Calls for GPs and practice nurses to be included in ARRS

Practice makes GPs redundant in favour of ARRS staff

Primary care network (PCN) leaders support a proposal for GPs to be employed through Additional Roles Reimbursement Scheme (ARRS) funding, but suggest that spending on other roles should still be protected, our sister title Pulse PCN has been told.

ARRS funding is currently ringfenced for general practices in England to employ additional members of the multidisciplinary team within specific roles, but cannot be used to employ doctors and practice nurses.

Between 2019 and 2022, 46% of the total funding was spent on the recruitment of clinical pharmacists.

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Last week, locum GP Dr Stephen Katona last week launched a petition arguing GP practices should be able to use the money to pay for roles currently excluded from the ARRS – namely practice nurses, and salaried and locum GPs.

The petition currently has more than 3,200 signatures and has been supported by the Doctors’ Association UK. At 10,000 signatures, the government will be required to respond to the petition.

Dr Sarit Ghosh, clinical director at Enfield Unity PCN, said that he 'would be very supportive of using a proportion of ARRS funding for locum GPs which would allow more flexibility in how we deliver services, maintain resilience and help maximise use of budgets'.

And he suggested that ARRS spending on GPs could be capped at 10-20% of the allocated funding 'so as not to destabilise the other roles'.

He also stressed that funding GP activity through the core contract should remain.

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Others highlighted that adding GPs to the ARRS would not address the challenge of recruiting doctors.

Dr Kieran Gilmartin, clinical director of Fareham and Portchester PCN, said: ‘It would be good to add [GPs] but the issue is that there are not enough of them out there to recruit. On top of that, in many cases ARRS funding will be taken up by other roles. In our PCN for example, we have no budget left to spend of ARRS.’

He added: ‘All roles should have been available under ARRS from the start, without such restrictions on roles which have been gradually added to over time.’

The government has refused to say whether it has any plans for GPs to be included in the scheme going forward.

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Community pharmacy representatives have previously called for ARRS funding to be opened up to support roles in the community to help retain pharmacists in the sector.

This article first appeared in our sister publication Pulse PCN, covered by senior reporter Jess Hacker.

GPs made redundant in favour of ARRS staff

A Surrey GP practice is making three GPs redundant, citing ‘new ways of working’, including virtual appointments and the use of ARRS staff.

The 19,000-patient practice invited its 11 salaried GPs to apply for voluntary redundancy in December, and the three who took up this offer will be leaving at the end of March, according to the BBC.

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Managing director Joe Todd said that the introduction of 'many new roles at the practice', including pharmacists, meant that the team was 'working differently and more efficiently to help people get the care they need from the right healthcare professional’.

‘As we have started to work differently, we have needed to re-look at our staffing so we are aligned to deliver services in this new way,’ Mr Todd added.

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Surrey Heartlands ICB told our sister title Pulse that practices in the area are taking forward ‘a range of improvements for patients’ in line with NHS England’s GP recovery plan.

A spokesperson said: ‘Practices are already working differently due to an increase in the use of online services, where Surrey has some of the highest usage rates in the country, and other changes that are happening nationally, including the introduction of new roles, where the NHS is bringing in professionals with very different skills, to enhance the practice team and the local offer to patients.

‘As a result of these changes, the practice has re-looked at how they operate and considered opportunities to work more efficiently, including the workforce they need moving forwards – and the changes they are making locally, reflect this.'

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A version of this article first appeared on our sister site Pulse, covered by reporter Eliza Parr.

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