Practice nurses want to be added to ARRS, survey shows

Almost two-thirds of primary care and community nurses believe general practice nurses (GPNs) should be included within the additional roles reimbursement scheme (ARRS), according to an exclusive survey.

This comes as NHS England confirmed the exclusion of GPNs from the scheme was set to be reviewed and as GPs have been added.

Introduced in 2019, the ARRS can be used by primary care networks (PCNs) to reimburse the salaries of some staff, including nursing associates, advanced nurse practitioners and more recently enhanced level practice nurses.

There have been concerns raised over the last year about ARRS roles – namely nursing associates – being used as a cheaper alternative in place of GPNs, sparking calls for them to be added to the scheme.

An exclusive Pulse PCN survey, had responses from 122 GPNs and 29 community nurses, and asked respondents about the current state of primary care.

Of those, 62% said they believed GPNs should be included within ARRS roles.

When broken down by sector, the feeling appeared slightly stronger among GPNs (66%) than community nurses (56%).

Just 11% of GPNs thought GPNs should not be included, while 8% of community nurses said the same.

A significant proportion of nurses were unsure – including 23% of GPNs and 36% of community nurses.

In last week’s Primary Care Bulletin, NHSE said it recognised that some nurses are not included within the scheme and said that ‘this will be reviewed’.

In last week’s Primary Care Bulletin, NHSE said it recognised that some nurses are not included within the scheme and said that ‘this will be reviewed’.

Earlier this year, the enhanced practice nurse role was added to the ARRS – designed to be a role that delivers ‘enhanced clinical care’ and to act as a ‘clinical role model’ for evidence-based practice.

In another announcement last week, the government confirmed GPs would be included within the scheme for 2024/25 in the hope of recruiting more than 1,000 newly qualified GPs.

Described as an ‘emergency measure’, it added that the move would be paid for with £82m from existing budget.

Steering committee member of the Royal College of Nursing (RCN) General Practice Nursing (GPN) Forum, Ellen Nicholson, welcomed the move to include GPs, but warned against forgetting about GPNs.

‘It’s great GPs are being added to ARRS, we’d like to see GPNs added too,’ she told Nursing in Practice.

‘However, it’s worth recognising this is at present only a measure for 2024/25. We need to see a sustainable future for both GPNs and GPs.’

At a Pulse PCN Event, NHS England primary care nursing lead, Louise Brady outlined the work of enhanced nurses which were added to the ARRS earlier this year confirming that she wouldn’t want to see GPNs transferred into enhanced nurse roles by PCNs.

‘We don’t want to take established general practice nurses out of their practice. The ARRS is about the additionality principle. We’d be looking for an experienced nurse to manage complexity at an enhanced level of practice across a PCN.’

The State of Primary Care survey took place between April 29 and May 20 2024 across Pulse PCN, Pulse, Healthcare Leader, Nursing in Practice, The Pharmacist, Management in Practice, Hospital Healthcare Europe and Hospital Pharmacy Europe.

Read the full State of Primary Care report here.

A version of this story was first published on our sister title Nursing in Practice.