Only ‘enhanced’ practice nurses will be added to the additional roles reimbursement scheme (ARRS) in 2024/25, NHS England has announced.
This covers only a specific level nurse as opposed to all GPNs, and the move has not been agreed by the BMA’s GP Committee for England.
A contract letter sent this afternoon by NHS England said nurses ‘working at an enhanced level of practice’ and holding a level seven or above postgraduate certification in one or more specialist areas of care will be eligible for recruitment via ARRS.
As a new role, this will initially be capped at one per PCN – or two where the list size is 100,000 or over – and PCNs will be able to recruit other direct patient care non-nurse and non-doctor MDT roles, if agreed with their ICB.
According to the Primary Care and General Practice Nursing Career and Core Capabilities Framework, enhanced practice nurses are a level above registered nurses and below advanced and consultant level practice nurses.
In a letter to practices, detailing the changes, NHS England primary care director Dr Amanda Doyle said: ‘We know that the ARRS has been hugely successful in expanding teams, increasing appointments and supporting the delivery of proactive care, but we have heard that PCNs would welcome more flexibility in how the scheme operates.
‘We are widening the number of reimbursable roles and removing role restrictions.’
The letter also said that in 2024/25 the mechanism which allows commissioners to redistribute unclaimed funding from the Additional Roles Reimbursement Sum between PCNs will be removed from the Network Contract DES.
Other changes to the ARRS include:
- Caps on advanced practitioners will be removed.
- PCNs will be able to claim reimbursement for the time personalised care roles spend out of practice undertaking training or apprenticeships to obtain a level three occupational standard.
- Where PCNs already have one mental health practitioner (MHP) in place, 50:50 funded by the PCN and the mental health provider, funding arrangements for subsequent MHP roles will be for agreement between the PCN and the mental health provider, subject to ICB approval. This could include additional MHPs being up to 100% funded through ARRS. All mental health practitioners will continue to be employed or engaged by the mental health provider.
The Department of Health and Social Care (DHSC) had previously said that ARRS, which currently allows recruitment of 17 roles in primary care but not GPs, would be expanded as part of the contract to cover nurses and mental health practitioners.
As part of the negotiations, the GPC had also demanded for GPs to be included in the ARRS, and a petition with the same aim has gathered thousands of signatures.
This will allow ARRS to become responsible for even more secondary care work that they should be doing rather than strengthening core general practice.