Source · Select Committees · Health and Social Care Committee
Recommendation 7
7
Accepted
Paragraph: 46
Additional Roles Reimbursement Scheme lacks funding for supervision and high-need areas.
Conclusion
We welcome the progress made in recruiting additional professionals to general practice and recognise the potential they have to improve the range of services on offer in general practice and to ensure patients are able to see the right professional at the right time. We are also pleased the Government has committed to increasing the flexibility of staff recruited under the Additional Roles Reimbursement Scheme. However, we are concerned about some gaps within the scheme, particularly the lack of funding for supervision and the absence of any uplift for areas of high need. At present it appears that some staff are not regularly being effectively integrated into general practice and do not receive adequate supervision.
Government Response Summary
The government partially accepts, acknowledging that ARRS doesn't explicitly cover supervision for all roles but states support creates supervisory capacity for Advanced Practitioners. It commits to reimbursing Primary Care Networks (PCNs) for First Contact Practitioners' training time and has increased the cap on Advanced Practitioners. It also states that inner and outer London weightings are reflected within current ARRS allocations to PCNs.
Paragraph Reference:
46
Government Response
Accepted
HM Government
Accepted
Partially Accept. The Department partially accepts this recommendation. While supervision and training are not explicitly covered through the Additional Roles Reimbursement Scheme (ARRS) for all roles, the support for the growing multidisciplinary team does create supervisory capacity, particularly in the Advanced Practitioner roles. We have recently increased the cap on recruitment of Advanced Practitioners, and are reimbursing Primary Care Networks (PCNs) for the time that First Contact Practitioners spend out of practice undertaking education and training to become Advanced Practitioners. We are exploring measures to improve supply into these roles in 2023/24. The ARRS reimburses time spent in training for some roles, balancing the overarching aim of the scheme to increase direct patient care with support for staff development, and PCNs are able to access other pots of funding through the contract to cover the costs of either staff backfill or training itself (e.g., PCN funding based on the population size, leadership, and management funding). System Development Funding for primary care provides systems with investment to commission programmes from training hubs which focus on the training and development of primary care staff. It also includes a broad ‘GP Transformational Support Fund’, worth £78m in 2022/23, which can be used to build staff skills and capabilities. Within the ARRS itself, we have allowed the use of apprenticeships for some roles, such as those providing a supply of practice nurses, and NHS England will continue to explore the expansion of these schemes through the ARRS review. We are supportive of practices and PCNs employing their staff on Agenda for Change terms and conditions. Inner and outer London weightings are reflected within the current ARRS allocations to PCNs.