LMCs demand ‘greater transparency’ as ARRS used to ‘exploit’ early-career GPs

LMC leaders have demanded greater transparency and accountability around the additional roles reimbursement scheme (ARRS) to make sure it is not used to ‘exploit early-career doctors’.

GP leaders from across England voted in favour of a motion asking the BMA to condemn the introduction of ARRS GPs that has created a ‘two tier’ system of GPs.

At their conference in Manchester on Friday, they highlighted the ‘unacceptable situation’ in which some GPs face a real-terms pay cut upon qualifying, ‘undermining the value of their professional status’.

The ARRS was extended to newly-qualified GPs last year with an £82m addition to the £1.4bn ARRS fund. 

But BMA leaders have told Pulse ARRS roles were being funded below the market rate which have led to the union ‘bartering’ to secure uplifts.

GP leaders speaking in favour of the motion said that ARRS GP reported the lower pay made them feel ‘devalued and disrespected’.

Proposing the motion, Dr Jessica Court, from Nottinghamshire LMC, said: ‘ARRS was intended to support general practice by expanding the multidisciplinary team, but in reality, it is being used to employ newly qualified GPs on salaries well below market rate, often with restricted duties and reduced autonomy.

‘The expectation that GPs in their first two years should work across numerous practices is impractical and undermines job satisfaction, morale and retention. It also fails to support continuity of care, which is at the heart of general practice.

Dr Court added that the financial consequences for GPs employed under the ARRS are ‘stark’.

She said: ‘Some newly qualified GPs face a real terms pay cut on qualifying and for international medical graduates, which is around 50% of our GP registrars, the low salaries can even create visa sponsorship difficulties making the scheme impractical for them.

‘This is not just about pay. It is about professional respect, equity and sustainability. If left unchallenged, this two tier system will drive talent away from general practice, damage morale and weaken continuity of care for our patients.’

Cheshire LMC’s Dr Shana Tam, who spoke in favour of the motion, said: ‘Unequal pay breeds division, resentment and low morale. It sabotages healthy practice culture. In Cheshire, ARRS GPs have said their lower pay made them feel devalued and disrespected, and they left their roles within a few months.

‘Is this what GP retention looks like? Newly qualified ARS GPs are not a stopgap. They are the future partners and leaders of our health service.’

LMC leaders voted in favour of demanding that the BMA campaign for greater transparency and accountability around the scheme and urge that ARRS GPs ‘be treated no differently to GPs directly employed by GP practices’.

Health secretary Wes Streeting claimed recently that the Government was ‘smashing through’ its target to recruit 1,000 extra GPs through the scheme after new figures showed cumulatively 2,533 GPs (by headcount) had been recruited since last October.  

Ahead of the start of the 2025/26 contract year, the GPC said it had secured a commitment from NHS England to bring ARRS GP salaries in line with the union’s recommended pay range for salaried GPs.