PCN Workforce – ARRS
Page Contents
Introduction
The update to the GP Contract Agreement 2020/21-2023/4 brings enhancements to the Additional Roles Reimbursement Scheme (ARRS).
• increasing the cap on Advanced Practitioners from two to three per PCN where the PCN’s list size numbers 99,999 or fewer, and from three to six where the PCN’s list size numbers 100,000 or over;
• reimbursing PCNs for the time that First Contact Practitioners spend out of practice undertaking education and training to become Advanced Practitioners;
• including Advanced Clinical Practitioner Nurses in the roles eligible for reimbursement as Advanced Practitioners; • introducing apprentice Physician Associates as a reimbursable role;
• removing all existing recruitment caps on Mental Health Practitioners and clarifying that they can support some first contact activity.
• amending the Clinical Pharmacist role description to clarify that Clinical Pharmacists can be supervised by Advanced Practice Pharmacists
NHSE has full details of the Network Contract DES
NHSE has also produced a useful quick reference summary for the ARRS roles
We have a detailed account of all the ARRS roles on a dedicated webpage.
In brief, details of the expanding roles can be found here, including the new Induction Checklist template and the Supervision guidance
The roles from April 2023 are:
- Clinical/Senior Pharmacist
- Pharmacy Technician
- Social Prescribing Link Worker
- Health and Wellbeing coach
- Care Coordinator
- First Contact Physiotherapist
- Paramedic
- Dietitian
- Nursing Associate
- Trainee Nursing associate
- Adult Mental Health Practitioner
- Children and young people’s mental health practitioner
- Physician Associate
- General Practice Assistant
- Digital and Transformation Lead
- Advanced Practitioner
There is also a full list of these new roles in primary care with detailed role specific information on e-learning for health.
Advanced Practitioners
There are additional requirements to the base role for anyone working at the advanced practitioner level, please visit our dedicated webpage for Advanced Clinical Practice including roles.
Useful Resources
- The FutureNHS Platform now has a dedicated space for the ARRS including the claims process and portal link.
- ARRS Claims Portal FAQs Nov 2023 (FutureNHS login required)
- NHSE now has a dedicated page entitled “Expanding our Workforce” that details each of the new roles above.
- PCN & Practice Ready Reckoner 24/25 (inc ARRS funding)
- The LMC website has a skills and competency matrix that includes these roles that can be seen at :- https://www.wessexlmcs.com/guidance/costing-a-service/
Funding for ARRS
The tables below set out the maximum annual reimbursement rates for 2024/25. (Includes HCAS – High Cost Area Supplements).
Whilst these tables show the maximum reimbursements, it is recommended that you look at chapter 10.5 Workforce (pg61 onwards) within the PCN Requirements and Entitlements 2024 document for more detailed guidance.
Table 2: Maximum reimbursement amounts per role for 2024/25
Table 3a: for initial (existing) MHPs funded 50:50 with Mental Halth Provider
Table 3b: Additional MHPs, where funding arrangements are for agreement between PCN and mental health provider.
N.B. the amounts provided in table 3b reflect the maximum reimbursement available to the PCN, and are based on the PCN funding 100% of the role. The actual amount claimed will depend on local funding agreements. For example, if the PCN and mental health provider agree to fund 70% and 30% of the role respectively, the PCN will only claim 70% of the amount quoted above.
Social Prescriber Link Workers
10.5.9. In addition to the reimbursement of 100 per cent of actual WTE equivalent salary and employer on costs (pension and national insurance contributions), where a PCN does not employ a Social Prescriber Link Worker and sub-contracts the delivery of the social prescribing service, a PCN may claim a contribution towards additional costs charged by the sub-contracted provider for the provision of the social prescribing service. A PCN may claim a contribution of up to £200 per month (£2,400 per year) for each whole WTE that the sub-contracted provider has appropriately apportioned to PCN-related activity provided that:
- a claim for the contribution towards additional costs charged by the subcontracted provider must not exceed £200 in respect of any month; and
- the total annual amount claimed by the PCN in respect of the social prescribing element in respect of each WTE does not exceed the maximum reimbursable amount set out in Table 2. For the avoidance of doubt, the contribution towards additional costs charged by the subcontracted provider is included when considering whether the total annual amount is within the maximum reimbursable amount.
Worries around accrued employment liabilities were addressed in the update contract agreement 20/21 as follows:-
• For those PCNs who do not wish to employ extra staff directly, we encourage them to engage their community-based partners, who can employ staff on their behalf. ICBs can help broker these arrangements;
• Under this agreement, we can confirm that the level of reimbursement already drawn down to support new staff employed by a PCN will now be guaranteed during this GP contract period with their ongoing participation in the Network Contract DES, and these staff will be treated as part of the core general practice cost base beyond 2023/24 when we consider future GP contract funding, like the practice global sum; and
• Furthermore, should all the practices which comprise a PCN ever decide in future to hand back the DES, the commissioner must arrange timely alternative provision for the same services from another provider, e.g. another PCN or an NHS community provider. In this circumstance the law regarding transfer of staff would apply as normal. The commissioner will approach the appointment of the new provider on the basis that, unless there are exceptional circumstances not to do so, (1) relevant staff will transfer from the outgoing practice(s) to the replacement(s), (2) the TUPE Regulations will apply to that transfer and (3) transferring staff will be treated no less favourably than if the TUPE Regulations had applied.
The network will need to decide how the additional workforce is employed (ie by a single lead practice, by an organisation (eg a Federation or community trust) on behalf of the network, or different professionals being employed by different practices within the network). The workforce may be employed in these ways but must provide services for the Network rather than individual practices.
The workforce and network will be led by a Clinical Director, chosen from within the clinicians of each practice in the network. This Clinical Director will be funded for 24/25 at the rate of £0.722 per registered patient per annum.
There is also a Leadership and Management payment of £0.698 multiplied by the PCN Adjusted Population.