Is it time to break the link between ARRS and New Roles?
Is it time to break the link between ARRS funding and new roles and encourage practices to spend their own money on new roles? or Encourage the ICBs to give more to the PCNs?
As we go into 23/24 the ARRS funding increases one last time and most PCNs are trying desperately to spend it. The new contract/DES has once again expanded the number of roles that you can use.
While I don’t have comprehensive data on this, it seems some roles are more popular than others. A lot of PCNs have pharmacists/ pharm techs/ MSK / CCs some have paramedics and PAs, a few have OTs/ dietitians. While there may be a rush for ANPs there are other interesting roles the GP assistant for instance.
The ARRS funding has helped introduce these roles to GPs but what we dont have yet is a lot of evidence that practices are hiring these staff from their own GMS money - yet there is much to be gained if they do - especially if the shortage of GPs continues.
The concern a lot of practices have is that they are funding services that were funded in a different way. EG has the excellent MSK service my surgery now has - actually just reduced the burden on the local physio and orthopaedic teams from my primary care budgets. (ie ive spent money that could have reduced my burden on reducing others burdens.. see later)
The local mental health trust are really keen for us to spend ARRS money on mental health workers - is this to create a integrated service or is it adding capacity to their service from my budget? If I flipped it around - would they hire GPs to reduce the work I had to do seeing their patients?
However there is no doubt some of the roles reduce GP workload and reduce “admin workload” do we need practices to keep thinking - could I use a PA? Could I use a GP assistant?
However given the possibility of these PCN staff having whole system workload implications should the local system put its money into the ARRS pot?
If we believe in PCN/Care community care and we think that on the whole ARRS money has been well spent - let the PCNs run a bigger team of people matched to the needs of the population.