The Government has added GPs to the additional roles reimbursement scheme (ARRS), in the hope practices will be able to hire 1,000 more doctors this year.
Health secretary Wes Streeting has added £82m to the £1.4bn ARRS pot to fund what he described as an ’emergency measure’.
The expansion of the scheme aims to allow practices to hire ‘newly-qualified GPs’ who face potential unemployment this summer and comes as GPs are due to start collective action today.
NHS England said talks to avert GPs taking protest action were ongoing but Pulse understands ballot results are due this morning, with action still planned for today.
Primary care networks (PCN) will only be permitted to use the dedicated funding to recruit GPs, since the £82m will be ‘ring-fenced’ to ensure existing ARRS staff are not impacted.
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 it.
Since its introduction in England in 2019, the ARRS has only allowed recruitment of 17 ‘new’ roles in primary care, including clinical pharmacists, occupational therapists, and physician associates.
But many leading GPs have criticised the scheme, claiming it is a ‘Trojan Horse’ that has resulted in GPs being ‘replaced’ as practices are unable to afford employment of GPs using their core funding.
Earlier this year, the BMA’s GP Committee argued for the inclusion of GPs in the ARRS, saying it could be ‘an obvious solution to practices’.
DHSC has highlighted that the change today is not permanent as it is an ’emergency measure’ for 2024/25, and the Government will work with the profession to ‘identify longer-term solutions to GP unemployment and general practice sustainability as part of the next fiscal event’.
This announcement follows the Government’s commitment earlier this week to increase salaried and partner GP pay by 6%, following the doctors’ pay review body recommendation.
Speaking today on the ARRS expansion, Mr Streeting said it is ‘absurd’ that patient access is still an issue ‘while GPs can’t find work’.
He continued: ‘This government is taking immediate action to put GPs to work, so patients can get the care they need.
‘This is a first step, as we begin the long-term work of shifting the focus of healthcare out of hospitals and into the community, to fix the front door to the NHS.
‘I want to work with GPs to rebuild our NHS, so it is there for all of us when we need it.’
In May, the BMA warned that thousands of newly qualified GPs could be unemployed this August due to a ‘nearly non-existent’ job market in some areas.
Unemployment issues have also affected GPs further into their careers, with a recent survey suggesting that more than 80% of GP locums ‘cannot find work’.
In an update to primary care today, NHS England confirmed that adding GPs to the ARRs is ‘an emergency measure that will be targeted at recently qualified GPs to address current challenges around recruitment’.
The update continued: ‘This measure does not impact existing ARRS staff because recruitment of GPs will use ring-fenced funding – and continuing to build on the success of multi-disciplinary teams is vital to support delivery of proactive care.’
NHS England has also recognised that most nurses are not included in the scheme, and confirmed that this arrangement ‘will be reviewed’.
Further information on the changes to ARRS ‘will be sent to practices shortly’, according to the update today.
NHSE national primary care director Dr Amanda Doyle said it is ‘vital’ GPs are given the ‘the resources’ to manage increasing demand.
She said: ‘Adding General Practitioners to the scheme is something that the profession has been calling for in recent months to make it easier for practices to hire more staff – so I welcome this measure which is an important first step to increasing GP employment in the long-term.’
Dr Doyle added that she will continue to work with the BMA and the Government to ‘avert any potential action’, which was due to start today following the ballot closure on Monday.
RCGP chair Professor Kamila Hawthorne said she is pleased that Mr Streeting is ‘listening’ to the college, who called for this ARRS expansion ‘months ago’.
But she warned that this is ‘by no means the long-term solution’ to the ‘underfunding’ of general practice.
Professor Hawthorne added: ‘This funding is a welcome start as an emergency measure to help ensure that GPs are able to find work and deliver much needed patient care.
‘In our next steps to revive general practice, we need to move towards a situation where GP practices are trusted to utilise funding in the best interests of their patients, not bound by restrictions.’
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What does one call this type of ‘U’ turn———it must have a special name, surely?
Sensible
JGM it’s called common sense, welcome baby step to end death knell of GP, hopefully more to come.
Yay. Finally some good news for GPs. May not look like such good news for some of the other ARRS-employed health workers.
Good move… but now ARRS is dead in the water and should go, the monies returned to the contract proper.
Whilst this is a big step in the right direction, I would be very cautious of hiring a GP on BMA model contract if the funding is only guaranteed until April 2025. I expect this will be used on locums instead to allow flexibility. Not a bad thing but I do worry about IMG new CCTs who need a substantial contract in order to meet the visa rules. Definitely moving the right way, but the devil is in the detail.
