Financial Stress in Practices: Rethinking Pay and Support

Financial pressures between pay cycles are increasingly affecting primary care staff, with new data showing that one in five UK employees has requested early access to their wages to cover essential costs 

CREDIT: This is an edited version of an article that originally appeared in People 2 People

Within GP practices, where workforce pressures are already significant, this trend adds another layer to staff wellbeing considerations. Despite recent pay increases in some areas, many employees continue to find it difficult to manage monthly expenses, with a substantial proportion relying on credit or borrowing to bridge the gap between pay days. 

There is also growing interest in more flexible pay arrangements. Nearly half of UK workers say they would prefer to receive their salary in smaller, more frequent instalments, while many want greater control over when they are paid. For practice staff balancing demanding roles with rising living costs, this flexibility could help reduce financial stress. 

For practice managers, this raises practical questions about how best to support teams. While NHS and practice payroll systems can limit flexibility, there may still be opportunities to explore financial wellbeing initiatives. 

What GP practices can do within current constraints 

Even where payroll flexibility is limited, practice managers can still take practical, meaningful steps to support staff financial wellbeing. 

1. Explore salary advance and earned pay options

Some practices are beginning to work with third-party providers that offer salary advance or earned wage access schemes. While not suitable for every setting, these approaches can provide short-term relief for staff facing unexpected costs, without requiring changes to core NHS payroll systems. 

2. Strengthen signposting to financial support

Many staff are unaware of the support already available to them. Practices can play an important role in signposting services such as NHS financial wellbeing resources, credit union schemes, debt advice charities and local support networks. 

3. Use flexible non-financial support where possible

While pay structures may be fixed, other forms of flexibility can still make a difference. This might include: 

• Greater control over shift swaps or working patterns where feasible  

• Access to wellbeing time or protected breaks  

• Support with travel costs or onsite facilities that reduce daily expenses 

Supporting staff in a constrained system 

While NHS and practice payroll systems may limit structural flexibility, there is still scope for meaningful action. The key lies in recognising financial wellbeing as part of workforce sustainability, not a separate issue. 

For practice managers, the challenge is not to solve wider economic pressures, but to ensure that within existing constraints, staff feel informed, supported, and able to access help when they need it.