Lack of clarity on pay uplift for ARRS staff

Clinical directors and their additional roles reimbursement scheme (ARRS) staff will need to wait for further detail on how the 37,000 staff employed through the scheme are included in pay uplifts announced this week.

On Monday the government announced a 2024/25 pay award of 5.5% for Agenda for Change staff on NHS terms and conditions and 6% for doctors and dentists, backdated to 1 April 2024.  

While the 6% uplift is intended to cover GP contractor, salaried GPs and salaried practice staff, Pulse PCN understands that further detail on ARRS eligibility will be confirmed in due course.

Last year reimbursements under the ARRS were uplifted to match the Agenda for Change pay increase, but there was no overall change to the total funding available. This meant that while PCNs could pay current staff more, they had less money to hire further roles.

Clinical director of West Warrington PCN, Dr Laura Mount called for ARRS staff to be ‘treated fairly’.

‘I hope that ARRS staff are treated fairly and for that to happen we would need to see an announcement of a 7-8% ARRS budget uplift to accommodate for on costs. Without it we will not be able to afford the pay rises without cutting current service provision which is hard to do when we are mid-year and staff are on permanent contracts,’ she said adding that similar rises need to be made to the management and clinical director payments to ‘avoid discrimination’.

Addition of GPs to ARRS

Yesterday, the government added GPs to the ARRS, with a ‘ring fenced’ extra £82m added to the £1.4bn ARRS pot, to ensure existing ARRS staff are not impacted.

In a letter to GPs health secretary Wes Streeting described it as an ’emergency measure’ in the hope practices will be able to hire 1,000 more doctors this year and that the Department of Health and Social Care and NHS England ‘will discuss the detail on how to implement this with the profession’.

The expansion of the scheme aims to allow practices to hire ‘newly-qualified GPs’ who face potential unemployment this summer and comes as GPs voted to start collective action.

Mr Streeting’s letter stated that the ARRS has been successful in expanding teams, increasing appointments and supporting the delivery of proactive care but that the recruitment into salaried GP posts has not been prioritised.

‘It is my intention that by putting additional funding into ARRS this will protect existing staff and continue to build on the success of multidisciplinary teams as we develop a neighbourhood health service, ensuring patients are able to access care from a range of healthcare professionals,’ he stated.

Clinical director of North Halifax PCN, Dr Geetha Chandrasekaran, welcomed the measure.

‘This has been something that we have wanted but there needs to be additional resource above what is in the ARRS budget now and this needs to be permanent not an emergency sticking plaster,’ she said.

The Department of Health and Social Care (DHSC) said this change to the ARRS has been ‘hard fought’ by the BMA and RCGP, as well as many grassroots GPs, including the 11,000 who petitioned for ARRS money to be used for GPs and practice nurses.

NHS England stated today that PCNs will be able to draw down funding from October and the exact criteria for employing GPs will be set out in a revised Network DES specification about which it will consult with GPC England over the coming weeks.

‘This will include ensuring that the GPs employed are in addition to the existing GP workforce employed by practices’, it stated.

Practice nurses

Mr Streeting  recognised there had been calls for both practice nurses and GPs to be added to the scheme.

However, he said ‘some nurses are already within the scheme’ and that for now he wanted to ‘address the specific challenge of GP employment’. He added that the government would keep ‘the whole scheme under review’.

In this weeks’ Primary Care Bulletin, NHS England went further stating: ‘Some nurses are already within the scheme, but it is recognised other nurses are not included and therefore this will be reviewed.’

Earlier this year, the enhanced practice nurse role was added to the ARRS  while nursing associates and advanced nurse practitioners are already included within the scheme.

Pharmacists

Pharmacists, which are the most popular role hired under the scheme, welcomed the move but Brendon Jiang, vice-chair of the RPS England Pharmacy Board, told sister title The Pharmacist that this announcement ‘must not jeopardise pharmacists’ roles that are already embedded into primary care teams’.

‘With continued pressures on the health service, we need a strategic approach to workforce planning across the system, and for all professions.

‘This must be backed by the ongoing investment needed to deliver high-quality patient care,’ he said.

Graham Stretch, president of the Primary Care Pharmacy Association (PCPA), welcomed the announcement.

‘PCPA have long advocated for strong multidisciplinary teams in general practice. That naturally includes at the centre of these teams, general practitioners,’ he said.

‘Support for recruitment, training and retention of general practitioners is central to the effective delivery of primary care in general practice and in PCNs, and we welcome [the] announcement.

‘We eagerly await further details of extra funding that will allow PCNs and practices to recruit doctors to strengthen our ability to look after patients close to their homes.’

It was also confirmed last month that PCNs are employing 37,000 staff through the ARRS, including pharmacists, social prescribers and physician associates.

A Pulse PCN investigation found that PCNs in England had underspent on ARRS funding by more than £45m in the year 2023/24.