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The Additional Roles Reimbursement Scheme (ARRS) is designed to expand the primary care work force and enable more proactive, personalised and integrated health and social care. Through the scheme, Primary Care Networks (PCNs) are entitled to access funding to recruit staff for additional roles that will provide multi-disciplinary support according to local needs.

Expanding the primary care workforce is a priority to enhance patient care. With demands on GP practices likely to remain high due to the ongoing pandemic, backlog of patient needs and COVID-19 vaccination campaigns, recruitment of additional staff will also help to relieve some of the pressure.

The update to the GP Contract Agreement 2020/21-2023/4 introduces extra investment in the scheme and more roles for PCNs to choose from. Here’s what you need to know.

Which roles are funded through ARRS in 2021?

With the update to the GP Contract Agreement, a further 6000 staff are being funded through ARRS, meaning a total of 26,000 additional staff by 2023/24. More flexibility has also been introduced with the addition of more roles: nursing associates and trainee nursing associates from October 2020, plus paramedics, advanced practitioners and mental health practitioners from April 2021.

This means that from April 2021, PCNs are able to recruit staff for the following roles, to be reimbursed through ARRS: social prescribing link worker, clinical pharmacist, first contact physiotherapist, physician associate, pharmacy technician, community paramedic, occupational therapist, dietitian, chiropodist/podiatrist, health and wellbeing coach, care coordinator, nursing associate, trainee nursing associate, and mental health practitioners (including Improving Access to Psychological Therapy [IAPT] practitioners).

Advanced Practitioner roles include: clinical pharmacist, physiotherapist, occupational therapist, dietitian, podiatrist, and paramedic.

PCNs can decide which roles are required depending on their existing workforce and local needs.

How will additional roles be funded?

ARRS funding will increase from £430m in 2020/21 to a maximum of £746m in 2021/22. For most roles, the reimbursement is 100% of the aggregate Full Time Equivalent (FTE) salary, including on costs (Employer NI and Employer Pension) up to a maximum reimbursable amount.

From April, PCNs are entitled to a FTE mental health practitioner. These roles will be jointly funded by the PCN (through ARRS reimbursement) and the local mental health provider, each providing 50% of the cost.

All PCNs are urged to use 100% of their available funding, which should allow the average PCN to recruit an additional 20 FTE staff by 2023/24. However, many PCNs raised concerns that they would miss out on their full share of funding during the last financial year. Issues included lack of time for planning and recruitment, lack of available staff and inflexibility of the scheme. With the update introducing more flexibility, this should help PCNs to claim their full share of the funds.

What other schemes can boost GP practice expansion?

In March, NHS England announced a new £120m General Practice Covid Capacity Expansion Fund for six months from April. This money is to make further progress on the priorities set out in the COVID-19 support fund announced in November, such as boosting GP capacity and tackling the backlog in chronic disease management. Spending is prioritised for PCNs committed to deliver the COVID-19 vaccination enhanced service.

Also keep in mind the GP Retention Scheme, designed to help doctors who are thinking of leaving the profession to remain in clinical general practice. The scheme provides financial support to the retained GP and the practice that employs them. It also offers more flexibility and educational support than a ‘regular’ salaried GP post. In GPonline, Dr Sarah Matthews explained  how the scheme works for her.

Helpful resources for the ARRS

Guidance on the ARRS is available from NHS England and NHS Improvement, including the process for claiming reimbursement for additional staff.

Expanding our Workforce details the additional roles that are funded.

The Additional Roles Reimbursement Scheme (ARRS) new online portal provides a simple way for PCNs to claim, and CCGs to approve, reimbursement for the roles hired.

FutureNHS provides recruitment support and guidance for ARRS roles.

Medical Defense Society is on hand 24/7 to help members needing advice about legal matters related to staff recruitment and expansion of GP practice teams.