There now needs to be a concerted effort to remove self-serving PCN Clinical Directors who have acted against their profession and the colossal sums which have been cynically siphoned off for simple secretarial work and misdirected from patient care into the pockets of these CDs or their limited companies.
PCN CDs who have up to date shown a disgusting miserable scant regard for their colleagues and played a pivotal role in the increasing unemployment we have seen amongst GPs for which they are also responsible having purposefully replaced( yes there were some choices which CDs could have made differently) while feathering their own CD nests having left a legacy of misery for upcoming GP generations.
GPs have a spine after all! Who knew?!
Good to see that the Government has added GPs to the staff that can be recruited via the Additional Roles Reimbursement Scheme (ARRS). This will give general practices greater flexibility to appoint GPs, improve access to primary care, and help address wider NHS pressures. Although including GPs in the ARRS is an emergency measure for 2024-25, I hope the government will come up with an appropriate long-term primary care workforce plan that increases the number of GP appointments in the NHS.
GPs are going to be allowed to work in General Practices. This is, of course, only an emergency measure.
Not sure how this will help practices. PCNs are already overspent on ARRS and the 82 million promised won’t even cover the pay increases for existing ARRS staff once on-costs are considered. I don’t see how our PCN could employ a GP through ARRS.
IMO funding for GPs and Nurses through ARRS should be heavily resisted as this is a completely different contractual vehicle, which further weakens the independence of practices (as the funding goes to PCNs – that could be taken over by the private sector if the political will changes – rather than to practices in the Global Sum). GPs and Nurses are not ‘Additional’, but core workers, so funding should be in the core contract.
This announcement is small beer. Should have put ARRS money into core funding, and then some. Suspicious that Wes still hasn’t made a progressive big bang statement about a meaningful core funding increase. Nothing to see here. Agree with ST’s comments above.
Great news about ARRS money to employ gps. If it is emergency measure, what happens to employment of these gps later?
Wes has hit the ground running !
Also agree with ST above but this payment to PCNs and not to practices will not change as the greed of PCN CDs (with exceptions) will see this as further opportunity to increase their own personal CD /practice side-lined gains & profits .
This combined with the status of being a PCN CD they so crave etc regardless of the cost /damage to their colleagues, to the detriment of careers of newly qualified GPs and to Primary Care as a whole that we are all seeing, has not stopped PCN CDs previously and will not stop them now.
PCN CDs have been acting in collaboration with the government for years and unless this predicament is dealt with and their susceptibility to monetary offers or carrots such PCN CD payment incentives (better described as bribes imo) , then we cannot make progress.
It is PCN CDs have emerged from within the Trojan horse of PCNs and continue to wreak havoc within Primary care amongst their colleagues.
The expansion of the scheme aims to allow practices to hire ‘newly-qualified GPs’ who face potential unemployment this summer. What about older experienced GPs. Totally age discrimination!
Newly qualified/appointed GPs need a consistent stable team and venue to work from to thrive and develop. This is achieved by core funding and belonging to a practice not by being scattered around a PCN.
GPs via ARRS is a terrible idea so if an emergency measure needs to be time limited with a plan.
Step 1: Employ newly qualified GPs via ARRS.
Step2: Audit their performance and compare to PAs and paramedics.
Step 3: Government has “proof” that GPs can be replaced by lesser qualified (staff because GPs are fully formed from day one obvs)
Step 4: Primary care is now very profitable for big companies to buy.
Step 5: welcome to the United States of America.
Its a Trogen horse to replace general practice with PCN. BMA should reject this.
Dear All,
At last a sensible decision from a polotician.
Regards
Paul C
Read the small print “newly qualified GPs” ..not GPs ..”newly qualified GPs”. This is a statement that Wes and his lot agree there A WHOLE LOAD OF GPs THEY ARE NOT INTERESTED IN EMPLOYING – EXPERIENCED ONES
money is for newly qualified GPs only
other ARRS spending at this point unchanged
IA or WTR if it can squeeze 2′ care without harming patients only show in town to force HMG hand
Amanda’s Doyle and Pritchard and Fuller still committed to stocktake
This appears to have been devised for headlines “ Wes gets GP’s back to work “ rather than actually helping practices recruit GP staff. It’s a tiny amount for 1 year only as an emergency measure.
If the ARRS staff are so useful to their practices compared to GP’s why do they need their funding protected?
Read a great phrase from American site re physician associates accusing them of ‘ professional appropriation’
By the way the American doctors seem to see and call out the threat to their existence without any concerns about’ just be kind’ they seem far more aware than we are that they need to protect the integrity of their licence first and foremost
Blindingly obvious now. Get rid of PCNs altogether and put the money into core contract along with specification on how many FTE GPs needed for the list size.