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QNI expresses ‘significant’ concerns over ARRS impact on general practice nurses

QNI expresses ‘significant’ concerns over ARRS impact on general practice nurses

The Queen’s Nursing Institute (QNI) has expressed ‘significant concerns’ over the impact of the Additional Roles Reimbursement Scheme (ARRS) on general practice nurses.

In a statement published today, the QNI said that the role of the general practice nurse (GPN) was being ‘devalued’ by the number of new staff being recruited through the scheme, with other ARRS roles ‘perceived as the life savers of primary care’.

The QNI warned that there is a risk of losing GPNs to other areas of health and social care unless there is ‘clear acknowledgement of the value of GPNs is needed, along with a plan to support GPNs to stay, grow, and develop in general practice alongside their colleagues’.

The ARRS programme, introduced in 2019, allows primary care networks (PCNs) to claim reimbursement for the salaries and some costs of hiring a number of multidisciplinary roles into practices.

While advanced nurse practitioner (ANP) roles were added to the scheme earlier this year, general practices nurse roles are not eligible for reimbursement through ARRS.

The QNI has suggested that many practices are now employing large numbers of staff through ARRS, and that this is having a detrimental impact on the existing GPN workforce.

‘Many GPNs are being required to support new starters, despite nurses themselves being excluded from being recruited into the scheme,’ the QNI said.

The organisation argued that it is ‘well documented’ that GPNs are spending ‘a substantial part of their clinical time’ developing and delivering induction and training programmes for new starters, despite receiving no benefit or recognition.

This is causing GPNs to work longer hours in order to continue providing their required clinical care alongside the additional training responsibilities.

Additionally, the QNI suggested that GPNs may be deskilled as a result of the changes, saying: ‘There is an emerging risk of deskilling expert GPNs in favour of the new roles introduced through the ARRS, where clinical practice becomes divided into tasks and the continuity of care with a holistic approach currently provided by GPNs is diminished.’

In response to challenges in supporting new staff into general practice, the statement called on NHS England to allocate resources to support comprehensive induction and supervision of new members of the general practice team recruited through ARRS.

This is particularly important, the QNI said, where new joiners have no previous experience of the sector.

‘Advanced Nurse Practitioners,’ the organisation noted, are ‘often routinely named as the lead nurse over GPNs, even when they have not previously worked in general practice’.

The QNI said that it will survey GPNs in the coming months to better understand the impact of ARRS and that it is ‘keen to work with NHSE to determine what further support is needed now and into the future’.


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