ARRS should be ‘disbanded’ with money redirected to core contract, MPs told

The additional roles reimbursement scheme (ARRS) ‘needs to be disbanded’ and the money redirected to core GP contract funding, the then-chair of the Royal College of General Practitioners (RCGP) argued at the end of last month.

Giving evidence to the Health and Social Care Committee on 26 November, Professor Kamila Hawthorne – who was then still chair of the college – said the move would give practices and neighbourhood teams greater powers to employ ‘who and what they need’, which could include nursing staff.

The RCGP is set to be an important voice in negotiating the next GP contract, following the government’s recent decision to consult a wider range of stakeholders beyond the British Medical Association’s GP committee.

It has said it will ‘stand ready’ to contribute to negotiations, but that it was ‘not the role’ of the college to negotiate terms and conditions.

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Giving evidence, Professor Hawthorne said there was ‘no doubt’ the ARRS scheme was necessary when it was set up as ‘we were desperately short of staff in primary care’.

‘For a long time, we weren’t able to determine whether we could employ more GPs or more nurses through that scheme. Now you can, but that’s only been in the last year or so, and that’s been a learning point,’ she said.

‘I personally think that for practices, it needs to be through core funding now, and that the scheme needs to be disbanded and that money moved into core funding, so that practices and their neighbourhood teams can decide who and what they need to employ depending on what their community needs.’

Professor Hawthorne made the comments during her final week as college chair, with Dr Victoria Tzortziou Brown assuming the role on Monday last week.

Asked if Professor Hawthorne’s comments aligned with the college’s, an RCGP spokesperson said: ‘While we would like to see urgent improvements to the GP roles in ARRS – including widening the narrow eligibility criteria and increasing the generally low pay scales – ultimately, sufficient core funding for practices is essential.

‘The college has called for practices to have the funding to hire the GPs they need, something many practices are telling us isn’t currently the case. This is key to ensuring there are enough GP roles across the country, that GP to patient ratios are brought down to safe levels, and that patients can promptly access the care they need.’

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Earlier this year, the ARRS was extended to include general practice nurses and consultant nurses. Prior to that, last August it was announced that newly-qualified GPs could also be hired through the scheme.

A new paper launched today by our publisher Cogora in September, urged the BMA and the government to consider ‘central funding’ of all general practice staff, including nurses – with the money given directly to practices as part of the next contract negotiations.

A separate and direct funding stream to support staffing costs – including that of practice nurses – has been long called for by the Royal College of Nursing (RCN) and more recently by the Institute of General Practice Management (IGPM).

Like the RCGP, the IGPM will also be involved in the negotiation of the GP contract for 2026/27. Other organisations invited by the government include: the National Association of Primary Care (NAPC), Healthwatch England, National Voices and the NHS Confederation.

The move from government marks the end the BMA’s role as sole negotiator of contract terms for the next financial year.

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At the committee session last month, Professor Hawthorne was speaking alongside chief executive of the Queen’s Institute of Community Nursing, Steph Lawrence, who spoke about the ‘critical’ need for flexible working opportunities for nurses.

A version of this article was first published by our sister title Pulse