Practices are ‘under no obligation’ to recruit GPs through the Additional Roles Reimbursement Scheme (ARRS) and should not be pressured into doing so, a group of LMCs has advised.
Surrey and Sussex LMCs pushed back on NHS England’s request that all PCNs should ‘use their GP ARRS funding entitlement’ for the current year.
The LMCs’ chief executive Dr Julius Parker wrote to practices in the area clarifying that PCNs ‘should feel no obligation’ to recruit GPs under the scheme if this is not considered beneficial, adding that recruitment so far has been ‘lukewarm’.
He pointed out several possible reasons why practices have been reluctant to employ GPs under the scheme, including the reimbursement salary cap and the requirement that limits recruitment to GPs within two years of their CCT.
The BMA has previously criticised the amount of funding made available for GP salaries under the ARRS, arguing that it is ‘derisory’ and ‘uncompetitive’.
Dr Parker said that it is ‘not feasible’ to recruit GPs ‘at a sessional rate of £8,124’ and that instead, PCNs ‘are supplementing’ salaries via other PCN income streams, and that by doing so, ‘are subsidising the real cost’ to NHS England of securing GPs to work within general practice.
He said: ‘When considering recent NHS England or ICB correspondence, PCNs should be reminded that they are under no obligation to recruit GPs under their remaining 2024/25 GP in ARRS budget if member practices do not believe it is in their best interests to do so.
‘One can only speculate why NHS England has felt it appropriate to specifically encourage such recruitment at this stage.’
He also said that the LMC is aware that ‘many’ PCN CDs and GP practices ‘are being targeted’ by locum and recruitment agencies who are highlighting GPs available for recruitment under the scheme.
He added: ‘This often comes with required agency or commission fees which must be paid by the PCN. This cost cannot be reclaimed under ARRS funding and seems a complete waste of NHS resources.
‘PCNs should therefore feel no obligation to say they plan to recruit GPs under ARRS if encouraged by the ICB to do so.’
Meanwhile, in Cambridgeshire, the LMC also said that the rollout ‘has been fraught with challenges’ and that the ‘human cost’ of both the GP unemployment crisis and this ‘rushed’ solution came ‘into sharp focus’.
The LMC wrote to the Department of Health and Social Care and NHS England to express ‘deep’ concerns regarding the scheme, after it received first-hand accounts from registrars who are ‘distressed’ by the ‘limited’ employment opportunities available to them.
The letter said: ‘The scheme has set a grossly inadequate salary for these GPs, further devaluing salaried GP positions. Additionally, the lack of integration into individual practices deprives newly qualified doctors of the essential support needed for their professional development and growth.’
According to the LMC, international medical graduates (IMGs) have been particularly affected, as many require visa sponsorship to continue working in the UK.
It added: ‘Peterborough has a high number of IMGs, many of whom have traditionally remained in the area to serve its deprived population. However, we are now hearing from registrars who are unable to find roles which will support them to remain.
‘Furthermore, there is a cohort of early career GPs who are ineligible for this scheme. Many of them are struggling to find sufficient work and feel unfairly disadvantaged by NHS England and the
Department of Health and Social Care.
‘In light of these concerns, we urge NHSE and the DHSC to urgently review the GP role in the ARRS and its well-intended but damaging consequences. We strongly recommend that future funding be allocated at the practice level, ensuring that all newly qualified GPs have equal access to the support necessary for professional development.’
Pulse has contacted NHS England and the Department of Health and Social Care for comment.
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.
NHS England has so far held back from publishing the number of GPs hired via the scheme, amid conflicting reports.
In December, RCGP said that of the 1,000 ARRS GP roles available, just over 300 had been filled – a figure which came directly from the Department of Health and Social Care (DHSC), according to college chair Professor Kamila Hawthorne.
Most recently health secretary Wes Streeting said that with the extra £82m of ARRS funding which began in October, the Government has ‘recruited hundreds of GPs to the front line already and will recruit hundreds more in the months to come’.
These figures do not, however, align with recently published NHS data on the PCN workforce, which in December was updated to include GPs funded through ARRS.
Pulse’s latest major investigation has looked into the reasons why general practice is going through a recruitment and unemployment crisis.
I feel the funding to employ only newly qualified GPs is discriminatory and should be contested in court. The pay is also derisory as mentioned in this article.
The pay is realistic in the current environment, worker supply is far in excess of demand for newly qualified GP’s.
Not sure that a FTE salary which is no more than a GPr was enjoying for less responsibility and 30% educational activity is market forces. it is a complete and purposeful disregard for the newly qualified into the profession. Shame on NHSE and HMG 😢
But if there is a funding, why not use it? We hired one GP on ARRS, and it worked well. In our PCN some practices were hesitant, but later on all agreed to use these funds to improve patient care, and to create employment, and to have extra support for clinicians in the surgery.