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Lack of clinical support and isolation driving retention issues among ARRS staff

by Beth Gault
14 October 2022

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A lack of clinical support and feelings of isolation within general practice is causing lower retention among Additional Roles Reimbursement Scheme (ARRS) staff, according to a PCN strategic lead.

Yuen Toh, who is also a PCN lead senior pharmacist at Apex Primary Care Network, told Management in Practice’s event in Newcastle last month that these two factors were leading to poorer integration of ARRS staff members within general practice.

Ms Toh referenced a study from 2021 that evaluated the role and integration of general practice pharmacists in England. It found that a lack of understanding of the pharmacists’ role was a barrier to integration within the practice, alongside unreasonable expectations, and a lack of support from practice.

One pharmacist who took part in the study said: ‘The role can still be quite isolating as you can be the only one in a practice.’

However, another who said they had a supportive practice added: ‘My practice manager was key to my integration and was the advocate for the role.’

Ms Toh said being welcoming to staff and showing them you care can make a big difference.

‘Changing from being part of a big team to working in a room on your own can lead to feelings of isolation,’ said Ms Toh. ‘Practice managers have a role here to check in with them, though it’s not just their responsibility. Managers can lead by example and help create a caring and compassionate culture.’

Meanwhile, clinical support needs to be more tailored to individuals as there is a wide range of roles within ARRS and those coming in also have different levels of experience.  

‘I find it really helpful to start with a conversation about success, as part of the induction process or even separately. Be curious about what the person’s role was before and what their expectations are and have this chat early on to prevent later frustrations. Also, have this conversation regularly,’ said Ms Toh.

Exit interviews can also be helpful, as people will often be more honest and open about the struggles they faced in their role when leaving it, she explained.

‘Any points they’ve mentioned, especially constructive ones, can always help you reflect on how you lead the practice,’ said Ms Toh.

She added that it’s important not just to review issues and problems at the point when the practice loses staff, but be continuously focused on culture and how to improve retention.

‘Culture has always been a thing that isn’t really looked at that much because it’s harder to measure,’ said Ms Toh. ‘It’s also tricky because it’s about holding people accountable for their behaviour and changing behaviours.  Because everyone is so stressed, it becomes less of a priority.

However, culture makes a big difference, she said.

‘If a practice has a caring and compassionate culture, whoever new goes in is going to feel that straightaway.’

Find out more about our upcoming Management in Practice events here.