‘Enhanced’ general practice nurses recruited through the Additional Roles Reimbursement Scheme (ARRS) must not be used for ‘plugging gaps’ and should instead be seen as a leadership role for the profession, a senior nurse leader has urged.
UK professional lead for primary care at the Royal College of Nursing (RCN) Heather Randle said she saw the move to include enhanced nurses – an experienced GPN with postgraduate qualifications – on the scheme as an opportunity to have a nurse at every primary care network (PCN) ‘who will lead on the nursing voice’.
It was announced last week that enhanced GPNs will soon be included in the list of roles that PCNs can claim salary reimbursement for under the ARRS, as part of the 2024/25 GP contract arrangements.
Capped at one per PCN or two for those with 100,000 patients, an enhanced practice nurse has been defined by NHS England as a nurse with ‘a level seven or above postgraduate certification or diploma in one or more specialist areas of care’.
The role is understood to be in line with the Primary Care and General Practice Nursing Career and Core Capabilities Framework, which states enhanced practice nurses are a level in between registered nurses and advanced level practice nurses.
According to the framework, which is supported by the RCN and the Queen’s Nursing Institute, nurses at this level ‘require a critical understanding of detailed theoretical and practical knowledge, which can be generalist with a special interest and/or have management and leadership responsibilities’. And it suggests the role is suitable for senior practice nurses, nurse practitioners, specialist nurses and nurse managers.
While there has been some confusion among the profession over the role and what it requires, two webinars hosted by the RCN in recent days have discussed the news.
Ms Randle from the RCN said in an online meeting for members last night: ‘I see this as an opportunity for a leadership role.
‘For me, I see this as an opportunity to have a nurse at every PCN who will lead on the nursing voice – so providing leadership and guidance to the nurses, and leadership and guidance to the PCN as well.
‘That’s my vision for it – whether that becomes a thing or not, I don’t know.’
She added: ‘One of the things that I wouldn’t want to see is, is [it] plugging gaps in services. I don’t think that’s what the role is about.’
Together with the British Medical Association (BMA), Ms Randle said the RCN would work to ‘help with the definition of it and what we see that role as’.
Meanwhile, in a separate webinar on Friday – hosted by the RCN and NHS England, national primary care nursing lead Louise Brady said she thought the move was ‘really positive news’.
‘There are 1,250 primary care networks across England. So, that means 1,250 nurses at least will have the opportunity to be working at enhanced practice level across PCNs.
‘I think it’s a really good opportunity both clinically, and to develop education training, mentorship, and leadership skills.’
Recognising ‘queries and concerns’ about what enhanced level practice is, Ms Brady once again pointed to the Primary Care and General Practice Nursing Career and Core Capabilities Framework.
She reiterated that ‘enhanced nursing is a level of practice’ and that it was ‘clearly defined’ in this framework.
Notably, she pointed to the ‘capability section’ in which she said the level of practice was focused on ‘acting as a role model, empowering and enabling others, [and] mentorship of general practice nurses’.
‘A PCN could be one large practice, or it could be two or three practices within a conurbation where registered nurses working at enhanced level know their patients, know their adjacent practices and communities,’ added Ms Brady.
In addition, Ms Brady said she wanted to clarify that those recruited under the ARRS ‘are not on full Agenda for Change terms and conditions’ and therefore do not have maternity or paternity pay.
‘We sub a proportion of those additional roles at the maximum midpoint of Agenda for Change,’ she added.
PCNs are allocated an additional roles reimbursement sum for the year and the maximum reimbursable amount per role are typically linked to Agenda for Change pay bands.
ARRS staff were also eligible for pay rises in line with Agenda for Change pay uplifts last year, however the total budget PCNs have for the scheme did not account for this.
