Adding GPs to ARRS gives us hope

Professor Aruna Garcea says the inclusion of GPs in the additional role reimbursement scheme (ARRS) is a cause for hope and primary care should heed the call of the new government that it is at the heart of future plans

The GPC has voted in favour of collective action. It’s sad that we have reached this stage but when I talk to our primary care members there is an overwhelming feeling of being underfunded and undervalued. Even for those that are the most innovative, solution-focused leaders there is a sense of dismay and frustration.

The value of primary care is clear – not only to patients, to the system but to the economy. When the narrative is so compelling why are people not listening? Or maybe they are. The arrival of our new Secretary of State is bringing us hope – starting with the recent announcement of providing additional funding for more GPs through ARRS.

There is no doubt in anyone’s mind that we need to stabilise general practice now, but we also need to do it in a way that speaks to the future, creating pragmatic and sustainable solutions to the increasing pressures of changing demographics, workforce and complexity. GPs have long known the value of an integrated primary care team around their patients, particularly for complex comorbidity. In turn, the Labour party has also understood this value, having won the election on a manifesto which was strong on more investment in primary and community services and an emphasis on neighbourhood working.

At the NHS Confederation, through our Primary Care and ICS Networks, we wholeheartedly support this ambition, recognising some of the extraordinary achievements in many PCNs and Federations. Integrated working – like AI and prevention – are often touted as a panacea to save the NHS, but experientially is more than often moved onto the ‘important but not urgent’ list. So how this will happen remains to be seen – how can this be achieved while every part of the system is under pressure is difficult to understand.

But we need to take note and heed the call a new government is signalling. Primary care is at the heart of this move and the need to collaborate across practices through PCNs, Federations and collaboratives; across primary care with our pharmacy, dentistry, optometry and audiology colleagues; and across the whole of the system. This is more important than ever if we are to secure a sustainable future for general practice.

Our work on primary care provider collaboratives shows the potential to not only have a strong and effective voice for primary care in the system but to come together to deliver services in a more cost-effective way and in a way that reduces the burden on individual practices. A strong collaborative has general practice at its heart, but equally embraces the opportunities to do more with our wider primary care colleagues. Successful collaboratives are already demonstrating a force for good within their system both in the way in which services are designed and commissioned but also in the financial and non-financial benefits of being a vehicle for left shift of services closer to those that need them.

If we want a strong future for general practice and primary care, we need to be seen as part of, or the whole, solution to wider system problems. So greater investment in primary care is not only through the GP contract and PCN DES, but it also lies in the opportunities beyond that, working with our partners, to support delivery of care in a different and more patient-friendly way whether that be through neighbourhood working or place-based collaboratives.

Professor Aruna Garcea is clinical director for Leicester City and Universities PCN, medical advisor for networks and partnerships at Leicester, Leicestershire City and Rutland Patient Care Locally (LLR PCL), a GP and chair of the NHS Confederation’s Primary Care Network. Read more of her articles here.