The Additional Roles Reimbursement Scheme (ARRS) was first launched by NHS England in 2019 as part of the Primary Care Network (PCN) Directed Enhanced Service. It was designed to ease the mounting pressures on GPs by offering funding for the recruitment of healthcare professionals such as clinical pharmacists, social prescribers, paramedics, and physician associates.

By bringing these allied roles into primary care teams, PCNs could spread the workload more evenly, allowing GPs to focus on patients requiring more complex care. Some of the key roles introduced through the ARRS included:

• Clinical Pharmacists – Managing medication reviews, supporting chronic disease management, and providing specialist medication advice.
• Paramedics – Conducting home visits and dealing with urgent cases to reduce the immediate burden on GPs.
• Social Prescribers – Addressing non-medical patient needs, from mental health support to housing advice, improving overall patient wellbeing.
• Pharmacy Technicians – Assisting with dispensing, medication management, and administrative tasks.

Over time, the range of roles covered by the ARRS expanded further to strengthen multidisciplinary care. From October 2024, NHS England took the notable step of including GPs under the ARRS, signalling a shift towards supporting newly qualified doctors while continuing to protect existing GPs from excessive workloads.

Why Were GPs Added to ARRS Funding?

A key reason for adding GPs to the ARRS is the growing number of newly qualified GPs unable to secure long-term positions. Increased GP training places in recent years led to an influx of newly trained doctors entering the job market, outpacing the availability of roles in established practices.

Under the expanded ARRS, PCNs receive dedicated funding to employ these newly qualified GPs, offering advantages such as:

1. Boosting GP Employment
   By creating more than 1,000 new positions, the scheme helps match newly trained GPs with PCNs that have been under pressure due to rising patient demand.
2. Supporting PCNs in Need
   Many PCNs have been stretched thin, managing high patient volumes with limited GP resources. By integrating additional GPs, they can improve patient access, reduce waiting times, and provide more targeted, quality care.

This initiative not only tackles immediate unemployment among early-career GPs but also strengthens general practice by reinforcing front-line services with fresh talent. While the funding offers a positive short-term solution, questions remain about how it will evolve beyond March 2025.

How Will GPs Be Recruited Under ARRS?

Recruiting newly qualified GPs through the ARRS involves a structured approach aimed at minimising administrative barriers for PCNs. The process features:

1. Ring-Fenced GP Funding
   NHS England has allocated a dedicated pot of money specifically for GP recruitment under ARRS. This funding is separate from existing ARRS allocations for non-GP roles, ensuring there is no competition for resources.
2. PCN-Led Recruitment
   PCNs conduct their own recruitment drives, similar to how they hire paramedics or social prescribers. Once they identify suitable candidates, they can confidently offer positions knowing the funding for these roles is secured.
3. Reimbursement Through Existing Portals
   After a GP is hired, PCNs claim reimbursements via the same system already used for other ARRS positions. This familiarity helps speed up processes and ensures funds reach PCNs promptly.
4. Increasing Capacity Without Replacing Existing Staff
   GPs recruited under ARRS must be additional, not replacements for established roles. This ensures the scheme genuinely increases capacity rather than reshuffling existing staff.

Through these measures, PCNs can bolster their teams with newly qualified GPs and improve overall patient care. Clarity on how this funding will continue beyond March 2025 remains an important consideration for long-term workforce planning.

Short-Term Nature of GP ARRS Funding

While the GP expansion of the ARRS brings immediate benefits, it currently extends only until March 2025. This limited timeframe carries several implications:

1. Short-Term Contracts
   Many PCNs are expected to offer six-month or similarly brief contracts to stay within the financial guarantees provided by the scheme. This could deter some newly qualified GPs seeking more stable positions.
2. Potential Legal and Financial Risks
   GP leaders have highlighted concerns around redundancy costs and continuity of service if funding isn’t renewed. Should the ARRS not continue after March 2025, PCNs may face additional financial or legal responsibilities when contracts expire.
3. Long-Term Uncertainty
   Although there are discussions about extending the scheme beyond March 2025, no formal confirmation has been given. PCNs and newly qualified GPs must factor in this uncertainty when planning for the future.

In this environment, PCNs are balancing the immediate gains of extra GP capacity against the risk of abrupt funding withdrawal. Calls for a more permanent funding model are growing as the deadline approaches.

Impact on Primary Care Networks and General Practice

Adding GPs to the ARRS can have a transformative effect on primary care:

1. Reduced Workloads
   By increasing the GP headcount, PCNs can better manage the growing demand from patients. Complex cases can be tackled more effectively, while routine care is distributed among a larger pool of professionals.
2. Greater Patient Access and Enhanced Services
   A bigger clinical workforce in each network helps address appointment backlogs and shortens waiting times. The combined input of GPs, pharmacists, paramedics, and social prescribers offers a more comprehensive healthcare experience.
3. Tackling GP Unemployment
   The ring-fenced ARRS funding directly addresses the surplus of recently trained GPs, providing them with valuable career opportunities. This approach also nurtures a pipeline of experienced doctors for the future.
4. Future Contract Reforms
   Although immediate benefits are evident, broader questions loom about sustaining these developments. With ARRS funding for GPs due to end in March 2025, more stable and enduring solutions are required. Stakeholders continue to call for reforms that will secure the continuity and growth of the primary care workforce in the long term.

Final Thoughts and Key Takeaways

The decision to incorporate GPs into the ARRS represents a strategic response to pressing challenges in primary care. By offering newly qualified GPs funded positions within PCNs, the scheme alleviates workforce shortages and unlocks employment paths for doctors poised to make a meaningful contribution.

• Immediate Workforce Relief
  PCNs gain additional GP capacity, better equipping them to manage rising patient demand and free existing GPs to deal with more complex cases.
• Opportunities for Newly Qualified GPs
  The introduction of over 1,000 new GP posts under ARRS helps resolve the bottleneck of unemployment, facilitating career progression and reducing early attrition from the NHS.
• Short-Term Funding Raises Questions
  With funding currently guaranteed only until March 2025, PCNs must navigate uncertainty regarding the potential end of contracts, redundancy costs, and continuity of service.
• Demand for Sustainable Solutions
  Long-term reforms and extended investment will likely prove crucial to ensure the lasting stability and growth of GP services within primary care networks.

ARRS funding for GPs brings a welcome boost to workforce capacity across the NHS. As this initiative unfolds, the direction of future policy decisions will determine whether its benefits can be maintained or expanded, securing a more sustainable model for general practice in the years ahead.