Under the GP contract deal unveiled earlier this month, NHS England increased the pool of allied healthcare staff PCNs could hire from April 2020 under the additional roles reimbursement scheme (ARRS) to 10 roles.
In a letter to primary care leaders and CCGs, director of primary care strategy and NHS contracts director at NHS England Ed Waller has revealed that PCNs will be allowed to recruit to these added roles early due to forecast underspends.
The move means that PCNs can now use unspent funding for 2019/20 to cover 100% of the cost of hiring not only the social prescribing link workers and clinical pharmacist roles included in the current financial year's ARRS, but also physios, physician associates, pharmacy technicians, health and wellbeing coaches, care co-ordinators, occupational therapists, dietitians and podiatrists. Funding to support recruitment of this wider range of staff had been expected to be available only from April 2020.
GPs and PCN leaders welcomed increased flexibility on ARRS spending, saying it would help networks 'get a head start' on recruitment for next year. But they questioned whether the change would make a difference so close to the end of the current financial year and suggested overall funding for PCNs may still need to rise.
Mr Waller said the increased flexibility would 'provide impetus for PCNs to move forward swiftly to recruit additional staff' and ensure that networks were drawing down on their full recruitment entitlements.
He added: ‘We are aware that some commissioners are forecasting an underspend on their ARRS funding, even after having considered use of a local scheme to share unused financial entitlements across the PCNs in the area.
‘NHS England encourages commissioners to use this unspent entitlement to enable PCNs to recruit now to any of the 10 roles which will be included in the ARRS from 1 April 2020.
‘Whilst we would not recommend using this flexibility to increase the rate of reimbursement for existing staff, commissioners are encouraged to reimburse any new appointments from 17 February at 100% of salary and employer "on-costs", up to the maximum reimbursable amounts for each role.’
GPonline reported earlier this month on PCN clinical directors warning that they had been unable to persuade CCGs to allow them to make use of unspent 'slippage' funding from the ARRS programme, amid fears the funding would be lost to networks.
Responding to the announcement, director of the NHS Confederation’s PCN Network Ruth Rankine, said: 'We are pleased that the use of underspends has been extended into the wider range of staff. However, with just over a month until the end of the financial year it’s unlikely that PCNs will really be able to make much progress on this if it’s not already underway given how long it takes to recruit people.
'There are opportunities to work with other providers in the system for example, community providers, who may be able to support PCNs with existing staff but these discussions need to be well advanced to meet these timescales.
Ms Rankine also argued rules around how slippage funds were spent could be relaxed to allow directors to support PCN development.
'Clinical directors are expressing real frustration that they are restricted as to how the funding can be spent, yet any remaining underspends will be recycled within the system to be spent elsewhere,' she added.
GPC England chair at the BMA Dr Richard Vautrey, said: 'This announcement follows our negotiations with NHS England and reflects our mutual aim to ensure as much of the ARRS workforce funding is spent as quickly as possible for the benefit of local practices.
'In order for PCNs to be truly effective, they need adequate funding and support, and we hope this announcement goes some way to ensuring they are able to get a head start on recruitment and in turn, help to reduce practice workload pressures as well as enabling the provision to patients of the high-quality care they deserve.'