The update to the GP Contract Agreement 2020/21-2023/4 brings enhancements to the Additional Roles Reimbursement Scheme (ARRS). Additional workforce will be introduced and funded through the Network. Extra Government investment is funding a further 6000 staff through the scheme at 100% reimbursement, bringing the total to 26,000 rather than previously stated 20,000 staff.
From 2019, each network was be able to employ one clinical pharmacist and one social prescriber.
From April 2020, in addition to the previously agreed roles of
- Social Prescriber Link Worker
- Clinical Pharmacist
- First Contact Physio
- Physicians Assistant
- Paramedic (from 2021)
PCNs can now also choose to recruit from the following additional roles
- Pharmacy Technician
- Care Coordinator
- Health Coach
- Occupational Therapist
- Nursing Associates (From 1st Oct 2020)
- Mental Health Practitioner (from 2021)
A further update from NHSE in August 2020 about expanding the primary care workforce advises that to provide additional flexibility to PCNs now, an additional role will be added 1 October 2020. With agreement of the Chief Nursing officer, nursing associates will be added.
The LMC website has a skills and competency matrix that includes these roles that can be seen at :- https://www.wessexlmcs.com/skillsmatrix
Additional Funding Opportunity for SPLWs
NHSE have made a time limited offer for accelerating the recruitment of social prescribing link workers.
There are two options
- Funding available for local voluntary, community and social enterprise (VCSE) organisations to provide a full recruitment and induction service. A one-off fee of £3,000 (including VAT) will be provided for the first link worker, and £2,600 for each subsequent link worker. This includes advertising the post, processing applications, shortlisting applicants, virtual interviews, taking up references, DBS checks and notifying candidates and basic induction, ensuring that the SPLW has access to appropriate equipment and supervision.
- For PCNs to undertake the recruitment themselves but with a recruitment administration service from the South, Central and West Commissioning Support Unit. This includes processing applications, setting up interviews and supporting DBS checks.
This offer will be available for six months from 3 August 2020 to 31 January 2021. All PCNs interested in expanding the number of DES-funded SPLWs are encouraged to submit an expression of interest (see Appendix 1). This should be returned to firstname.lastname@example.org by Monday 24 August.
If you would like to discuss this support offer, please contact: email@example.com
Funding for ARRS
The funding for all ARRS roles will be 100% including on costs up to a maximum reimbursement (on costs are defined as Employer NI and Employer Pension).
The table below sets out the maximum annual reimbursement rates for 2020/21
The average PCN will have a pocket of £344,000 in 20/21 to spend on the ARRS. It is up to each PCN to decide the distribution of roles required, limited only by differentially available supply of different roles in different parts of the country.
It is important to note that medicines optimisation in care homes (MOCH) clinical pharmacists and pharmacy technicians must be transferred into the Scheme at the point at which they have completed their training. The last date at which this transfer can happen is set at 31 March 2021. Where the roles were counted in the 31 March 2019 staffing baseline, they form an exemption from the calculation of additionality. Aside from this specific exemption, together with the existing exemption for clinical pharmacists transferring to PCNs from the Clinical Pharmacists in General Practice scheme, reimbursement is only for those roles which are demonstrably additional to the 31 March 2019 baseline agreed by CCGs and PCNs. Baseline data for pharmacy technicians was collected as part of the original exercise to baseline the five original ARRS roles.
In November 2019 NHSE agreed to extend the Additional Roles Reimbursement Scheme (ARRS) funding for social prescribers, following calls from the GPC, LMCs and PCNs. Many organisations supplying a Social Prescriber Link Worker Service (SPLW) are passing on additional costs over and above the equivalent of the actual salary (plus on costs), for example in administration fees. The ARRS scheme has been updated, so that where a PCN engages a SPLW service through a supplier, a PCN will be able to claim an additional flat rate sum of £2,400 per SPLW (on an annual WTE basis and will be pro-rata to both WTE and duration of the roles providing the service as appropriate) as a contribution toward those additional costs. This must be affordable within the existing maximum annual reimbursable amount for social prescribing link workers. This will apply to any existing supply arrangements for SLPWs and any new supply arrangements for SPLWs agreed from this point forward.
Details of the Network Contract DES - Additional Roles Reimbursement Scheme Guidance can be found on the NHSE website , however the last update for this was December 2019. We are currently waiting for NHSE to update the guidance to relect the new additional roles and arrangements as above.
Training opportunity with funding
Health Education England (HEE) South School of Pharmacy are delighted to announce funding to support the training of pre-registration trainee pharmacy technicians (PTPTs) in general practice from February 2021.
HEE want to work with employers to support the training of up to 30 pharmacy technician apprentices across the South region (South West, Thames Valley and Wessex) with GP ideally as the host employer. This will enable a new pharmacy technician workforce with primary care experience.
The funding available is £32,000 per PTPT over the 2-year apprenticeship training period.
Funding can be used to support salary, educational supervision or other elements to support the trainee to successfully complete the apprenticeship, and the apprentice can be someone new to your team or an existing team member to upskill.
Click here to download their flyer for further information.
Worries around accrued employment liabilities have also been 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. CCGs 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 network. This Clinical Director will be funded – an average of a day a week for a network of 40,000 patients (including on-costs) from new funding provided by NHS England.