GPs in the Additional Roles Reimbursement Scheme (ARRS) - Challenges and Considerations
The employment of GPs under the Additional Roles Reimbursement Scheme (ARRS) continues to be a topic of considerable discussion among GPs and Primary Care Networks (PCNs) across England. There are ongoing concerns about the implications of this scheme, particularly with the structure and pay associated with the roles. The British Medical Association (BMA) has outlined that GPs in these roles are employed under a model contract and paid on a sessional basis, with a full-time equivalent (FTE) of nine sessions capped at £73,114, which PCNs can augment to £92,462 (outside London) to cover additional costs. However, these rates are generally perceived as uncompetitive, potentially fostering a two-tier salary system within PCN member practices.
Some Local Medical Committees (LMCs) have advised PCNs and GPs to forgo using this ARRS funding, viewing it as underfunded and inadequately structured, which reflects NHS England’s broader undervaluation of GPs. Concerns have been raised about the roles these newly qualified GPs would undertake; multiple practice deployments may not offer the practice team integration and supportive environment ideal for early-career GPs. The flexibility for PCNs to shape the job role exists, but it requires mutual agreement among member practices, especially since there is no specific job description for GPs under ARRS, unlike other ARRS roles.
PCNs may choose to supplement the sessional funding allocation for GPs, as they can for other ARRS roles, but they cannot use ARRS funding for cross-subsidisation between roles. Overspending in these allocations requires PCNs to draw on other income streams, such as PCN Core Funding, with member practices bearing the financial risk.
The flexibility within the BMA Model Contract allows PCNs to adapt the terms of employment and workload associated with these GP roles. However, there is concern over how Integrated Care Boards (ICBs) and NHS England might monitor the use of this funding. For example, if a PCN claims the maximum ARRS allocation, it implies nine sessions per week for a GP, including Continuing Professional Development (CPD) as part of the Model Contract. Currently, PCNs are not required to submit job plans, though it remains uncertain if NHS England might request monitoring to confirm the deployment of sessional commitments.
The BMA suggested funding specialist GP roles, such as safeguarding, through ARRS during the 2024/25 negotiations but expressed reservations about including generalist GP roles under this funding scheme. The BMA will continue to engage with NHS England, seeking clarification on these matters and advocating for appropriate funding and recognition of GP roles within PCNs. Further guidance will be circulated to PCNs and GPs as it becomes available.
To red the LMC view on the NHS England letter to General Practice regarding the 2024/25 GP ARRS Funding, click this link.
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Updated on Thursday 23 January 2025
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