Assessing the impact and success of the Additional Roles Reimbursement Scheme
Conclusion: the future of the ARRS
Ultimately, the ARRS scheme has met its key targets and delivered improvements to access, workforce pressures, and the range of services available direct to patients. The benefits of the scheme are evidence that the new roles have a place in the future of primary care, but continued success requires more than simply renewing the scheme.
The new roles have a place in the future of primary care.
Primary care and its partners have adapted to the new ways of working required to make a success of the new roles, but they are working against challenges that, if resolved, would enable further progress. The sustainable future of primary care, as envisioned by our network, will require further workforce development to be supported by policy which recognises its interconnected enablers and focuses on sustainability.
Creating conditions for success: our recommendations
- Ensure increased ARRS flexibility to allow primary care to determine their workforce needs within the funding available, including the number of practitioners that are funded and the flexibility to contract and deploy where most appropriate.
- Future funding models should include provision for the supervision, training and ongoing personal development required to retain and improve the workforce.
- Greater investment in primary care capital for estate and digital as part of the upcoming national estates plan and ongoing commitments to improved capital funding.
- Further work is required to align primary care contracts and funding to the rest of the NHS to ensure that primary care remains equipped to support a greater shift to out-of-hospital care. This would also ensure that primary care is seen as an attractive employment prospect in line with the benefits and pay uplifts available in the wider system.
- At-scale HR and employment support for ARRS staff has been a demonstrable success and providers should be encouraged to explore potential at-scale support in their area.
- Expand support to commission digital solutions at scale to enable integrated working across the health service and reduce unwarranted variation.
- Raising patient awareness of, and confidence in, multidisciplinary primary care is essential. The national education campaign on the roles available in primary care should be continued and integrated care systems supported to increase tailored campaigns at local level.
- Develop the primary care workforce dashboard to support tracking workforce development including staff turnover on a national scale.
- Shared funding commitments for roles like mental health practitioners should be evaluated and, where necessary, enable alternative contracting and funding arrangements co-designed between primary care and mental health providers.