ARRS increases in line with Agenda for Change, NHS England confirms

Increases to the reimbursable amounts for ARRS staff are in line with the 5.5% Agenda for Change pay increases announced earlier this year, NHS England has confirmed.

However, networks will need to find the money for these uplifts within their existing 2024/25 budgets, it added.

The government announced a 2024/25 pay award of 5.5% for Agenda for Change staff on NHS terms and conditions at the end of July. However, PCNs had been waiting for confirmation for updated ARRS reimbursements until last week when the Network DES update was published. But this document did not state whether this was in line with the Agenda for Change uplift.

In a clarification to Pulse PCN, a spokesperson for NHS England said this was the case.

They said: ‘The maximum reimbursement amounts per role for existing (non-GP) ARRS staff have increased (1 October 2024-31 March 2025) by 5.5% for employees’ pay following the NHS Pay Review Body Report 2024 and employers’ national insurance and pension contributions added.’

On why the PCN funding has not increased to accommodate this uplift and how they advise PCNs to pass on the raise, they said: ‘Funding for the Additional Roles Reimbursement Scheme (ARRS) was uplifted for the full 2024/25 year by 2% in April 2024.

‘In applying the 5.5% uplift from 1 October, Networks will need to ensure that the 2024/25 cost of their overall ARRS establishment remains within their available 2024/25 Network contract funding.’

Last year, reimbursements for ARRS roles were also uplifted to match Agenda for Change, but there was similarly no overall change to the funding available for the scheme.

Dr Sarit Ghosh, clinical director at Enfield Unity PCN, said: ‘A rise in the reimbursement figures without an increase in total budget puts PCNs in a difficult position caught between potential retention issues and financial stability.

‘In previous years, where either the full budget was not spent or there was an incoming increase in the allocation, this was not such an issue as there was a margin. Now with a push to utilise all of the funding, there is nothing left for rises meaning dipping into other pots.’

NHS England also stated that though the additional £82m in funding for GPs in ARRS was an emergency measure, they ‘recognise this is a change to PCN operating costs that will be considered in future budget setting, as in previous years when the ARRS has been expanded and PCNs have recruited additional staff’.

Dr Laura Mount, clinical director at Central and West Warrington PCN, said she was writing a proposal with her PCN manager on hiring GPs via ARRS this week.

However, she said the maximum reimbursable amount is a ‘major issue’. This was set at £92,462 across England and £95,233 in London, both of which include ’employer on-costs for NI and pension, in the Network DES update last week.

She added: ‘I have had a lot of interest from people over the roles, one person told me she had only three hours work since Certificate of Completion of Training (CCT) three months ago. I’m hoping we can help as many people as possible.’

However, Dr Ghosh said the restrictions on the role, including being within two years of CCT and not previously substantively employed were ‘prohibitive’, and the timings and minimum term ‘slightly opaque’.

‘Perhaps most importantly, the 95k reimbursement for 9 sessions (37.5 hours) works out at around £8,300 per session,’ he said.

‘The average sessional rate locally appears to be upwards of £11,000 per session leaving a liability of above 3.5K per session. Notwithstanding the other restrictions, to recruit a full time GP on this scheme will cost a PCN around £31,500 which is a significant blocker,’ he said.

‘There are a number of agencies with proposals to work around these financial requirements and as I am not sure how their interpretations hold up against the specification, this could potentially be an easy trap for a PCN to fall into.

‘We are going to explore the detail with the ICB and see if GP ARRS recruitment is viable for us.’

Clinical directors previously told Pulse PCN that they were divided on how to use the new GP ARRS role, with some looking to place it in a hub and others considering granting one practice an extra GP.

PA numbers level off

It comes as the latest PCN workforce figures show that physician associate (PA) numbers slightly levelled off over the summer months.

There were 1,183 PAs working in PCNs in August, compared to 1,184 in June and July. In May, the figure was 1,165.

Pharmacists remain the most popular ARRS role, with 5,357 in August, up from 5,330 in July. This is followed by care coordinators (4,784) and social prescribing link workers (2,785), both of which also increased since July.