Funding for GPs in ARRS ‘derisory’ and ‘uncompetitive’, BMA warns

The amount of funding made available to pay GPs employed under the ARRS is ‘derisory’ and ‘uncompetitive’, the BMA has warned.

The maximum reimbursement PCNs can claim for GPs in the Additional Roles Reimbursement Scheme (ARRS), who could be employed from 1 October, is £92,462 across England, except for those hired in London where it is £95,233.

But the union’s sessional GPs committee said it had ‘serious concerns’ about the level of reimbursement available, which could ‘undermine recruitment efforts’.

The expansion of the ARRS, announced in August on the eve of GP collective action, was introduced by the health secretary as an ‘emergency measure’ to tackle GP unemployment.

However, the full details of the scheme were not shared until the end of September when the updated PCN DES revealed that only GPs who qualified in the last two years will be eligible. 

The BMA said: ‘We raised serious concerns about the salary reimbursement available, which sits at the very bottom of the full-time DDRB salaried GP range at £73,114, is derisory, uncompetitive and does not recognise the true value of fully qualified GPs, especially when compared to the starting salaries of other employed NHS post-CCT doctors of £105,504.

‘This disparity risks undermining recruitment efforts and further deepening inequities in the system.’

The committee said that while this move is aimed at ‘alleviating the difficulties’ faced by newly qualified GPs in securing practice roles, the underlying issue of GP employment needs to be addressed through additional support and funding at the practice level.

‘It is crucial that any introduction of GPs into the ARRS is implemented fairly and effectively, ensuring GPs receive appropriate and competitive remuneration,’ it added.

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. 

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.

In a Pulse PCN roundtable on GPs in the ARRS scheme, clinical directors said there was potential for the role to be exploitative due to the nature of the job and the salary it pays.

They also said that the addition had done a ‘great disservice to younger doctors’ by only providing around £8,300 per session of funding for the role.

Dr Abhi Mantgani, clinical director Arno Primary Care Alliance, Merseyside, said: ‘In the bigger scheme of things, this has done a great disservice to the younger doctors, because it has now set the yardstick of about £8,300 pounds per session as what the Government recommends for a newly commencing GP.’

He added this would work against new doctors coming into general practice.

‘When the demand was there, GPs demanded whatever they wanted, and they got very, very high salaries. But now that the government has set a figure, I think this is going to work against new doctors coming into the general practice pool,’ he said.

Dr Dan Bunstone, clinical director, Warrington Innovation Network PCN, Cheshire, said at the roundtable that it was ‘our role as a CD’ to make sure any exploitation of the role was called out when seen.

‘On exploitation, I would argue that it’s definitely our role as a CD to absolutely make sure that you don’t do it with your salaried GPs and you call it out if you see it,’ he said.

Last month the health secretary revealed that funding to hire GPs via ARRS ‘will continue beyond March’ next year, but the BMA added that despite this there needs to be an ‘appropriately funded’ transition period when the scheme will eventually end.

The BMA has also recommended that GPs employed under the scheme should only work across a ‘limited’ number of practices within their PCN.