Maximise ARRS spending in DES final year

Clinical directors were urged spend additional roles reimbursement scheme (ARRS) funding in the final year of the current contract or risk losing it.

Speaking at the Pulse PCN event in London on Tuesday, Dr Richard Vautrey, CD of Central North Leeds PCN, said that while the details of the PCN contract beyond 2024 are unknown, the focus for the final year should be on spending ARRS money.

‘The key is trying to maximise the ARRS funding in this final year. Do all you can to recruit and to use that funding because once it’s embedded into the system then I think that will then be retained but then if you don’t spend it, it will get lost and there’s a real risk that we actually lose that funding from the GMS envelope beyond 2024,’ said Dr Vautrey, who is also assistant secretary of Leeds LMC and former chair of the BMA general practitioner’s committee.

The funding for ARRS is set to increase to £1.4bn in 2023/24 and ARRS-recruited staff will be treated as part of the core general practice cost base beyond 2023/24.

Recent changes to the ARRS contract saw the roles expaned to include GP assistants and Digital and transformation leads. There has also been an increase in the cap on hiring advanced practitioners (APs) through the ARRS, from one per PCN to two (double for those with over 100,000 patients) and the removal of the minimum 0.5 FTE restriction on clinical pharmacists once they have completed their required 18-month training course or have been granted equivalence/exemption from the Primary care pharmacy education pathway.

Dr Vautrey also cast doubt on the top recommendation in the Fuller Stocktake to split urgent and routine care saying it would lead to duplication.

‘I’ve real concerns around this idea of separating urgent care from more routine care when we know most patients turn up with a so-called urgent problem and in reality it’s a problem they’ve had for three years and ‘actually by the way can I talk about this other problem’,’ he said, adding it could lead to duplication with patients going into an urgent care service and then two days later going to the GP for the same issue.

When considering the Network DES contract beyond 2024 Dr Vautrey said that he thought the current funding would remain.

‘The reality is there is no new money coming over the hill and there isn’t a will to make massive changes before the election so my hunch is you’ll be expected to do the best you can with the limited resources you’ve got and I suspect the best we can hope for is the status quo.

‘I suspect, the back stop is whatever funding is in the contract in 2024 will be in the contract for 2025. I don’t think they would pull the rug because they know that to do so would remove all of the staff that are currently in the system. Someone is going to have to pay for that staff so I think you can be pretty certain the staff will remain the funding will remain to pay for those staff. Whether it gets inflated sufficiently enough beyond 2024 is another matter,’ he said.

Delegates at Pulse PCN London also heard talks about using group clinics to increase access from Dr Ellen Fallows, vice president of The British Society of Lifestyle Medicine and on leadership in PCNs from Dr Craig Newman, clinical psychologist.

Dates for Pulse PCN events in London, Birmingham and Manchester in 2023 will be announced soon.