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Nurses could leave general practice due to feeling ‘devalued’ by ARRS

by Sofia Lind
23 August 2023

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The role of general practice nurses (GPNs) is being ‘devalued’ by the additional roles reimbursement scheme (ARRS), a leading nursing charity has warned.

The Queen’s Nursing Institute (QNI) said GPNs – as well as GPs – are working longer hours to introduce new team members, calling on NHS England to dedicate resources to training.

It also noted with ‘disappointment’ that ARRS now caters to 17 multi-disciplinary team roles in primary care with the ‘continued exclusion) of GPNs from the scheme.

It called on NHS England to ensure GPNs feel valued or they will vote with their feet and go work outside general practice.

‘Many GPNs are being required to support new starters, despite nurses themselves being excluded from being recruited into the scheme,’ the charity warned.

‘It is well documented that many GPNs, alongside GPs, are spending a substantial part of their clinical time developing and delivering induction programmes, supervision, and training schemes for new starters, but are receiving no additional benefit or recognition for this, and there are minimal resources to deliver these induction programmes.

‘Indeed, the impact is one of longer working hours to enable GPNs to continue providing their clinical care alongside these additional responsibilities.’

To remedy the situation, NHS England should allocate ‘resources to support the comprehensive induction and supervision of new members of the general practice team recruited through the ARRS’, QNI said.

QNI went on to warn that ‘Advanced Nurse Practitioners, who are now included in the scheme, are often routinely named as the lead nurse over GPNs, even when they have not previously worked in general practice’.

There is also ‘an emerging risk of deskilling expert GPNs in favour of the new roles introduced through the ARRS’ the charity said, with clinical practices becoming ‘divided into tasks’ and patients losing the continuity of care that GPNs provide.

‘A unique part of a GPN role is the ability to deliver holistic, personalised care for the whole population; many other roles are providing care that is chiefly task orientated, risking duplication, omissions, or unnecessary interventions,’ it said.

‘By recruiting such a high proportion of new staff through the ARRS, the role of a GPN is being devalued. ARRS roles are perceived as the “life savers” of primary care – and there is no doubt that they have value – but GPNs have been central to the delivery of excellent care in general practice for decades.’

Unless there is a ‘clear acknowledgement of the value of GPNs’ and ‘a plan to support GPNs to stay, grow, and develop’, general practice risk losing GPNs to other areas of the health service, QNI concluded.

NHS England’s long-term workforce plan, published in June, said it would look to increase capacity and free up available appointments in general practice by bringing in 15,000 non-GP direct patient care (DPC) staff and more than 5,000 primary care nurses.

A version of this story was first published by our sister title Pulse