Remove restrictions from the ARRS, says report

The government needs to remove restrictions from the additional roles reimbursement scheme (ARRS), according to the latest report carried out by our publisher Cogora.

The report, called the Cogora General Practice Workforce White Paper, looked at why general practice is facing simultaneous recruitment and unemployment problems, and how to solve both.

It suggested that one of the solutions was to remove restrictions from the ARRS scheme as they ‘no longer make sense’.

‘When the ARRS was first introduced, there was some justification for limiting the roles PCNs could employ, to protect other areas of the NHS from having staff taken away,’ said the report.

However, it added: ‘The time has come to give general practice owners free rein on who they now employ. Everyone agrees a strong general practice is essential for the NHS to function. If this requires a shift in staff then so be it.’

The report called for an increase to core funding and to consider increasing the proportion of overall funding ringfenced for staffing costs.

‘Governments have been reluctant to increase funding for practices in the past because they fear headlines about partners keeping the money for themselves,’ it said. ‘Increasing the ringfenced proportion would negate any such worries and remove any concerns around increasing funding when it is necessary.’

The report also highlighted ‘innovative thinking’ within PCNs, such as how they are using the ARRS GP role, which was added to the scheme from October.

It found that some PCNs have offered more responsibilities for GPs undertaking this role, such as helping them develop a speciality area, running a population health project, or shadowing the PCN’s clinical director.

It also noted how many PCNs are putting in place measures to try and place GPs ‘at the heart of their communities’, including running community wellbeing days to provide health education and proactive, preventative care, as well as supporting ARRS group consultations and developing better practice systems.

However, the report was broadly critical of ARRS, suggesting it is ‘too early for long-term studies on effectiveness of the scheme’ and that GPs have reported that it is a ‘black hole’ swallowing money for roles that ‘make little difference to workload’. Others suggested the scheme increased their workload.

It comes as NHS England has confirmed that PCNs will continue into 2026, but a report also suggested that the NHS had missed the opportunity to make the most of the new roles coming into primary care through the ARRS scheme.

At the end of last year it was reported that 300 of the ARRS GP roles had been filled, according to the RCGP chair.

A study also recently found that the ARRS scheme has the potential to reduce prescribing rates in primary care and increase patient satisfaction.

The white paper has been released today by the publishers of Pulse PCN, Cogora, on the changing general practice workforce in England, in conjunction with the Rebuild General Practice campaign group.

Alongside our sister titles – Pulse, Healthcare Leader, Management in Practice, Nursing in Practice and The Pharmacist – we have surveyed around 2,500 general practice professionals, interviewed more than 100 frontline practitioners, analysed hundreds of data for every practice in England and brought together all the editorial expertise within our titles to support the white paper.

The white paper is being launched at a Parliamentary event today, which will be attended by MPs, GP, nursing, pharmacy and practice manager leaders, and numerous frontline GPs.

 Download our General Practice Workforce White Paper here.