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Nursing must remain at the centre of the PCN workforce


Carolyn Scott


With the Spring print edition of Nursing in Practice now out, editor Carolyn Scott discusses some of the issues raised, notably the impact of the additional roles reimbursement scheme and how nurses can ensure they remain at the heart of future strategies and decision-making as the workforce continues to evolve

The recent addition of advanced nurse practitioners to the list of roles qualifying for the additional roles reimbursement scheme (ARRS) is a welcome development. This should support further expansion of senior and clinically expert nurses working in general practice, adding to the great work done by ANPs across primary care. The move is good news for nursing and for patients, but it should have come much sooner.

The ARRS scheme has been in place since 2019, bringing a wide range of new roles into general practice, broadening the skill mix and the care options for patients. Many thousands of staff in other new roles have been added to the workforce in a few years, so ANPs could be forgiven for wondering why they have been overlooked until now.

The Nursing in Practice team has been asking nurses in general practice what they think of ARRS and how it is impacting them. In our Spring 2023 cover feature, we report a wide range of responses – positive and negative. In general, the arrival of new colleagues to work alongside GPs and nurses has been embraced, bringing additional sources of advice and support. But we heard worries too. Some nurses, for example, have found themselves pulled into training new colleagues (some of whom are better paid) – adding to, rather than easing, their workload. 

Our research for the piece threw up a long list of concerns on the impact of the additional roles on the day-to-day work of nurses and on their future career prospects.

Some nurses clearly do not feel they’ve been sufficiently involved in the major changes happening within primary care networks and practices. Some are understandably concerned that general practice nursing will somehow become lessened in this phase of rapid change, with other professionals nibbling away at their role.

So, who will make sure this doesn’t happen? Some PCNs have clearly outlined strategies for nursing, but others may be less clear how the role of nurses will be supported and developed. Having enough nurses at senior levels in PCNs – and above – seems a critical element, and our interview with an ICB chief nurse group representative raises hopes that nurses will finally be involved in wider healthcare strategy from the outset. If this doesn’t happen, the ARRS could end up as yet another poorly thought-through and counterproductive initiative.

Nurses have been a key element of the development of general practice for many years – we mustn’t risk that for the future.

Get in touch
As the additional roles scheme expands, we are keen to hear about the experiences of nurses working alongside new colleagues – and from those working as ANPs as they are brought in by PCNs. Please get in touch at [email protected]

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Carolyn Scott is editor of Nursing in Practice. Follow her on Twitter