Assessing the impact and success of the Additional Roles Reimbursement Scheme

Key points

• The Additional Roles Reimbursement Scheme (ARRS) was introduced in response to government manifesto commitments to improve access and workforce pressures in primary care. The scheme has begun to address many of the long-term challenges facing primary care and has successfully met every target set in 2019.
• The benefits of the ARRS are evidence that the new roles have a place in the future of primary care. But continued success will require more than simply renewing the scheme. This report explores the views of Primary Care Network members on the ARRS so far and the challenges and opportunities it presents. It also considers priority actions for the future to ensure the scheme continues to make a positive impact on patient care, access pressures and integration.
• ARRS staff can, and have, supported and enabled the development of new ways of working, such as multidisciplinary working and integrated neighbourhood teams in primary care and should be supported to continue this role. Flexibility for local leaders to select the roles they need will be key to the future of the ARRS and the continued development of new services which are tailored to local needs.
• The existing ARRS workforce has been assured as part of the PCN Direct Enhanced Service for 2024/25, but to provide stability, primary care leaders are looking for commitment beyond 2025.
• The scheme currently provides insufficient funding for supervision or training. These must be addressed in any future iteration of the scheme to ensure it remains financially sustainable for PCNs.
• By tackling workforce recruitment challenges in isolation (without structural enablers such as estates and digital or retainment/professional development) an opportunity for a more thorough intervention was missed.
• ARRS staff are a new pool of staff to primary care, but they are often working elsewhere in the system and as such recruiting into primary care risks increasing competition or exacerbating workforce challenges in other sectors. A long-term approach to workforce improvement requires greater cross system integration.