Physician associate numbers continue to fall

We look at the monthly primary care workforce figures from December, which report on the National Workforce Reporting Service (NWRS) submissions to give a picture of additional roles reimbursement scheme (ARRS) PCN staff across England.

Physician associate (PA) numbers have continued to fall within PCNs, according to new workforce figures.

The recent monthly primary care workforce figures showed that the number of full-time equivalent (FTE) PAs has decreased by 37 to 1,147, from 1,184 in July.

The regulation of the profession began in December, however the role has been subject to controversy over the past few months, with reports of redundancies.

Pharmacists continue to be the most popular ARRS role, with an extra 33 FTE employed in December, followed by care coordinators, of which there were 21 more in December.

There were also 501 FTE advanced nurse practitioner roles reported in December, up from 495 in November, and which the spreadsheet said may include some enhanced nurses, as this role is not separately captured within the NWRS.

Enhanced nurses were added to the ARRS scheme in the 2024/25 contract, however there was initially some confusion over the role as it is a level of practice rather than a role in and of itself.

From November, the statistics have also said some ‘other’ direct patient care roles can be claimed for, whereas previously the reporting did not suggest this.

Under the ‘other’ category, which includes 407 FTE roles as of December, it said: ‘Roles under the ‘Other’ Direct Patient Care category may contain roles which PCNs can claim ARRS funding for, but are not yet reported on within this publication.’ However, it did not confirm what these roles were.

In December, the Department of Health and Social Care said the workforce figures would not include ARRS GP numbers, after the role was added to the scheme in October, and that there was no timeline for doing so.

However, the statistics suggest that the number of ARRS GPs has been rolled into the FTE and headcount figures that are reported monthly.

NHS England’s spreadsheet said: ‘From October 2024, PCNs can claim for GPs under the ARRS, provided the individual has not been substantively employed as a GP in general practice previously, is not employed as a locum, and gained their certificate of completion of training within the last two years.

‘Therefore, from October 2024, Salaried GP FTE and headcount figures include GPs funded through ARRS. Before this date, all recorded Salaried GP workforce related to the PCN Extended Access DES.’

This FTE salaried GP workforce figure has more than doubled since July and August when there were 68 GPs reported in this role, to 176 as of December (see chart). The figure has also increased by 91 since October, when the GP ARRS role funding began. The headcount total is 348. When the policy was announced, it was intended to fund an additional 1,000 newly qualified GPs.

Pulse PCN also reports on the quarterly primary care workforce figures, which alongside the NWRS submissions includes ARRS claims data, to keep a track on the number of ARRS PCN staff in England.

All figures are full-time equivalent.

*While all the above roles from the primary care network workforce statistics are reimbursable under ARRS, NHS England has not confirmed whether the FTE numbers have been claimed for under the scheme.

We are no longer reporting on Healthcare Assistant and Health Support Worker figures because Pulse PCN understands they are not eligible for ARRS reimbursement, which has been clarified in this month's data.