Additional Roles Reimbursement Scheme (ARRS)

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Camden

Under the Primary Care Network DES, networks are able to recruit new roles to expand their care team with NHSE&I with a forecast of 26,000 additional staff working in general practice by 2024. 

The aim of the scheme is to build and utilise the additional roles to solve the workforce shortage in general practice. Whereas the funding will be for new roles being introduced within PCNs, each network will have the flexibility to determine which roles form a core list they require based on their patient population requirements.

Although some roles were to be 70% reimbursable when the ARRS was first released, it has since been agreed that all roles are 100% reimbursable, affording the extra flexibility for networks. Currently London weighting is not covered and this is under review.

The BMA's primary care network handbook also includes a lot of useful information on ARRS scheme.
    
During 2019, each PCN had to agree a workforce baseline which indicated the number of staff they employed within the then five ARRS roles of:

Clinical Pharmacists work as part of the multidisciplinary team in a patient-facing role to clinically assess and treat patients using their expert knowledge of medicines for specific disease areas. The Clinical Pharmacist can be a prescriber or undertake training to become one. All practice pharmacists should be signed up to the  Primary care pharmacy education pathway (PCPEP) to align the education requirements of the pharmacists and pharmacy technicians and the primary care Network Contract Directed Enhanced Service. NHSE has commissioned CPPE to deliver this. Visit the CPPE website for more information about PCPEP 

There is a list on the website as to which prior qualifications would be exempt from this. It requires 28 days of study over 18 months. See the job descriptions and interview questions

The maximum reimbursable amount for this role per annum is £55,670 and there is no limit on the number eligible for reimbursement.

Social Prescribing Link Workers connect people to community groups and agencies for practical and emotional support and complement other approaches such as care navigation and active signposting. Peer support across London and education can be accessed through the Bromley by Bow Centre website or by contacting Lianna Martin, London Regional Learning Coordinator for Social Prescribing – NHS England:
t: 07446383875
e: lianna.martin@bbbc.org.uk

The maximum reimbursable amount for this role per annum is £35,389 and there is no limit on the number eligible for reimbursement.

Physician Associates are healthcare professionals with a general medical education who work alongside and under the supervision of GPs providing clinical care as part of a wider multidisciplinary team. Currently they are restricted on being able to sign prescriptions, fit notes and requests for ionising radiation. Find out more from the Faculty of Physicians Associates

The maximum reimbursable amount for this role per annum is £53,724 and there is no limit on the number eligible for reimbursement.

 

First Contact Physiotherapists can assess, diagnose, treat and manage musculoskeletal (MSK) problems and discharge a person without a medical referral. Those working in these roles within a network can be accessed through direct referral by staff in GP Practices.

The maximum reimbursable amount for this role per annum is £55,670 and one WTE per PCN is eligible for reimbursement unless the patient population is over 100,000 where two will be eligible.

This role is currently being developed. Some networks have already trialled this role where the request for a home visit was triaged by the GP and then home visits, apart from those which were complex or end of life care, were undertaken by the paramedic. Some of the outputs were that more patients were managed at home and there was earlier intervention by the multidisciplinary team. In other trials they have seen patients at the practice with minor illnesses and been trained to manage some elements of long term condition management. Currently paramedics are restricted in their ability to undertake cervical smears.

During this current year (2020-21), each network has been allocated a maximum reimbursement sum based on its weighted population. Following feedback from networks who wanted greater flexibility in the roles they could recruit, there have been six more roles added to the ARRS. During 2020-21, PCNs can recruit and employ the following roles as part of the scheme:

Care Co-ordinator works closely with GPs and other primary care professionals within the network to identify and manage a caseload of identified patients, making sure that appropriate support is made available to them and their carers.

The maximum reimbursable amount for this role per annum is £29,135 and there is no limit on the number eligible for reimbursement.

 

Pharmacy Technicians will complement the work of the Clinical Pharmacist by using their pharmaceutical knowledge to help patients to get the best from their medicines by switching medications to agreed and approved protocols, improving repeat prescribing processes in General Practice, including promotion of repeat dispensing and online ordering, minimising clinical risk and aiming to reduce wasted medicines. This role will be under the supervision of the Clinical Pharmacist and will be part of a wider PCN pharmacy team.

The maximum reimbursable amount for this role per annum is £35,389 and one WTE per PCN is eligible for reimbursement unless the patient population is over 100,000 where two will be eligible.

Dietitians diagnoses and treats diet and nutritional problems. Dietitians can support patients of all ages with their food intake to address diabetes, food allergies, coeliac disease, metabolic diseases and weight loss.

The maximum reimbursable amount for this role per annum is £53,724 and there is no limit on the number eligible for reimbursement.

Health and Wellbeing Coach use health coaching skills to support people with self-identifying existing issues and encourages proactive prevention of new and existing illnesses. They may provide access to self-management education, peer support and social prescribing.

The maximum reimbursable amount for this role per annum is £35,389 and there is no limit on the number eligible for reimbursement.

Nursing Associate is a new support role that bridges the gap between healthcare assistants and registered nurses. The role will be part of the PCN nursing team under the supervision of a nurse.

The maximum reimbursable amount for this role per annum is £29,135, and includes qualified and training Nursing Associates.

Occupational Therapists supports people of all ages with problems arising from physical, mental, social or development difficulties. OTs can help GPs across the network with frail patients, those with complex needs, those who live with chronic physical or mental health conditions and who need help with managing anxiety or depression.

The maximum reimbursable amount for this role per annum is £53,724 and there is no limit on the number eligible for reimbursement.

Podiatrists can help diagnose and treat foot and lower limb conditions.

The maximum reimbursable amount for this role per annum is £53,724 and there is no limit on the number eligible for reimbursement.

This role will be added to the ARRS from April 2021, however further guidance is to be developed.