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Salary and responsibilities of ARRS enhanced practice nurses revealed

Salary and responsibilities of ARRS enhanced practice nurses revealed

‘Enhanced’ practice nurses employed through the Additional Roles Reimbursement Scheme (ARRS) can earn up to £70,330, it has been revealed.

New guidance from NHS England has given more detail about what the new role entails and the qualifications needed – as well as the requirements of primary care networks (PCNs) for implementing the post as part of the ARRS.

According to the latest Network Contract Directed Enhanced Service (DES) specification, published last week, enhanced practice nurses will work as part of a multidisciplinary team within a PCN to deliver ‘enhanced clinical care’, train and supervise colleagues, and act as a ‘clinical role model’ for evidence-based practice.

It was announced in February that enhanced practice nurses – an experienced GPN with postgraduate qualifications – would 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.

The role, which can be implemented from April 2024, is capped at one per PCN or two for those with 100,000 patients.

The new Network Contract DES has confirmed the role is a band 7 level and that PCNs can use the ARRS to claim up to £60,401 per year for the role on a national basis – increasing to £67,369 in outer London and £70,330 within inner London.

The document states that the PCN must ensure enhanced practice nurses have a post graduate qualification at level 7 or above relevant to their area of enhanced practice, such as: wound care, diabetes, respiratory and cardiovascular disease, dementia, women’s health and public health and population health management.

And it reiterated that those in the role must work at an ‘enhanced level of practice’ as described in the Primary Care and General Practice Nursing Career and Core Capabilities Framework.

Enhanced practice nurses will work as part of a multidisciplinary team within a PCN to deliver ‘enhanced clinical care in the context of continual change, challenging environments, different models of care delivery, innovation and rapidly evolving technologies’, the guidance said.

Those in post will also be required to ‘undertake assessments of patient need and devise and evaluate complex care plans’ and teach and advise patients and families on managing their condition.

They must also recognise ‘boundaries of their practice and know when and to whom patients be referred’ and use the ‘principles of delegation’ to delegate work to colleagues.

In addition, enhanced practice nurses must also participate in clinical audits and research projects and implement change, ‘including the development, and updating of practice protocols/guidelines and procedures locally’.

An enhanced practice nurse will also hold responsibility for ‘team performance and service delivery’, and provide supervision to trainee nursing associates, nursing associates and GPNs.

And they will ‘facilitate and support the development and delivery of innovative training and education to staff, to improve competence and confidence’.

More widely, those in post must provide ‘professional and clinical leadership and mentorship’ and act as a ‘clinical role model on the delivery of evidence-based practice, the guidance said.

In addition, enhanced practice nurses will ‘work proactively with key local and national stakeholders to develop more integrated care pathways and holistic models of care, through dissemination of specialist skills and knowledge’.

The Primary Care and General Practice Nursing Career and Core Capabilities Framework – to which this role is aligned – 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 Royal College of Nursing 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.

Last month nursing leaders stressed the new ARRS role must not be used for ‘plugging gaps’ and should instead be seen as a leadership post for the profession.

The ARRS, introduced in 2019, allows PCNs to reimburse the salaries of some staff, including nursing associates, advanced nurse practitioners and pharmacists.

Chief executive of the Queen’s Nursing Institute (QNI) Dr Crystal Oldman recently warned GPNs were ‘put to one side’ while other professionals employed under the Additional Roles Reimbursement Scheme (ARRS) are doing the work they used to do.

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