ARRS improves patient access, study finds

The Additional Roles Reimbursement Scheme (ARRS) has improved patient access, according to a study in the BJGP.

The research paper, which has been accepted for publication by the BJGP, found that there was a small increase in both perception of access and patient satisfaction associated with direct to patient ARRS roles.

These increases equated to around 210-350 (0.7%) more patients who were able to make appointments for each FTE ARRS role employed in a typical PCN (30,000-50,000), and 240-400 (0.8%) more patients satisfied with their care. The average number of FTE ARRS roles per 10,000 registered patients was 2.91, it added.

However, it also found there was ‘no association’ with overall QOF achievement.

The research looked at the NHS statistics on PCN and general practice workforce, the general practice patient survey, annual QOF results, population lists and indices of multiple deprivation between March 2020 and March 2023. This included 1,253 PCNs and 6,771 GP practices who had submitted data. Only 76 practices, who are not part of a PCN, were excluded.

Led by researchers at the University of Bristol medical school, the study also found that single-practice PCNs had around 0.6 more FTE ARRS roles per 10,000 patients compared to the PCNs with the most practices (7-22). However, it added that the commissioning of the roles ‘does not vary by area-level deprivation’.

The authors said that while there was a ‘slightly better’ patient reported satisfaction and ability to make appointments, that the ‘effect size was very small’ given the investment in the scheme.

The authors said: ‘The ARRS scheme expanded existing roles and introduced new roles into NHS primary care in England. It remains unclear if minimal increases in patient perceptions of access and overall care represent value for money.

‘The relationship between PCN organisational structure and commissioning of ARRS roles may have implications for the evolution of PCNs.’

They added that future research should look at the lack of patient-level data on consultations with ARRS staff.

The authors said: ‘This would give a better understanding of the types of patients seen by each of the roles and outcomes of those consultations, which would inform overall workforce planning, training needs of staff in these roles, and opportunities to develop these roles. Finally, it may be beneficial to understand how and why the structure of PCNs affects their ability to commission ARRS roles.’

It comes as an exclusive investigation by Pulse PCN found that around £45m of ARRS funding was unspent by PCNs in 2023/24.