Navigate the complexities of managing ARRS staff as the end of five-year contracts and potential shifts in funding approach, ensuring a clear strategy to maximise impact
CREDIT: This is an edited version of an article that originally appeared on Ockham Healthcare
As the culmination of the five-year contract approaches, bringing with it the potential conclusion of the PCN DES (Primary Care Network Directed Enhanced Services), it becomes imperative to ensure that your PCN (Primary Care Network) has a well-structured strategy in place for managing ARRS (Additional Roles Reimbursement Scheme) staff.
To initiate this process, the primary questions the plan should address are multifaceted. They encompass strategies for optimising the recurrent funding associated with ARRS, strategies to retain staff within the PCN rather than losing them to other providers, and the strategic allocation of the ‘additional’ funding contributed by the PCN. Additionally, it’s crucial to anticipate and address potential future challenges that might arise.
While NHS England has made commitments to sustain the cost of ARRS staff recurrently irrespective of the fate of PCN DES after March 2024, the specifics of the reimbursement mechanism and calculation remain ambiguous. Historical patterns suggest that a somewhat arbitrary date might be assigned with relatively short notice, possibly even as early as December of the current year. This retrospective expenditure could potentially serve as the benchmark for future reimbursement levels.
Though this approach carries evident shortcomings, it’s more likely that NHS England would opt for this method rather than committing to definitive allocation totals for each PCN. While the latter would be a fairer approach, it’s costlier due to the existing underspend on ARRS budgets, making it less likely.
The recent NHS Long Term Workforce Plan has indicated a deceleration in the introduction of additional roles compared to the pace witnessed during the five years of the PCN DES, with only half as many roles being introduced over the subsequent 13 years. Given this projection, PCNs should strategically leverage their allocation to maximise its utilisation.
While some PCNs might currently feel unprepared for additional roles, this sentiment might transform into regret in the years ahead when funding for such roles becomes scarce.
Amidst the rapid recruitment of ARRS roles by PCNs in recent years, other community providers without the added funding have been observed with envy. A plausible scenario is that as ‘integrated neighbourhood teams’ with broader community engagement than PCNs take shape, calls will arise for ARRS staff to assume roles with a more community-centric focus rather than being predominantly practice-based.
While ARRS staff play a vital role in enhancing local neighbourhoods’ health and outcomes, their involvement in the PCN DES also holds the responsibility of ensuring the sustainability of local practices. Therefore, it’s prudent for practices and PCNs to integrate staff seamlessly into practice work while aligning them with wider PCN initiatives, making their disengagement impractical.
A potential concern lies where roles have been funded using sources outside of ARRS. As ARRS funding transitions into recurrent status, other funding sources like the £1.50 core funding might dwindle. To prepare for such a scenario, PCNs can formulate contingency plans beyond relying solely on replacement funding. ARRS staff could potentially be deployed for income-generating services like enhanced access, and this income could supplement any excess beyond ARRS.
Alternatively, roles might be redeployed from existing PCN responsibilities to more targeted practice activities. Practices might be amenable to covering additional costs if they had greater control over staff time and deployment.
Several additional factors merit consideration. These encompass the push for NHS terms and conditions for ARRS staff, the amalgamation of primary and community care workforce planning, and the potential expectations that may arise from those engaged in Integrated Neighbourhood Teams.
In essence, the crux of the matter lies in proactive planning and strategizing. Crafting a well-defined plan to mitigate risks and amplify the long-term impact of ARRS roles stands to yield substantial benefits beyond the threshold of next year’s March.
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