PCNs are struggling to recruit several roles through the additional roles reimbursement scheme (ARRS), including pharmacists and advanced nurse practitioners (ANPs), according to a survey.
The survey, carried out by our sister title Pulse PCN, found that 42% of the 228 PCNs that responded said they had recruited a pharmacist, but they had found this difficult.
An additional 4% said they were unable to recruit a pharmacist.
Almost one fifth (19%) of respondents said they were unable to recruit an ANP, with an additional 18% saying they had recruited, but it was difficult to do so.
Hiring mental health practitioners (MHP) and physiotherapists was also found to be challenging, according to the respondents, as 42% and 26% respectively said that although they had recruited this role to their PCN, the process had been difficult (see also Table 2 below).
Additionally, PCNs reported that they were having to pay greater salaries than the maximum reimbursable amounts (as specificied under the PCN Directed Enhanced Service) for both pharmacists and ANPs.
More than half (55%) of the 147 PCNs who answered this question said they had paid over 5% more than their allowances for their pharmacist, with 8% of those paying more than 20% above this.
Meanwhile, 40% of the 60 PCNs who answered the question for ANPs said they were paying extra for these roles, with 12% recording that this was more than 20% above allowances (see Table 1 below).
Table 1: Do you pay above the reimbursable allowances for any PCN staff member recruited through the ARRS?
| Pharmacist | Paramedic | ANP | Physio | MHP | |
| No (or by less than 5% above the allowances) | 45% | 72% | 60% | 73% | 76% |
| Yes, between 5%-20% above the allowances | 47% | 24% | 28% | 22% | 19% |
| Yes, more than 20% above the allowances | 8% | 5% | 12% | 4% | 5% |
| Total number of PCN respondents | 147 | 85 | 60 | 98 | 88 |
Earlier this year, it was revealed that practices and PCNs were at risk of losing out on hiring experienced nurses due to the NHS digital badge scheme, which is a requirement under ARRS.
One PCN representative flagged this issue up, saying they had experienced difficulties with recruitment as ‘no one had a digital badge’.
‘It feels like unnecessary rules are applied so money cannot be spent,’ they explained.
Another PCN respondent who had employed an enhanced nurse said they had ‘run out’ of ARRS funding and had to resort to using other funds.
Meanwhile, one PCN that had recruited a pharmacist easily, raised the points that they were ‘very difficult to retain’.
And another network noted that all of the ARRS positions have a ‘very high turnover’, with most staying in role for only one year.
The findings come as ARRS workforce numbers have dropped over the past six months, according to official figures.
There were 36,862 staff working through ARRS as of 30 September 2024, compared to 37,294 at the end of March, with the biggest drop being among care coordinator and pharmacist staff.
Table 2: Have you recruited any of the following staff for your PCN?
| Pharmacist | Paramedic | Enhanced nurse | ANP | Physio | MHP | |
| Yes, with little or no difficulty | 49% | 32% | 5% | 15% | 49% | 31% |
| Yes, but recruitment was difficult | 42% | 23% | 9% | 18% | 26% | 42% |
| No, we were unable to recruit | 4% | 10% | 15% | 19% | 4% | 11% |
| No, we haven’t tried to recruit | 3% | 33% | 60% | 43% | 18% | 11% |
| Total number of PCN respondents | 228 | 225 | 222 | 227 | 227 | 227 |
This survey was run by our sister title Pulse PCN and open between 19 September and 18 October 2024, collating responses using the SurveyMonkey tool. After removing duplicate entries from the same primary care network, a total of 228 PCN representatives from England responded to these questions. For the question on paying above allowances, we removed don’t knows. The survey was advertised to our readers via the website and email newsletter, with a prize draw for a John Lewis voucher as an incentive to complete the survey. The survey was unweighted, and we do not claim this to be scientific – only a snapshot of the PCN population.
This article was first published by our sister title Pulse PCN
