GP ARRS role sets new ‘yardstick’ for pay, CDs warn

The new GP role in the additional roles reimbursement scheme (ARRS) will set a precedent for future GP pay, clinical directors have warned.

In a Pulse PCN roundtable on GPs in the ARRS scheme, clinical directors said it had done a ‘great disservice to younger doctors’ by only providing around £8,300 per session of funding for the role.

Dr Abhi Mantgani, clinical director Arno Primary Care Alliance, Merseyside, said: ‘In the bigger scheme of things, this has done a great disservice to the younger doctors, because it has now set the yardstick of about £8,300 pounds per session as what the Government recommends for a newly commencing GP.’

He added this would work against new doctors coming into general practice.

‘When the demand was there, GPs demanded whatever they wanted, and they got very, very high salaries. But now that the government has set a figure, I think this is going to work against new doctors coming into the general practice pool,’ he said.

‘I don’t think this has been a great idea, and it needs to be rethought.’

The role, which was announced in August by health secretary Wes Streeting, set out £82m of ringfenced funding for 1,000 GPs. This equates to £92,462 across England and £95,233 in London, both of which include employer on-costs for NI and pension, as set out in the Network DES update.

Dr Sajid Nazir, clinical director Viaduct PCN, West Yorkshire, added that the funding needed to be compared to consultants when they start their roles.

‘I don’t think the government has selected that pay grade because of the slightly junior status of those GPs. I think that’s their yardstick. This is what you are worth,’ he said.

‘We’ve got to be very careful if we accept it and say, ‘Well, if you’re new you can accept this pay’ because it doesn’t work like that in hospital. There is a rate scale they worked up towards. But if you look at their starting scale and remember their employer’s pension, national insurance, etc., is paid on top of that, it’s significantly higher than what we’re being offered. And actually, it’s nowhere near those sorts of rates.’

The starting salary for consultants is £105,504, according to the BMA.

Dr Nazir added that he had not seen £8,000 a session offered in the past 10 years.

‘I do think it’s undervalued and I think it’s a slippery slope,’ he said. ‘I understand people need to be grown into the role, and there is junior and senior, but NHS England took away seniority payments a few years ago. That was their own thoughts on someone being paid differently, so there’s a concern that if they expand the scheme, it will be open to other GPs, not only new GPs. And I can’t see them opening different pay scales depending on how much experience you’ve got.’

Clinical director in West One PCN, East London, Dr Shanika Sharma, added that it was also not the same pay offered as in the Salaried Portfolio Innovation (SPIN) scheme in London, which helped to develop portfolio opportunities for GPs and general practice nurses.

‘The starting salary for that was in the range of £9,500 to £10,000 or £11,000 per session,’ she said.

‘I think there is a risk here that we’re undervaluing the profession. We are in a recruitment and retention mess, and that’s really because the GMS contract is not being funded proportionately to demand and rising populations.’

She added that though it was ‘fantastic’ ARRS roles have been brought in, it has meant many practices have not been able to afford newly qualified GPs.

‘As a partner, we have to think twice before taking on a locum for a session because of how it will impact the practice financially. It’s not that we don’t want GPs; it’s just that we can’t afford to have locum GPs for sessions,’ she said.

However, Dr Dan Bunstone, clinical director, Warrington Innovation Network PCN, Cheshire, said it would take around £800m a year to afford the GPs primary care needs.

‘We’ve long talked about needing an additional 8,000 GPs; if you do some very quick maths and work out that each of those GPs’ average wage might be £100,000 a year, that’s £800 million pounds, nearly a billion,’ he said.

‘I don’t see a billion pounds sat sloshing around the primary care budgets with nothing attached to it. That’s why we’ve got this really weird disconnect where we need the GPs, but to have the GPs, the funding needs to come with that, too.’

Read the full roundtable here