Red tape red flags

The updated PCN DES and confirmation of the GP additional roles reimbursement scheme (ARRS) role was a welcome and a much-needed injection of resource into General Practice for a role that has seen diminishing numbers in recent years.

Announcing a scheme for newly qualified GPs to enter roles that can then shape their future is a step in the right direction. However, you cannot throw them in the deep end and see if they sink or swim. They will need to feel valued, they will need mentors, they will need supervision, they will need peers to talk too, they will need knowledge of local systems and processes.

Once again, the red tape and strict rules on engaging these roles may impede any progress made into finding the doctors who will be willing and to take them on.

The remuneration rules and total reimbursements as per the ARRS will undermine the role of GPs. It does not take into consideration a fair rate of pay.

I am no financial expert, but my interpretation and several conversations give me the following understanding of the finances.

Funding for the new ARRS GP roles has been calculated at £1.303 multiplied by the PCN’s weighted population, as at the start of 2024.

The maximum reimbursement PCNs can claim for these GPs, who can be employed from 1 October, is £92,462 across England, except for those hired in London where it is £95,233 – and these amounts include ’employer on-costs for NI and pension’.

So as an approximate calculation for a sessional rate for GPs per annum (pa) this will possibly equate to around £8,400 per session pa. This is below the current advertisements you see for salaried GPs which are more in the range of £10K – 11Kper session pa.

We also need to factor in supervision as they are newly qualified and potentially new to the area/ practices and, subject to variables, over a week for a full time ARRS GP it would equate to two to three hours per week with an experienced GP as a minimum.

For us this is will only be workable through extra funding from within PCNs or the Practices’ already stretched finances.

The recent news of GPs – newly qualified, locums and sessionals being unable to find jobs should not mean that the profession is undermined and made an offer that does not recognise and reward their training, skills or responsibilities they will hold.

This will not attract future trainees into General Practice. Those who are already burning out will continue to leave and we will continue in this downward spiral. Properly funded roles both for new workforce and for the current workforce to supervise them is desperately needed to save General Practice.

As a GP on the ground, I always wonder who advises and who actually finalises these schemes as more often than not they are far from the reality of what can be done within the constraints of the announced contact.

I look forward to a day when NHS England will value primary care, general practice and the vital role GPs play as part of the wider team and as gatekeepers to the NHS.

 A scheme with additional resource has been agreed – we are extremely grateful. Just give us some flexibility to recruit our workforce, to nurture and grow them, to retain them and make them the cohort of future GPs that our populations need. Let us pay them what they deserve.

Many of us will make this work because that’s what we always do to help our populations. That doesn’t make it right!

Please don’t hold us back let us move forward. We seriously want to find a solution too.

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