ARRS linked to reduced prescribing, study suggests

GP practices with more staff employed through the additional roles reimbursement scheme (ARRS), including pharmacists, have 'lower' prescribing rates, a study has suggested.

Published in the British Journal of GPs (BJGP), The effects of ARRS staff in England on prescription patterns and patient satisfaction, found that the hiring of ARRS staff was ‘significantly associated’ with lower prescription rates and higher patient satisfaction.

The study found that practices with more ARRS staff had lower prescribing rates for all prescriptions, including statins, analgesics and antibiotics, but they were particularly low for mental health medications.

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And it recognised that pharmacists were 'by far the most common [ARRS] role'.

The study also found that overall patient satisfaction was high, with patients especially satisfied with the management of long-term conditions.

The researchers from the Universities of Oxford and Bristol also found that ARRS staff tend to be hired in large practices and those with a shortage of GPs. They were also more common in surgeries with a greater number of overseas-trained GPs.

The study concluded the scheme had ‘potential to have a positive role in primary care’ because of the reduced prescribing and high patient satisfaction.

But the study authors warned that further research was needed to explore the long-term effects of ARRS on primary care, including patient outcomes and health care costs, and the potential barriers to its implementation.

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Additional research was also required to test the link between ARRS and the findings, said the researchers, since the associations were not necessarily causal.

For example, the paper said that the lower prescribing rate could be attributed to the strong emphasis on adherence to guidelines in the training of advanced practitioners, and to the availability of a wider range of forms of help, which may reduce the need for prescribed medication.

And the study said that ARRS staff may improve satisfaction, especially for patients with ongoing health conditions requiring regular monitoring and coordination, by providing more time with a broader care team.

Further research should explore whether specific ARRS roles, such as health and wellbeing coaches, drive improvements in satisfaction with long-term condition management, the researchers said.

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The study included data from more than 6,000 general practices between 2018 and 2022. The ARRS was introduced in England in 2019 to increase access to general practice.

A version of this article first appeared on our sister title Pulse PCN.