Newly qualified GPs added to Additional Roles Reimbursement Scheme
Primary Care Networks (PCNs) exist to enhance and support the incredible work which goes on in General Practice. Whilst any additional funding is welcome, the money available for recruitment of newly qualified GPs falls woefully short of achieving the promised increase in capacity for patients.
The new contract variation has been issued on 26th September, with funding available from 1st October. This leaves PCN’s just 2 working days to recruit a GP to fully utilise the funding. This is clearly an impossible timescale when there is a need to follow a fair recruitment process and perform the due diligence required.
This additional funding is only guaranteed until March 2025, so PCNs and their member practices are taking significant financial risks in offering permanent contracts to these newly qualified GPs. For GPs who are starting out in their career, it offers little security for their future. Those who are at the beginning of their career benefit from being in a supportive practice, with experienced clinicians to offer guidance and mentorship. They may not receive this in a PCN based role, without the financial support for mentorship. Sadly, the GP Fellowship programme which did just that is no longer available.
Whilst the public is being sold the headline of more GP appointments, in reality the funding is nowhere near enough. In a PCN with a“weighted” population of 50k patients, they will get £65k for the six-month period. This will fund, at best, around 9 sessions of GP time per week (this is equivalent to 4.5 days per week) which, when spread across all the PCN practices, is a drop in the ocean of what is needed. Often PCNs consist of 4 or 5 member practices, so the impact for each practice is negligible, and this offer is only for six months.
Other uplifts
In the covering note to the contract variation, NHS England state they are uplifting certain funding “to fund – in full – the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) pay recommendations for GPs.” They have completely failed to acknowledge or offer any additional funding for any other staff employed under the Additional Roles Reimbursement Scheme (ARRS), including nursing roles, pharmacists and paramedics who, elsewhere in the NHS, have been given pay awards.
Whilst the maximum amount PCNs can claim for each ARRS role salary has increased, the amount of overall funding in the ARRS ‘pot’ is unchanged, meaning PCNs and their member practices must choose between cutting services or having to use precious core practice funding to pay staff in line with the rest of the NHS to aid retention. This is either a gross oversight by NHSE, or a divisive move to destabilise the primary care workforce.
Many PCNs received a funding uplift of less than 1% in April 2024, and this further offer still does not bring PCNs up to the level general practice has received to fund staff pay rises. We have already seen staff leaving PCN roles because of the uncertain future and inequitable funding, and this contract variation will do little to give confidence that NHSE are committed to supporting General Practice and their staff.
IGPM would welcome urgent discussion on these matters from NHS England.
Kay Keane Robyn Clark Nicola Davies Sarah Cole
Directors of the Institute of General Practice Management IGPM National PCN Rep
