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

Exclusive 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 Pulse survey, which ran for a month until mid-October, 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 276 different PCNs, and of these respondents, just under a third said they are not planning to hire a GP through the ARRS at all, and 29% have not yet decided.

Several PCN leaders told Pulse 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 told Pulse 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, which is roughly the same as GP salary. 

Dr Yule added: ‘I think, just for once in our lives, we were quite fortuitous in the position we were in. 

‘We would have recruited her anyway, but actually it’s just supported our recruitment opportunities. And actually now, 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.’

She also told Pulse that the new ARRS GP will be based only at her practice, and this was agreed with the other practice in the PCN as they work together 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, which was agreed with the other three practices in the PCN due to underspend across other ARRS roles. 

Dr Grundy said: ‘For us it was easier because within our PCN we were underspent for other roles so we had some money left over. So they were happy that we’ve used the funding for a GP within our practice. 

‘But I think in 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.’

‘It’s a shame it relies on goodwill, because if you don’t have that it’s a problem,’ he added.

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 take up the bulk of their sessions at her practice and 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. 

‘And I think particularly in PCNs with more practices they’re spread thinly, which is really tricky when you’re newly qualified. The reimbursement for practices that aren’t in our position, who weren’t recruiting anyway, doesn’t cover it at all.’

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’. 

But he told Pulse that his practice’s situation is ‘slightly unusual’ as they are ‘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, and 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’ve 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 GP employed under the scheme have ‘dedicated places of work’.

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

This survey was run with our sister title Pulse PCN and 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.