Unclaimed ARRS Funding to Be Unavailable to PCNs Under New Contract
In a significant update, NHS England has announced that Primary Care Networks (PCNs) must fully utilise their Additional Roles Reimbursement Scheme (ARRS) allocations or risk losing the funding. The new contract specifies that the redistribution mechanism for unclaimed ARRS funds will be removed, meaning that any unclaimed funds will no longer be available to PCNs.
Dr. Amanda Doyle, NHS England’s primary care national director, stated in a letter:
“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. We continue to encourage PCNs to recruit up to their individual entitlements.”
Previously, Integrated Care Boards (ICBs) could invite PCNs to bid for any unclaimed funding. However, last year, it was forecasted that at least £64 million of ARRS funding would go unspent. This unclaimed funding will not revert back to primary care under the new regulations.
The changes made to ARRS Roles and Funding:
Changes have also been made to ARRS roles, with the introduction of the enhanced nurse role. Initially, this role will be capped at one per PCN, or two for PCNs with a patient list size of over 100,000. Enhanced nurses are defined as being between registered level nurses and advanced level nurses, holding a postgraduate certificate or diploma in one or more specialist areas of care.
Additionally, NHS England has removed the cap on the number of advanced practitioners (APs) that PCNs can recruit under ARRS. Previously, PCNs with a list size under 100,000 could recruit up to three APs, and those with a list size over 100,000 could recruit six.
The contract also outlines changes to the employment of mental health practitioners (MHPs), allowing them to be fully funded by the ARRS scheme. Currently, MHPs are funded 50:50 by the PCN and mental health provider, but moving forward, they will continue to be “employed or engaged” by the mental health provider.
Dr. Doyle emphasised that these changes are intended to increase the flexibility of the ARRS by widening reimbursable roles and removing certain restrictions. “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,” she added.
As of 31 January 2024, the top three recruited roles under ARRS were pharmacists, care coordinators, and social prescribing link workers.
Despite the inclusion of enhanced nurses, general practice nurses are not included in ARRS. This decision follows an online petition that received 10,967 signatures. The Government responded on 22 February, stating that the 2024/25 GP contract arrangements are still under consultation with the British Medical Association and that it would be inappropriate to comment further at this stage.
Furthermore, changes made during Covid-19 to the medical performer’s list (MPL) will be made permanent, allowing PCNs to employ doctors other than GPs who are already employed by an NHS trust or foundation trust.
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