13 PCNs hire GPs via ARRS funding in first weeks of expanded scheme

At least 13 PCNs hired GPs through the Additional Roles Reimbursement Scheme (ARRS) in the first few weeks of the new £82m funding pot becoming available.

A survey run by our sister title Pulse PCN revealed that 13 PCNs had ‘already hired a GP’ via the ARRS, while over a third of GP respondents involved in their PCN said they are ‘planning’ to do so. 

The survey question captured responses from 276 PCNs, and of these, just under a third said they are not planning to hire a GP through the ARRS at all. A further 29% have not yet decided (see also box below).

Several PCN leaders have said that the reimbursement covers only a small number of sessions, and it was used to hire GPs they would have recruited regardless of the new scheme.

At the start of August, health secretary Wes Streeting announced that the ARRS scheme would be expanded to include GPs for the first time, as an ‘emergency measure’ for 2024/25. 

Since 1 October, an £82m ‘ring-fenced’ funding pot has been available to PCNs to hire GPs who qualified in the last two years.

Dorset GP partner and PCN clinical director Dr Simone Yule said the extra funding was ‘fortuitous’ as the newly-qualified GP her practice wanted to hire started work in October, which ‘tied in with the new GP ARRS role’.

She said that the money is ‘especially’ helpful now given that the recently announced increase to employers’ National Insurance contributions is estimated to cost her practice £81,000 – roughly the same as a GP salary. 

Dr Yule added: ‘We would have recruited anyway, but actually it’s just supported our recruitment opportunities. And with the employers National Insurance and the increase in the living wage, in hindsight we probably wouldn’t have been able to afford that recruitment.’

Dr Yule explained that the new ARRS GP will be based only at her practice, an arrangement agreed with the other practice in the PCN to ‘balance [their] books carefully’.

South West London GP partner Dr Nick Grundy said the extra money meant that his PCN could hire a GP who had been a trainee at his practice and had been doing locum work.

The funding pays for around two sessions per week in just one practice, he said, which was agreed with the other three practices in the PCN due to underspend across other ARRS roles. 

Dr Grundy said: ‘It was easier for us because within our PCN we were underspent for other roles so we had some money left over. [The other practices ] were happy that we’ve used the funding for a GP within our practice. 

‘But I think for other PCNs it’s a little bit tricky because everyone has to agree and if you split this extra money four or five ways it doesn’t pay for anyone. So you have to get agreement within the PCN.’

Another GP partner, based in Northampton, said they were ‘really fortunate’ as they were in the middle of a GP restructure and recruitment process anyway, and have now hired four new GPs in total. 

But she said that the £44,000 reimbursement will cover ‘almost nothing’ in terms of sessions. The GP will work the bulk of their sessions at her practice and then a ‘few hours a week’ at the other practice in the PCN. 

‘The money is quite nice, but even without it, we’d have still done it. So this was just really fortunate timing.’

The same GP partner, who wished to remain anonymous, said of the ARRS scheme: ‘I think it is helpful, but it doesn’t provide a solution, either in the numbers or the certainty of employment.

‘There are far more unemployed newly qualified GPs than this scheme could ever support and it doesn’t give them the long term continuity that they need. 

She also warned that in PCNs with a greater number of practices, the ARRS GP will be ‘spread thinly, which is really tricky when you’re newly qualified’.

Dr Simon Mitchell, a GP partner at Your Health Partnership in the West Midlands, said the extra money ‘fitted nicely into a recruitment process that was already in place’. 

He explained that his practice’s situation is ‘slightly unusual’ as it is ‘vertically integrated’ into Sandwell and West Birmingham Hospitals, an acute trust.

Dr Mitchell said: ‘We didn’t have to go through a process of working out “OK, how many clinics will the GP do in practice A or B? Or how will we make that fair?”

‘It just slotted in perfectly to our existing delivery model. Also because we are integrated with an acute trust, we didn’t feel the financial jeopardy of not quite knowing what would happen next year with ARRS funding. 

‘So in effect, we were able to recruit at risk and take advantage of the fact we’d got some good applicants at that specific point.’

He suggested that ‘working at scale’ can ‘make some of the rules and processes’ around the ARRS ‘work a bit better and a bit more smoothly’. 

In recent guidance on GPs hired through the ARRS, the BMA recommended that they only work across a ‘limited’ number of practices within their PCN. 

The union’s sessional GPs committee said that patients ‘deserve continuity of care’ and that this can only be provided if the GPs employed under the scheme have ‘dedicated places of work’.

Mr Streeting confirmed last month that the funding for ARRS GPs will ‘continue beyond March’ next year in order to provide ‘certainty and stability’.

This survey was run by our sister titles Pulse PCN and Pulse was open between 19 September and 18 October 2024, collating responses using the SurveyMonkey tool. After removing duplicate entries from the same PCN, a total of 276 GPs with decision-making roles at their PCN in England responded to these questions. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a £200 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 GP population.

A version of this article was first published on Pulse