Ensure ARRS role is not exploiting GPs, CDs told

Clinical directors (CDs) must make sure that the new GP role via the additional roles reimbursement scheme (ARRS) is not exploiting newly qualified GPs who are ‘desperate for work’, CDs have said.

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

The role was announced in August by the health secretary Wes Streeting as an ‘emergency measure’ to tackle GP unemployment, with £82m of ringfenced funding set aside for 1,000 GPs.

CDs at the time were split on how they would use the role, with some suggesting they would place this GP in a hub and others granting the funding to one practice rather than spreading the GP across practices in the PCN.

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.

‘We’re working as a team across the community. We have to level up. We have to raise that standard of what we can achieve from our colleagues.’

He added that PCNs must make sure the job itself is manageable.

‘You want to be careful that the job looks okay,’ said Dr Bunstone. ‘Working across seven surgeries, five days a week, covering frail, elderly, mental health and children will be a pretty challenging job to do. Maybe speak to your trainer and say to them, “Would you apply for this job?”’

However, Dr Sajid Nazir, clinical director Viaduct PCN, West Yorkshire, warned that some GPs might be quite ‘desperate’ for work, meaning they may decide to take on the role despite unfavourable terms. He said he was concerned GPs may not get protected time when they should do.

‘Because people are quite desperate for work at the moment, they might decide to put up with it,’ he said. ‘It’s incumbent on us as CDs to make sure that’s not what we’re pushing.’

He added that the funding for the role was ‘undervaluing’ colleagues.

‘They’ve been asked to take a significant cut and accept it,’ he said. ‘It’s woefully underfunded.’

However, he added that the PCN would still be hiring a GP for the position as otherwise the funding may be lost to primary care.

‘We’ll make it work because we have to make it work – if we don’t take the funding, we’re probably going to lose it,’ he added.

The updated Network DES said the GP role would be for those who are newly qualified and who have not been substantively employed yet. An NHS London FAQs document last week clarified that this could be newly qualified GPs who have undertaken locum shifts before.