Primary care networks in England used less than half of the funding they were entitled to last year to recruit additional clinical staff, leaving CCGs with the surplus.
Just over 40% of the additional roles reimbursement (ARRS) scheme money in 2019/20 went towards hiring clinical pharmacists and social prescribers, according to data supplied to Pulse by 77 CCGs.
The leftover funding was in some cases redistributed to other PCNs, as NHS England ‘strongly encourage[d]’ CCGs to do last year.
But 22% of the cash – or £9.8m – was still unspent by CCGs at the end of June, when Pulse requested the data through a freedom of information (FOI) request.
The total value of the ARRS scheme for 2019/20 was £110m, meaning if this were extrapolated across the country, CCGs could be holding on to around £24m to which PCNs are entitled.
GPs said it has been ‘predictably slow’ getting hold of the surplus cash, with some having ‘no idea’ where the remaining money went.
Pulse’s data reveal the 77 CCGs were entitled to a maximum reimbursement sum of £43.9m, but only used £18.2m (42%) on hiring the two roles in 2019/20.
Some CCGs said they had spent a small portion (£2.2m) of the leftover money on hiring extra clinical staff under the 2020/21 ARRS, while others said they had handed much of the surplus funding over to PCNs or to offset wider primary care commissioning budgets.
But a total of 39 CCGs were still sitting on £9.8m (22%) of 2019/20 ARRS funding in June (see chart below).
GPs said it had been hard to recruit staff in 2019/20 as PCNs were in competition with each other to offer the best salary amidst staff shortages.
They said the remaining funding should be handed back to PCNs to invest in staff training and support.
Dr Mike Smith, clinical director of Abbey Health PCN in Herts Valley, said: ‘In Herts Valley, to get hold of a clinical pharmacist has proved something of a challenge because of the lack of availability of trained medical professionals.
‘Last year, three pharmacists replied to our advert, but we found they’d all applied to other PCNs in the area. So inevitably they went to the networks paying the most money – and they were offering 40% more than the salary reimbursed by NHS England.’
He added: ‘Getting the unspent money has been predictably slow and complicated. I believe there are sensible plans locally to use it for a bolstered flu campaign but I haven’t seen any details.’
Dr Geetha Chandrasekaran, clinical director of North Halifax PCN and a GP partner in the town, says the PCN under-recruited last year but she has ‘no idea’ where the unspent funding went.
She said: ‘If we could have used the funding for other things, even training for existing ARRS roles or supervision and support, we might have actually been able to recruit more people… it’s a shame that the money will get lost to primary care.’
A spokesperson for NHS England said: ‘Expanding the primary care workforce remains a top priority to achieve improvements in patients’ care, and support practice staff.
‘That is why we have taken significant steps this year to support PCNs, including raising the reimbursement rate for new staff, increasing the number of PCN roles from two to twelve, and providing more support for recruitment.’
NHS England recently warned PCNs that they may lose any funding they do not spend on recruiting additional roles this year, despite its advice to CCGs in 2019 to reallocate the money.
The 2020/21 additional roles reimbursement scheme offers £340m to PCNs to cover 100% of the costs to employ new staff from a pool of clinicians, such as occupational therapists, dieticians and pharmacy technicians.
To compare reimbursement levels and the amount of unspent funding at different CCGs go to Pulse Intelligence, our new platform providing financial tools and advice for practices in England. Sign up for a free trial to access articles and features including income comparison tools.
Additional reporting by Costanza Pearce