap breaks down the essential skills you need to invest in, separating them into two key areas: the core skills for navigating the immediate changes, and the strategic skills for becoming a leader in the primary care of the future.
Essential skills for today's changing landscape (The 'survive' skills)
The changes outlined in the 10-Year Plan are not a distant prospect; they are happening now. The rollout of new provider contracts and digital tools is aggressive. To ensure you and your practice remain viable, mastering these foundational skills is non-negotiable.
At-scale collaboration and integration The era of the isolated practice is over. The plan's entire structure is built around encouraging GPs to "work over larger geographies by leading new neighbourhood providers".
What this means for you: You must shift from managing a single entity to operating as part of a wider network. This involves building strong relationships with neighbouring practices, formalising collaboration within your Primary Care Network (PCN), and exploring mergers or federations.
How to build this skill now: Propose and lead a joint project within your PCN. Start with something tangible, like creating a shared bank of locum staff, developing a standardised protocol for a non-clinical area (like complaints handling), or running a joint procurement for a service like waste management. This gives you direct, hands-on experience in cross-organisational project management and negotiation.
Digital literacy and tech implementation The plan is clear: the future of the NHS is moving "from analogue to digital". For practices, this means digital transformation is not an optional extra but the core of the new service model. The NHS App is set to become the "full front door" to services by 2028.
What this means for you: You are the on-the-ground implementation lead for this digital shift. You will be responsible for overseeing the adoption of new system-wide technologies, from cloud-based telephony to the Single Patient Record (SPR) and AI tools.
How to build this skill now: Become the practice champion for a new piece of technology. Take full ownership of the rollout of your new digital telephony system or an online consultation platform. This means going beyond simple implementation; analyse the data it produces (e.g., call waiting times, peak demand hours) and present insights to the partners on how to use the tech to genuinely improve workflow and patient access.
Deep experience with Artificial Intelligence (AI) AI is singled out in the plan as a key enabler for reducing administrative load and supporting clinicians. As a manager, you need to move beyond seeing AI as a buzzword and start building a practical understanding of its capabilities and, just as importantly, its limitations.
What this means for you: You need to become the person in the practice who can critically evaluate AI tools and advise on where they can be implemented safely and effectively. This requires hands-on experience.
How to build this skill now: Start by researching and trialling AI-powered tools for non-clinical tasks. A safe, low-risk starting point is to experiment with AI in administrative areas that don’t involve patient data. For example, using a tool like My Practice Manager to generate draft policies and procedures can be an excellent way to learn how to write effective AI prompts and understand the technology's strengths and limitations before considering higher-risk clinical applications. This hands-on learning is crucial for building the expertise to assess more complex tools like AI scribes in the future.
Diversified workforce and HR management The practice team of the future is a broad multidisciplinary team (MDT). Your role will expand to coordinate a more diverse workforce, including clinical pharmacists, physician associates, health coaches, and social prescribers, all working together in Neighbourhood Health Centres.
What this means for you: You will manage the integration and workflow of these new roles, ensuring they are used effectively to reduce GP workload and improve patient care.
How to build this skill now: Volunteer to take the lead on integrating a new ARRS role across your PCN. Create the induction plan, design the rota, and map out the patient pathways and referral criteria. By becoming the go-to person for making a new role a success, you gain invaluable experience in complex HR and operational integration.
Strategic skills for tomorrow's senior leaders (The 'thrive' skills)
Beyond survival, the 10-Year Plan creates a pathway for ambitious Practice Managers to become senior strategic leaders within 'Multi-Neighbourhood Providers' or Integrated Care Systems (ICSs). These larger entities will require a new breed of manager with a skillset more akin to a chief operating officer.
Data analytics for population health The reformed NHS will be data-driven. Funding and performance will be linked to demonstrating value through improved population health outcomes, not just activity.
What this means for you: To lead at a senior level, you must be able to interpret and act on a wide range of data, from clinical outcomes and patient experience metrics to predictive analytics that identify at-risk populations.
How to build this skill now: Start a small-scale Quality Improvement (QI) project. Choose one specific metric to improve, such as reducing DNAs for nursing appointments or improving uptake for health checks in a specific demographic. Take personal responsibility for gathering the data, analysing the trends (even with a simple spreadsheet), implementing a change, and presenting the results to the partners. This builds real-world experience in the full data-to-improvement cycle.
Complex financial and contract management The plan introduces novel payment models designed to reward outcomes. These include capitated 'Year of Care' budgets and performance-related bonuses, with trials starting as early as the 2026-2027 financial year.
What this means for you: A senior manager will be responsible for navigating these complex new financial models, managing large, risk-based budgets, and ensuring the financial sustainability of the entire network.
How to build this skill now: Take a more active role in your practice's financial planning. Ask the partners if you can shadow or assist with creating the next annual budget. Volunteer to model the financial impact of a proposed new service or hiring an additional ARRS role. Getting comfortable with this level of financial modelling is the fastest way to develop the acumen needed to manage future capitated budgets.
Strategic planning and system leadership The ultimate vision is a devolved NHS where high-performing providers are granted greater "earned autonomy". The leaders of these systems will not just be managing services; they will be designing them.
What this means for you: The Practice Manager of the future is a strategic leader responsible for estates strategy, digital transformation roadmaps, and workforce planning across multiple neighbourhoods.
How to build this skill now: Proactively draft a 3-year development plan for your own practice or PCN. Base it on the goals of the 10-Year Plan. Think about the physical space, technology, and staffing you would need to become a successful 'Neighbourhood Health Centre'. Presenting a forward-thinking, strategic document like this to your partners demonstrates your leadership potential and shifts your role from operational to strategic.
The message from the 10-Year Health Plan is clear: the role of the Practice Manager is becoming more complex, more strategic, and more crucial than ever. By investing in these skills today, you can not only navigate the immediate challenges but also position yourself to lead the transformation of primary care in the decade to come.
Disclaimer: This article is for informational purposes only and reflects understanding as of 3 July 2025. It does not constitute legal, financial, or medical advice. Practices should consult with relevant professional bodies or legal counsel for specific circumstances and always refer to the latest official NHS England (and other relevant bodies) guidance and contractual documents.