GPs employed under the Additional Roles Reimbursement Scheme (ARRS) should only work across a ‘limited’ number of practices within their PCN, the BMA has recommended in new guidance.
The union’s sessional GPs committee said that patients ‘deserve continuity of care’ and that this can only be provided if the GP employed under the scheme have ‘dedicated places of work’.
It recommended that under ARRS, GPs are employed on the BMA salaried GP model contract, and that there should be limits on the number of practices they can work across, with ‘no more than two practices per contract’.
The expansion of the ARRS, announced in August, was introduced by health secretary Wes Streeting as an ‘emergency measure’ to tackle GP unemployment.
However, the full details of the scheme were not shared until the end of September when the updated PCN DES revealed that only GPs who qualified in the last two years will be eligible.
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’.
However, the BMA guidance, created by the sessional GPs Committee and GP Committee England, contains a recommended pay range of £83,225 to £120,444 for GPs employed under the scheme, adding that it is ‘imperative’ that the roles come with a ‘competitive salary’.
The guidance said: ‘The salary for these roles must reflect the fact that this is likely to be a fixed-term position which provides little in the way of long term security, whilst also recognising that the DDRB salaried GP pay range is outdated and is not representative of actual GP salaries and that salaried GP pay has seen a more than 32% real-terms reduction in England since 2008/09.
‘The BMA salaried GP recommended pay range reflects market rates, as found by the sessional GPs committee survey in 2022, uplifted by the DDRB recommendation for 2024/25.
It is imperative that these short-term roles have a competitive salary, particularly in light of the 32% pay erosion salaried GPs have faced in England since 2008/09.’
GPs employed through the scheme should only be required to work during core hours, ‘to avoid lone working’ without the support of other more experienced GPs, the guidance added.
It also reiterated that the Government and NHS England must develop a plan with the BMA that transitions ARRS GPs into practice-based employment when the fixed-term scheme comes to an end, as this is ‘not a long-term solution’.
Earlier this month the health secretary revealed that funding to hire GPs via ARRS ‘will continue beyond March’ next year, but the BMA added that despite this there needs to be an ‘appropriately funded’ transition period that brings the scheme to a close.
‘We do not want to find ourselves in the same situation in the future with recently qualified
GPs facing unemployment and practices without the funding to hire them substantially, despite
patients wanting and needing to see GPs’, the guidance said.
‘There needs to be a long-term, sustainable plan for employing these GPs in the core practice-based workforce, with an appropriately funded transition period which brings the scheme to an end.’
It goes on to add that while the BMA supports any efforts to tackle the lack of opportunities for sessional GPs in England, it believes that adding GPs into ARRS ‘is a temporary sticking plaster which fails to address the issue of the lack of appropriate uplift to core funding’.
The roles must have ‘certain protections and entitlements, in order to make them safe, attractive and rewarding; and to retain these GPs long-term in the workforce,’ the guidance said.
The BMA recommendations in full
1. The recently qualified GPs employed by ARRS must be employed on the BMA salaried
GP model contract.
2. They must have mutually agreed, contractual job plans that enshrine the principles of the BMA Safe
Working Guidance. The BMA recommends 15 minute appointments and 25 patient consultations per day as safe limits.
3. Mentorship should be delivered by a nominated practice.
4. The GPs should only be required to work within core hours (8.00am-6.30pm) and should avoid lone working.
5. They should be paid a salary that falls within the BMA salaried GP recommended pay range (£83,225-£120,444).
6. There should be limits on the number of practices ARRS GPs can work across – no more than two practices per contract.
7. GPs employed through the scheme must have access to the NHS Pension Scheme.
8. The Government and NHS England must develop a plan with the BMA that transitions the
ARRS scheme GPs into practice based employment when the fixed-term scheme comes to
an end.
Source: BMA
A version of this article was first published on our sister publication Pulse
