GPonline analysis of NHS Digital workforce data from 78% of England's 1,255 PCNs suggests that 10,733 full-time equivalent (FTE) staff - equivalent to 8.5 staff per network - had been brought in by the end of September 2021 through the additional roles reimbursement scheme (ARRS).
The mid-year total suggests PCNs are more than 4,300 staff short of spending the full funding allocation available in the current financial year - a shortfall of 3.5 staff per PCN - and that hundreds of millions of pounds available through the scheme could be lost to primary care.
The ARRS - worth more than £3.5bn in total over four years from 2020/21 to 2023/24 - underpins a recruitment drive described by NHS England as 'foundational to all other goals' for general practice.
General practice workforce
General practice is facing unprecedented levels of workload with a depleted workforce. BMA estimates show the average GP is caring for around 300 more patients now than in 2015 - at a time when the profession has delivered the vast majority of more than 115m doses of COVID-19 vaccine UK-wide over the past year along with record numbers of appointments.
The ARRS aims to deliver an extra 26,000 FTE additional roles staff to general practice by 2023/24 - and is intended to fund seven staff per PCN in 2020/21, rising to around 21 in 2023/24.
A total of £746m in ARRS funding is available in 2021/22 - roughly £597,000 per PCN. Although NHS England has not specified a total number of staff that should be in post at this stage, the funding available suggests PCNs should be aiming for around 12 FTE staff on average in 2021/22.
GPonline revealed earlier this year that tens of millions of pounds went unclaimed in 2020/21 - but the national figure is likely to be much higher. GPs leading networks argued this month that recruitment money should be transferred into core GP funding to ensure it is not lost to general practice - and the BMA has warned the money must be retained by the profession at this crucial time.
Data from NHS Digital show that 2,626 FTE pharmacists have been hired under the scheme, the largest group of professionals by some margin. A total of 1,427 social prescribers have entered the workforce, while 888 care co-ordinators were in position.
NHS Digital has told GPonline that it is unable to provide a true figure of the number of ARRS staff that have been recruited, with no data available from a fifth of PCNs. NHS England primary care director Ed Waller told delegates at the NHS Confederation PCN conference in November that networks had employed around 12,000 staff.
Analysis by GPonline suggests that in headcount terms, the ARRS had brought in 12,675 people by the end of September. However, the FTE total is just 10,733 - meaning that just 41% of the overall 26,000 staff target have been recruited at the halfway point in the five-year GP contract deal that began in 2019.
Slow recruitment could have a significant impact on delivering the current COVID-19 booster campaign and the future delivery of COVID-19 jabs after the for next year and 2023.
BMA GP committee chair Dr Farah Jameel warned earlier this month that practices did not have ‘the staff or spare capacity’ to deliver the expanded booster campaign amid huge workload - although the government has now confirmed steps such as relaxation of some QOF targets and CQC checks to reduce pressure on GPs.
GPC executive team member Dr Krishna Kasaraneni told GPonline earlier this year: ‘The ARRS is reliant on there being sufficient availability of the relevant healthcare professionals in the areas that need them. Funding for staff is vital in order to deliver services to patients and while PCNs and practices want to recruit, many are simply unable to do so.
‘Where funding cannot be used due to the lack of available healthcare professionals, it should be retained within general practice so PCNs can use it flexibly in the way that best suits their needs, to deliver services to patients.’