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Redirect ARRS and Pharmacy First funding to core GP, says DAUK manifesto

Redirect ARRS and Pharmacy First funding to core GP, says DAUK manifesto

The next Government should reallocate ARRS and Pharmacy First money to restore GP core funding, the Doctors’ Association UK has recommended in its election manifesto.

The DAUK’s GP committee issued a 10-point manifesto to ‘relieve the pressure on general practice’, which was presented to prospective MPs during a webinar yesterday.

It said that the next Government should invest £3 per month per patient into general practice to ‘achieve a return to real terms funding last seen in 2015’ but that this ‘does not need to be new money’ and can be reallocated from the additional roles reimbursement scheme (ARRS), Pharmacy First and acute care hub pilots.

During the webinar, attended by Pulse, DAUK’s vice chair Dr Ellen Welch said: ‘The £2bn that has been spent on inefficient schemes which fragment care such as the Pharmacy First scheme and ARRS can be reallocated and reinvested into core general practice.

‘I think any additional staff members such as pharmacists, social prescribers, physios, they’re all very useful when they’re present – in addition to GPs.

‘We have the unbelievable paradox where GPs are currently out of work. So we need the additional schemes to help with exactly that and for the investment to be in GPs.

‘We need the freedom to use our budgets for the things that work. We need to aim to increase GP numbers so that we have safer ratios of patients to doctors.’

Following the launch of Pharmacy First, the DAUK had urged the Government to urgently review why pharmacies are paid ‘more than double’ per consultation compared with GPs.

Dr Steve Taylor, a GP in Manchester and member of DAUK’s GP committee, told the webinar that NHS England has been spending money on other primary care initiatives rather than core general practice.

He said: ‘Pharmacy First appointments, which are meant to reduce GP appointments, actually cost more, approximately £48.

‘GP practices are receiving £165 a year for an all you can eat buffet, and that all you can eat on average is seven appointments per patient per year, which averages out about £23 per appointment.

‘So it seems a bit weird that we’re spending so much money on other initiatives to improve access to primary care, but we’re actually spending less money in general practice, which is why this doesn’t make sense.’

DAUK’s GP lead Dr Lizzie Toberty explained that ‘some of the ideas’ around the acute care hub pilots ‘were voted down’ by the LMC leaders and that patients ‘want to be seen in their practices’.

In November last year England LMCs rejected a motion proposing ‘that the time has come to separate acute on-the-day care from planned general practice care’.

And GPs have opposed plans to create same day access hubs, modelled on the Fuller stocktake, in several parts of the country, including North West London, Hampshire and Oxfordshire, Buckinghamshire and Berkshire.

Dr Toberty said: ‘It isn’t the direction of travel that everyday GPs want to go in. It doesn’t seem that our patients have been particularly well consulted about it either.

‘There’s a current narrative that we need acute care hubs and then we need GPs doing only chronic care. So if you’re unwell in the future, you might be sent to an alternative site but we think patients want to be seen in their practices.’

The DAUK manifesto in full

  • Invest £3 per month per head of population to achieve a return to real terms funding last seen in 2015. That’s the equivalent of the price of cup of coffee per month. This does not need to be new money. Reallocate Additional Roles Reimbursement Scheme (ARRS) going to Pharmacy First and acute care hub pilots, which is worth £2 billion.
  • Aim for ratios of patient to GP full-time equivalent of 1:1600 patients – and even lower in deprived areas – to reduce pressure ensure all patients have equitable access to GPs.
  • Support partnerships with limited liability.
  • Develop meaningful careers for new GPs by supporting fellowships, educational funds and innovation.
  • Provide long-term benefits to enable GPs to stay rooted in their community.
  • Develop email and messaging capacity for practices. Phones are ok, but this way no one needs to wait, and doctors can clearly see who is on the list.
  • Relieve pressure on GPs by shortening secondary care waiting lists.
  • No more NHS reform or reorganisation. Form a cross-party group to make longer term decisions for our health service and stabilise the NHS.
  • Long term plan for estates. We need room for everyone, including any plan to expand places for healthcare students. We appreciate this is expensive but there needs to be long term aspirations
  • Improve the IT infrastructure. GPs desperately need computers which don’t freeze and crash.

Source: DAUK

Yesterday the RCGP said it also wants ARRS money to be made available to ‘allow practices the flexibility to plan their own staffing requirements’ and ‘to recruit the GPs they need’.

The inclusion of GPs in ARRS had been a ‘red line’ for GPCE in 2024/25 contract negotiations but NHS England declined the request on the basis that GPs are core, rather than additional workforce in practices.



Please note, only GPs are permitted to add comments to articles

Allister Woodstrover 21 June, 2024 4:14 pm

Agree- ARRS are a false economy.A GP does many things well and quickly – if you have a pharmacist doing a lipid clinic with long appointments,an associate physician ordering multiple unnecessary tests(which generate work),pharmacists being pain to deal with UTI’s etc and so on and so on- then you have incurred cost by expanding some of the many pieces of a GP role – much more efficient,less costly and better service to have a few more GPs.