GPs should be included in ARRS, says BMA

The BMA is lobbying for GPs to be included in the Additional Roles Reimbursement Scheme (ARRS) but facing resistance from NHS England and the Government.

Dr Katie Bramall-Stainer, chair of the BMA’s GP committee (GPC) for England, said that the committee was arguing for GPs to be included as it was ‘an obvious solution’ to practices’ financial and workforce issues.

But she said that NHS England and the Government were challenging it with a ‘comeback… that GPs aren’t additional’.  

Under the ARRS, primary care networks in England are given funding to hire pharmacists, physiotherapists, physician assistants and advanced nurse practitioners among other professionals.

However, the scheme currently excludes GPs.

Last week, Pulse PCN reported that PCN directors wanted GPs to be included after a petition to allow ARRS funding to be used to employ GPs and practice nurses gathered more than 8,000 thousand signatures.

Dr Bramall-Stainer said including GPs in the scheme would be an example of the ‘high trust, low bureaucracy, flexibility, and creative solutions’ needed when finances were tight.

GPC England deputy chair Dr Samira Anane said that if practices had been able to access ARRS funding, it would have created ‘a far more flexible, responsive and sustainable solution to the workforce crisis facing general practice’ and ‘better value for money…. in terms of patient care’.

In an update to members, she said: ‘Had the considerable financial support associated with the ARRS programme over the past five years been directly available to GPs for use within their practices, without the constraints on recruitment associated with the PCN DES specification, this would have created a far more flexible, responsive and sustainable solution to the workforce crisis facing general practice.’

Arguing against the view taken by NHS England and the Government that GPs could not be included in ARRS because they were not additional, Dr Bramall-Stainer said many GP roles were already additional because they were not included in the contract.  

She suggested a named GP at a neighbourhood level, which ‘will complement’ the named GP at a practice level and a named GP at a system level.

‘Or you could have additional roles GPs that lead frailty provision across a community,’ she added.

‘You could also have additional GPs in the enhanced access setting that could then provide greater resilience for those appointments, allowing substantive GPs to continue long-term condition management.’

In recent months, there have been increasing reports around GP locums struggling to find work, with some putting this down to an increase in ARRS roles.