GPs in ARRS has created a ‘race to the bottom’, CDs told

The creation of a GP role within the additional roles reimbursement scheme (ARRS) has created a ‘race to the bottom’, clinical directors (CDs) have been told at a Pulse PCN event in London this week.

Dr Clare Sieber, GP and CEO of The Well-Led Practice, told delegates that the addition of GPs to the ARRS scheme is ‘proving to be very complicated and tricky’.

‘It’s created this horrible, forced race to the bottom because you’ve got these GPs who are desperate for work and you’ve only got this finite money that we all recognise isn’t enough, and so everybody’s being forced to do it,’ she said.

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

In a Pulse PCN roundtable, CDs said they must make sure the new role was not exploiting newly qualified GPs who are ‘desperate for work’.

They also warned the pay, which works out at around £8,300 per session, warned that it could be the new ‘yardstick’ for future GP pay and has done a ‘great disservice’ to younger doctors.

Dr Sieber, who is a mediator and sits on GPC England, said some PCNs were topping up the salaries, while others are turning down the amount of work expected for the salary, and some are ‘just putting it out there and seeing if anybody is willing to do it’.

She called the funding envelope ‘rubbish’ and said the role itself was ‘quite restrictive’ with uncertainty about its longevity.

‘There’s lots of uncertainty about what will happen next year because we’re already halfway through the year, and how attractive it is for a new GP to take on a contract that’s only got the limited shelf-life expectancy to it potentially,’ she said.

The attractiveness for PCNs as employers was also questioned, as if the role is put on a BMA model contract there will be certain terms that need to be adhered to, such as the start date for sick pay eligibility.

‘It’s risky on everyone’s part and massively uncertain too,’ Dr Sieber added.

A recent survey by Pulse PCN found that at least 13 PCNs hired GPs through the ARRS in the first few weeks of the funding becoming available.

In October, Mr Streeting said the scheme would be funded beyond March, while NHS England has previously said it would recognise this is a change to PCN operating costs and would be considered in future budget setting.