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‘Enhanced’ practice nurses to be included in ARRS under new contract

by Anna Colivicchi and Rima Evans
29 February 2024

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Only ‘enhanced’ practice nurses will be added to the the additional roles reimbursement scheme (ARRS) in 2024/25, NHS England has announced.

The new imposed contract also removes the mechanism allowing commissioners to redistribute any unclaimed funding from ARRS to PCNs.

A contract letter sent yesterday by NHS England said nurses ‘working at an enhanced level of practice’ and holding a level seven or above postgraduate certification in one or more specialist areas of care will be eligible for recruitment via ARRS.

This covers only a specific level nurse as opposed to all general practice nurses (GPNs) – see also box below.

As a new role, this will initially be capped at one per PCN – or two where the list size is 100,000 or over.

However, all existing caps on hiring other ‘direct patient roles’ under ARRS will be removed to provide more flexibility for GPs and primary care networks (PCNs). For example, from April there will be no limit as to how many advanced practitioners a PCN can bring in.

In the letter to practices, detailing the changes, NHS England primary care director Dr Amanda Doyle said: ‘We know that the ARRS has been hugely successful in expanding teams, increasing appointments and supporting the delivery of proactive care, but we have heard that PCNs would welcome more flexibility in how the scheme operates.

‘We are widening the number of reimbursable roles and removing role restrictions.’

Other changes to the ARRS include:

  • PCNs will be able to recruit other direct patient care non-nurse and non-doctor MDT roles, if agreed with their ICB.
  • PCNs will be able to claim reimbursement for the time personalised care roles spend out of practice undertaking training or apprenticeships to obtain a level three occupational standard.
  • More flexibility for funding of mental health practitioners (MHPs), so subsequent MHPs posts (where one is already in place) can be 100% funded via ARRS. All mental health practitioners will continue to be employed or engaged by the mental health provider.

NHS England also announced that PCNs will no longer be able to bid for any unclaimed ARRS funding, as is the current arrangement.

The letter said: ‘In 2024/25 the mechanism which allows commissioners to redistribute unclaimed funding from the Additional Roles Reimbursement Sum between PCNs will be removed from the Network Contract DES.’

It added: ‘We continue to encourage PCNs to recruit up to their individual entitlements’.

It’s not yet clear what will happen to unused funds and whether they will remain available to primary care or be diverted elsewhere.

What is an enhanced practice nurse?

According to the Primary Care and General Practice Nursing Career and Core Capabilities Framework, enhanced practice nurses are working at a level above general practice nurses and below advanced and consultant level practice nurses. They will have completed modules or learning that ‘enable the delivery of general practice nursing at a specialist / enhanced level that are aligned to scope of practice’. 

It’s a role suitable for senior practice nurses or nurse practitioners, says the framework.