Unclaimed ARRS funding will not be available to PCNs according to new contract

NHS England has indicated that PCNs must use their full ARRS allocation or risk losing it.

In a letter from NHS England’s primary care national director, Dr Amanda Doyle said that the funding mechanism to redistribute unclaimed funding for ARRS would be removed.

It stated: ‘In 2024/25 the mechanism which allows commissioners to redistribute unclaimed funding from the Additional Roles Reimbursement Sum between PCNs will be removed from the Network Contract DES. We continue to encourage PCNs to recruit up to their individual entitlements.’

Currently, ICBs are able to invite PCNs to bid for any unclaimed funding.

Last year, at least £64m of funding from ARRS was forecast to go unspent.

Pulse PCN understands that the unclaimed ARRS funding will not go back to primary care.

In other changes to ARRS roles, NHS England said the role of enhanced nurse would be added, which will ‘initially’ be capped to one per PCN, or two where the patient list size is 100,000 plus, according to the letter.

Enhanced nurses are between registered level nurses and advanced level nurses, according to the Primary Care and General Practice Nursing Career and Core Capabilities Framework. They are at a level seven or above and hold a postgraduate certificate or diploma in one or more specialist areas of care.

Currently, the ARRS includes nursing associates and trainee nursing associates.

NHS England has also removed the cap on the number of advanced practitioners (APs) PCNs can recruit under ARRS. Previously, PCNs with a list size of under 100,000 could recruit up to three APs, and those above could recruit six.

The contract letter also outlined changes to the way PCNs employ mental health practitioners (MHP), allowing them to be fully funded by the ARRS scheme.

Currently, they are funded 50:50 by the PCN and mental health provider. However, MHPs will continue to be ‘employed or engaged’ by the mental health provider.

Dr Doyle said the changes to ARRS were ‘intended to increase the flexibility of the scheme by widening the reimbursable roles and removing role restrictions where possible’.

She added: ‘We know that the ARRS has been hugely successful in expanding teams, increasing appointments and supporting the delivery of proactive care, but we have heard that PCNs would welcome more flexibility in how the scheme operates.’

As of 31 January 2024, the top three recruited roles under ARRS were pharmacists, care coordinators, and social prescribing link workers.

The move to include enhanced nurses stops short of including general practice nurses in ARRS, which was the subject of an online petition which received 10,967 signatures.

To which the Government responded on 22 February: ‘The 2024/25 GP contract arrangements are subject to consultation with the British Medical Association. It would be inappropriate to comment further at this stage.’

The letter also indicated changes made during Covid to the medical performer’s list (MPL) would be made permanent. Meaning that PCNs are permitted to employ doctors other than GPs, who are already employed by an NHS trust or foundation trust.