Exclusive Around 40% of GP partners say their PCN is considering replacing non-GP Additional Roles Reimbursement Scheme (ARRS) staff with GPs, a Pulse survey has revealed.
As part of changes to the GP contract for 2025/26, the Government combined the ARRS funding for GPs, which was previously ringfenced, with the pot for all other roles, meaning there is now no cap on the number of GPs PCNs can recruit.
In a Pulse survey of 315 GP partners in England, respondents were asked whether their PCN is considering replacing non-GP ARRS staff with GPs.
Almost 16% of respondents said they had already done so or had ‘started taking action to do so’, while just under a quarter said they had ‘discussed’ this.
The BMA’s GP Committee England said decisions around ARRS employment should be based on ‘what benefits the community best’, but reminded practices that these decisions must be ‘made fairly and in line with employment law’.
Is your PCN considering replacing non-GP ARRS staff with GPs?
| Yes, we have done so already | 7.3% | 23 |
| Yes, we have started taking action to do so | 8.3% | 26 |
| Yes, we have discussed this | 23.5% | 74 |
| No | 40.3% | 127 |
| Don’t know | 20.6% | 65 |
| Total | 315 |
When GPs were first added to the ARRS in October last year, the £82m to hire around 1,000 newly-qualified GPs was ringfenced from the rest of the funding for all other roles.
For 2025/26, NHS England committed to the ‘continuation of funding’ for this cohort of GPs, which equated to £186m for the whole of the financial year.
But the removal of the ringfence around this money means PCNs are able to claim reimbursement for new GPs alongside existing roles, with practice nurses also added to the scheme.
One GP partner in the North West, who preferred to remain anonymous, told Pulse that his PCN had previously employed a paramedic to work across two practices, but the member of staff had ‘needed significant training input to be able to work independently’.
He told Pulse: ‘The PCN was considering making him redundant which would have been quite costly due to his previous NHS experience but fortunately he handed his notice in and we have now employed a new salaried doctor at our practice partially funded by the PCN ARRS funding that was released when the paramedic left.’
The GP partner also said his PCN is ‘still not sure’ that ARRS staff other than GPs ‘offer as good value for money’, but at the moment they still employ pharmacists, MSK practitioners and social prescribers via the scheme.
‘In my opinion there has been a massive amount of money wasted on ineffective ARRS staff by PCNs which would have been much better given directly to practices to decide where they wanted to spend the money,’ he added.
Another GP partner, based in Warwickshire, said her PCN is ‘split’ on the issue of replacing non-GP ARRS roles with GPs.
She said the PCN had previously advertised for a GP under the ARRS but there were no applicants, which is ‘hardly surprising as it cannot be satisfying to work for six practices in a week’ without the ‘support and continuity’ that newly-qualified GPs ‘really need’.
The GP partner continued: ‘The constituent practices asked for the equivalent money so that we could employ our own GP under this scheme. We were entitled to three sessions a week and agreed to top up the money the Government was offering to local standard rates.
‘We had a good candidate who wanted four sessions a week so we’re funding the extra session as well out of our own money. A GP started in March and things are going well.’
In terms of the rest of the ARRS money, this GP partner said they would ‘like control over how [their] proportion of the PCN allowance is spent’.
She added: ‘This is supported by some of the other practices locally but not all which is causing contention.
‘Certainly at my practice we are not happy about the value for money that we’re getting and the fact that we can’t choose the people for their roles and they’re not assigned specifically to our practice and therefore don’t attend meetings as part of the team.’
In response to Pulse’s survey findings, GPCE chair Dr Katie Bramall-Stainer said: ‘Rightly so, PCNs now have greater flexibility to use their ARRS funding allocation in ways that best meet the needs of their patients and practices.
‘Decisions about who is employed with this funding should be based on what benefits the community best.
‘Where PCN member practices decide that GP roles are most appropriate in terms of delivering patient care, this decision must of course be made fairly and in line with employment law.’
But she also said the GPCE ‘continues to call for a shift towards a practice-level reimbursement model’ as the ‘closer this funding gets to those delivering care the better’.
The committee chair had previously advised practices to carefully consider employment law if they are planning redundancies to hire more GPs through the ARRS.
In April, NHS data showed that over 1,500 newly-qualified GPs had been hired via the ARRS between October and the end of March 2025.
Pulse survey
This survey was open between 31 March and 14 April 2025, collating responses using the SurveyMonkey tool. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a £200 John Lewis voucher as an incentive to complete the survey. We asked for GPs’ practice codes or practice names and postcodes, and asked them to confirm what kind of GP they were. We removed those with duplicate email addresses, and searched for duplicate IP addresses, removing obvious duplicate entries. The survey was unweighted, and we do not claim this to be scientific – only a snapshot of the GP population.
This is both good news for GPs, and patients, and also an indication of the support for the view that GPs can actually be more cost-efficient than some other staff at Doctoring, although they should perhaps be more valued for their own non-Doctor roles, like in Nursing, Physiotherapy, etc
As stated throughout, with notable exceptions, the same smaller group of self-serving, financially incentivised PCN CDs backed by layers of unaccountable, unregulated managers with variable backgrounds, the latter who often do not understand the sheer weight of clinical risk , responsibility and overbearing potentially career ending overregulation by proliferating, equally unaccountable , unregulated oversight bodies have collaboratively with the government and NHSE increased risks within Primary Care and engineered one of the most catastrophic wastes of NHS resources in the history of Primary Care and unfortunately continue to do so;
The sentiment in the article above is totally correct.
‘In my opinion there has been a massive amount of money wasted on ineffective ARRS staff by PCNs which would have been much better given directly to practices to decide where they wanted to spend the money,’ he added
There is of course an important and valuable place for ARRs but once again the career path of this group as well as significant cohorts of GPs has been undeservedly and, in some cases, irreparably, derailed by the actions of this subgroup of PCN CDs and managers.