The updated PCN DES which will allow for GPs to be hired through the ARRS is not expected until the very end of the month, Pulse understands.
GPs have raised concerns about the lack of time to prepare and the delays that may ensue from October in hiring newly-qualified GPs, some of whom are ‘desperate for work’.
In August, health secretary Wes Streeting announced that the ARRS will be expanded for the first time to include GPs, as a measure to tackle unemployment among those qualifying this summer.
This was badged an ‘emergency measure’ for 2024/25, with NHS England later clarifying that PCNs would be able to ‘draw down funding’ of £82m from October.
NHSE also said that the ‘exact criteria for employing GPs will be set out in a revised Network Contract DES specification’, which would be decided in consultation with the BMA’s GP Committee England.
However, with only a week until the start of October, NHSE is yet to publish the updated DES.
The national commissioner has declined to set a date for publication, but has suggested to Pulse on background that it’s not immediately imminent and likely to publish even closer to the end of the month.
Gateshead LMC chair Dr Paul Evans told Pulse said the last-minute publication of the DES ‘just means it’s much less likely that any GPs will actually get hired by this’.
The ‘emergency measure’ was expected to last for six months from October since NHS England has not confirmed any extension to the arrangement beyond March 2025.
But Dr Evans, who is also the GPCE lead for education, training and workforce, said it will ‘absolutely be less than six months’ because ‘even if it were ready to go on the 1 October, no one’s going to advertise, hire, interview and appoint on day one’.
He added: ‘If there’s delay built in, I suspect lots of practices are just going to say “yeah, whatever”, and simply not bother drawing down on this funding, which would be a great shame for them, because it would be workforce they’re missing out on.
‘But it would also be a great shame for the GPs who could potentially be hired.’
Birmingham GP partner Dr Adnan Masood expressed similar concerns, telling Pulse there is ‘no clear direction from NHS England on the DES’.
‘So even if we decided one GP could be taken across a PCN, we still haven’t got information to be able to do that in terms of when the funding will be available, and we don’t even know exactly what qualifies as a recently qualified GP yet,’ he said.
Dr Masood highlighted that if the £82m addition to the ARRS is managed entirely by PCNs, rather than an arrangement where practices hire themselves and then reclaim the money back, it could take ‘six to eight weeks’ to complete interviews and recruitment for new GPs.
‘This would just delay the whole thing, and you’re left with three or four months of a token gesture,’ he told Pulse.
He also raised concerns about the inability to use monthly ARRS underspend to hire GPs, saying there are recently qualified GPs in his area who are ‘desperate to work’.
Dr Malinga Ratwatte, the immediate past chair of the BMA GP registrars committee, said the expansion of the ARRS scheme is an ‘embarrassment for Government that can be avoided’.
In a post on X, he said: ‘The promise of funding but no plan for how these GP roles are going to be implemented via this untested, experimental mechanism via ARRS.
‘PCNs facing too much uncertainty about future funding streams for employment to be worth the risk of future redundancy.’
The RCGP echoed GP concerns, saying it is important that practices ‘get clarity’ on how the scheme will work, especially given the nearing October deadline.
College chair Professor Kamila Hawthorne said: ‘Implementation of this scheme will be key and we’ve been clear it needs to work for patients and practices, including by offering geographical flexibility and as streamlined an application process as possible.
‘It’s important we get clarity on how the hiring process will work, and see the finer details of the expanded scheme soon – especially as the fund should be available from October.
‘The more notice GP practices have about how the scheme will work, so they can plan accordingly, the better.’
She said the RCGP welcomed the Government’s decision to expand the ARRS to GPs as an ‘short-term measure’, but stressed the importance of longer term funding of the core contract.
In August, the BMA wrote to the health secretary demanding that the extra ARRS funding for GPs is given directly to practices rather than to PCNs.
1. difficult to hire if the committment is only 6 months.
2. looks like secondary discrimination on an age basis, surely?
3. may be hard to recruit as the posts won’t be terribly attractive, being split across multiple sites etc.
4. overall it looks like a PR piece for public consumption rather than a serious suggestion.
So.. because of delays and difficulties we will see a massive underspend on this, thus proving it is not needed and the ICBs will use it to offset overspends in guess what sector.
Once again this is a PR announcement which has very little meaningful impact to either GP unemployment opps or improved local GP provision when (i) it provides for 15 hours a week of a GP across a PCN of 50,000 but funded only until the end of March 2025 and (ii) offers no opportunity to improve continuity given the lack of resource. Given the absence of detail, there is as yet no money or recruitment criteria. There is no suggestion that the scheme will be extended and that any GP who accepts a job should assume that they’ll be out of a role 4 months after recruitment and if extended they;ll likely be offered worse contractual rises than ther salaried GP colleagues receiving DDRB uplifts [but obviously only if the funding for the uplift probvide sufficient cash to deliver it… which the current one does not]
Stop meddlng around the edges (a) allow PCNs and practices therein to use PCN money to employ any GP – they can elect to decommission other roles which are not sufficiently beneficial to the practice skill mix and deliverables, and instead use that money to pay GPs. Then after 6 months, this ARRS money, with practice population, inflationary uplift and DDRB protected rises iTriple Lock, Anyone?) is rolled into a new improved GMS contract which more accurately reflects (i) the fixed costs and necessity or a capitation model but will added income to reflect higher contact patient groups, greater comorbidity patient groups, all phlebotomy/ECG/prescribing for secondary care (LCSs) as well as item service fees for LCS and all other additional and itemised service provision. I don’t mind where the money comes from – if this is stuff which secondary care isn’t doing and has been paid for and is passing the buck (without the payment) to GPs then it’s time for a historical trawl back with funding reassignment and reimbursement for GP. Looking forward however, all of this needs to be negotiated up front prior to any service being delivered with an initial 3-5 year contract with built in inflationary protection of the deliverables. Thus way practices can plan to resource if the business case makes sense.
anyone surprised ?