PCNs will be able to claim more money for their ARRS staff but the overall budget for the scheme will not be increased, according to a new contract document.
The reimbursable amount for ARRS staff has increased from October 1 this year by between 5.6% to 5.7%, depending on role, which includes employer on costs such as pension and national insurance.
There had previously been a lack of clarity around whether ARRS roles would be included in the 5.5% Agenda for Change uplift, with some PCNs warning that if the overall ARRS budget was not also increased, they would be facing shortfalls of between £26k and £60k.
The updated PCN Directed Enhanced Service (DES) document, published last week, outlined that PCNs’ ARRS sum would equate to ‘£22.894 multiplied by the PCN contractor weighted population as at 1 January 2024’.
This is the same figure as in the original 2024/25 DES document, despite the increase in reimbursable amounts.
However, core PCN funding has increased by 0.051p (1.7%) from £2.916 to £2.967 per patient. Enhanced access payments have gone up from £7.674 to £7.975 multiplied by the PCN’s adjusted population, and there has also been an uplift to the care home premium, from £120 per bed to £127.20 per bed. These are all backdated to 1 April 2024.
Capacity and access payments remain unchanged.
The DES also outlined the contractual terms around hiring GPs through ARRS, after the government added the role with a ‘ring fenced’ £82m budget in August as part of an emergency measure. The scheme is intended to fund 1,000 GPs across England’s PCNs, with funding to be made available from October.
PCNs will receive £1.303 multiplied by the PCN contractor weighted population, as of 1 January 2024, for GPs in the ARRS scheme.
The maximum reimbursement PCNs can claim for these GPs, who can be employed from 1 October, is £92,462 across England, except for those hired in London where it is £95,233 – and these amounts include employer on-costs for NI and pension contributions.
However, it’s not yet clear as to whether PCNs will be able to roll over any unspent funds for hiring GPs into the next financial year (2025/26).
The contract has stated PCNs can claim for GPs through the ARRS scheme, except where:
- GPs have been ‘substantively employed’ as a GP in general practice previously, subject to express agreement with the commissioner.
- The GP is to be employed in a temporary capacity i.e. as a locum.
- The GP is beyond the second anniversary of their certificate of completion of training, issued by the General Medical Council, at the start of their employment or engagement.
The Institute of General Practice Management (IGPM) has said the money allocated for hiring GPs via ARRS ‘falls woefully short of achieving the promised increase in capacity for patients’.
Its directors said: ‘While the public is being sold the headline of more GP appointments, in reality the funding is nowhere near enough. In a PCN with a “weighted” population of 50k patients, it will get £65k for the six-month period [October to March]. This will fund, at best, around nine sessions of GP time per week (equivalent to 4.5 days per week) which, when spread across all the PCN practices, is a drop in the ocean of what is needed.’
The institute also highlighted practical drawbacks, such as the fact there is little time to use the full allocation of funds.
‘The new contract variation was on 26 September, with funding available from 1 October. This left PCN’s just two working days to recruit a GP to fully utilise the funding. This is clearly an impossible timescale.’
It also pointed out that the additional funding is only guaranteed until March 2025, so PCNs and their member practices are taking financial risks in offering permanent contracts to newly qualified GPs, while at the same time it offers little security for the hired GPs.
In addition, the IGPM said: ‘Those who are at the beginning of their career benefit from being in a supportive practice, with experienced clinicians to offer guidance and mentorship. They may not receive this in a PCN based role, without the financial support for mentorship.’
Meanwhile, it said the decision by NHS England not to increase the overall funding pot for ARRS staff to help fund pay rises was either ‘a gross oversight or a divisive move to destabilise the primary care workforce.’
‘PCNs and their member practices must choose between cutting services or having to use precious core practice funding to pay staff in line with the rest of the NHS to aid retention.
‘We have already seen staff leaving PCN roles because of the uncertain future and inequitable funding, and this contract variation will do little to give confidence that NHSE are committed to supporting general practice and their staff .’
The IGPM said it is seeking urgent discussion with NHS England to raise these issues.
Parts of this article first appeared on our sister title Pulse PCN
