Dr David Turner shares his perspective on the expansion of the Additional Roles Reimbursement Scheme to employ GPs
Returning from a holiday is always a dubious pleasure in primary care. After the ritual distribution of sickly foreign confectionery to the team, there is the stomach-churning task of catching up with emails.
For me this is a three-stage process. The initial first quick skim through; check for complaints, unexpected deaths, resignations etc. Phew, all clear
During the second read through, I weed out the obvious time-wasting emails.
The third sweep is the political one. In the brief time I’ve been away, what fresh hell has NHSE and our ICB dreamt up for us?
What stood out like a lead-swinger in an emergency clinic was the email informing us about the ARRS payment for GPs. Yes, the long-awaited announcement of the funds available from additional roles money to pay for, what we really need, more GPs.
As I read this I was whisked back to the 1970, when we used to cut out ‘10p off’ vouchers from the back of food products to get a tiny discount when we next bought the item.
£1.30 per patient over the whole PCN. Yes, I had to read this twice, the whole PCN.
I wasn’t sure if this was a bad and rather late April fool’s joke or if I had misread and the ARRS money was in fact not for GPs, but to pay for a therapy cat for the waiting area. Although with what our colleagues in the veterinary profession charge, I doubt the budget would even stretch to a full-time practice moggy.
This sum would buy our practice around two hours of doctor time a week.
Maybe though, this would give us a chance to work ‘smarter’ as DHSC never tires of telling us. Maybe it’s time for true democracy and we allow patients the chance to decide how they would like to use the two hours of doctor time and put it to the vote.
6 x 20 min slots and hold a raffle each week to decide who gets them?
60 x 2 mis slots, for fit, fast talkers with a single very, very quick problem?
2x home visits?
Or a pick and mix of the above?
Seriously though, if this is the best the DHSC can do, we need to be very open with patients and tell them what doctor time we can fund.
I am not sure what message the DHSC is trying to send us here. We have been asking for ARRS funds for GPs for so long, that all I can imagine is this has been done so they can say ‘we are now funding new GPs through ARRS’ knowing full well that all most of the lay press and population at large will hear is ‘GPs are getting more money’, so ‘why can’t I get an appointment?’
Set against a background of all our expenses increasing and static or reductions to funding in other areas, this is too depressing for words.
GPs are now in an unenviable position. We are looking at our entire ARRS pot and looking at what we can cut back on; rob Peter to pay Paul with; or how we can tweak things to use the rest of the ARRS funds as efficiently as possible, with the knowledge that any new GP time we will have to pay for mostly ourselves.
Not a flying start for the new administration if their aim was to get GPs on board and prove they value us as much as they claimed in the pre-election run-up.
Maybe though, this is what Wes Streeting meant, when he announced at the recent RCGP conference he wanted to reduce paperwork to GPs – less of the folding stuff burdening our bank accounts?
That would be a promise they have fulfilled.
Dr David Turner is a GP in Hertfordshire
