Background
PCNs submit claims for ARRS staff using an online portal, which CCGs are responsible for approving based on guidance set out in the Network Contract Directed Enhanced Service (PCN DES) NHS England » Network Contract Directed Enhanced Service – contract specification 2022/23 – primary care network requirements and entitlements
A PCN is entitled to funding as part of the Network Contract DES to support the recruitment of new additional staff to deliver health services. The new additional staff recruited by a PCN or provided under contract as a service from a third-party organisation are referred to in this Network Contract DES Specification as “Additional Roles” and this element of the Network Contract DES is referred to as the “Additional Roles Reimbursement Scheme”. To receive the associated funding, a PCN must show that the staff delivering health services for whom funding is requested, comply with the principle of “additionality”. Additionality is measured on a baseline of staff supporting a General Practice as taken at 31 March 2019 against six of the reimbursable staff roles – clinical pharmacists, social prescribing link workers, first contact physiotherapists, physician associates, pharmacy technicians and paramedics. A PCN baseline will not be established for other ARRS roles however, the additionality principles still apply.
There are some limitations on the numbers of staff in particular roles which PCNs can claim for – see the DES for further detail. CCGs take this into account when approving claims.
ARRS roles
The following job roles are covered under the ARRS scheme. Note there are other job roles within PCNs which are not covered by this scheme, Healthcare Assistants for example.
- Clinical Pharmacist
- Pharmacy Technician
- Social Prescribing Link Worker
- Health and Well-being Coach
- Care Co-ordinator
- Physician Associate
- First Contact Physiotherapist
- Dietician
- Podiatrist
- Occupational Therapist
- Nursing Associate
- Trainee Nursing Associate
- Paramedic
- Mental Health Practitioner (bands 5-8a)
- Advanced Practitioners (Clinical Pharmacists, Physiotherapists, Dietitians, Podiatrists, Occupational Therapists and Paramedics).
Further detail on the ARRS claims data
PCNs submit claims via a portal administered by The North of England Commissioning Support Unit (NECS). The claims are then reviewed for approval by CCGs, and PCNs are then reimbursed for approved claims. The Network DES sets out expectations of the responsibilities of PCNs and CCGs in this process (see sections 7.2.5 and 7.2.7 for requirements on PCNs and 10.2 for the role of CCGs). NECS send monthly extracts of the claims data to NHS England and NHS Improvement Primary Care Workforce team. The data is currently sent in Excel format, but work is underway to set up an API to replace this.
There is currently no defined national schedule for the submission and approval of ARRS claims and it is acknowledged that some claims are made and approved retrospectively. For example, ARRS data for March may not be submitted until later months. As such, the figures presented cannot be considered to represent the entire picture of staff in post and should be considered an under-count. Early-stage work, lead by NHS England and NHS Improvement, is underway to support and encourage timely submission and approval of ARRS claims.
ODS codes are incorrect or missing for approximately 7% of claims and so are not included in the analysis, therefore potentially leading to further undercount.
ARRS claims can only be made for additional staff recruited since March 19. Therefore monitoring tends to consider changes net of the baseline.
General practice workforce data reported through the NWRS are used to establish that baseline.