PCNs falling short on 26,000 staff target and need more flexibility, GPs warn

Government plans to bring in 26,000 staff by 2024 to support general practice are behind schedule with just under 12,000 in post so far according to analysis by GPonline - as GPs called for more flexibility to accelerate recruitment.

(Photo: Ollie Millington/Getty Images)

GPonline analysis of NHS Digital workforce data from 85% of England's 1,255 PCNs suggests that 11,818 full-time equivalent (FTE) staff had been hired through the additional roles reimbursement scheme (ARRS) - the government’s flagship recruitment initiative for primary care - by the end of March this year.

The data suggest that 9.4 staff had been recruited per PCN on average, with close to 3,200 pharmacists representing the largest staff group employed by networks since 2019. The total staff per PCN figure is up from 8.5 per network reported in December last year.

But with PCNs three fifths of the way through the network contract DES, the data suggest that just 45% of the 26,000 staff goal has been delivered so far - meaning that they will have to employ around 14,000 extra recruits in just 24 months.

ARRS recruitment

The RCGP has called on the government to provide more flexibility within the scheme, and more support for the integration of staff. It has also stressed the importance of having strong plans to retain these professionals.

Figures suggesting that the initiative could fall wide of the mark follow a damning report from the King’s Fund think tank published in January which warned that it was ‘at risk of failure’ unless networks received more support to integrate staff.

GP surgeries have continued to come under huge strain in recent times as official statistics show that practices delivered 4m more appointments in March compared with the previous month. The workforce has also slumped by more than 350 GPs over the past year.

More than £1bn has been made available to PCNs to add to their ‘bespoke multidisciplinary teams’ for 2022/23 - and NHS England intends that each network will have an additional 21 FTE staff by 2024. They can currently recruit from a list of 15 professional roles.

Staff integration

But the data suggest that recruitment is slower than it should be at this stage of the scheme. GPs leading PCNs have previously said that a mixture of pandemic work, a lack of headspace to plan for incoming staff and a shortage of available candidates have all been factors.

Official statistics show that 3,183 FTE pharmacists, including advanced pharmacist practitioners, have been hired under the scheme - the largest group of professionals by some margin. A total of 1,741 social prescribers have entered the workforce, while 1,418 care co-ordinators were in position.

The new total for ARRS staff recruited as of March 2022 represents an increase of around 1,000 additional workers since December last year, when GPonline analysis showed that 10,733 FTE staff - equivalent to 8.5 staff per network - had been hired.

RCGP chair Professor Martin Marshall told GPonline that ‘better progress’ was being made on recruiting 26,000 ARRS staff than the 6,000 GPs promised to the profession by 2024. But he said results to come soon would provide a better indication of the scheme’s success to date.

GP workforce

He added: ‘Aside from recruiting sufficient numbers of healthcare professionals through the ARRS scheme, we would also like to see more flexibility within the scheme, and more support for the integration of ARRS staff into general practice.  As with GPs, efforts also need to be implemented to retain ARRS staff in the profession once they are recruited.

‘Currently, we simply do not have enough GPs or members of the wider practice team to manage the ever-growing need for care. We need the government to make good on its promise of 6,000 GPs and 26,000 members of the wider practice team by 2024 – and to tackle parallel workforce pressures facing practice nursing teams.

‘We also need to see clear public messaging about who patients may expect to get care and services from in general practice, so that patients understand this is about ensuring they get the most appropriate care for their health needs, and not just about not being able to see their GP.’

NHS Digital has told GPonline previously that it is unable to provide a true figure for the number of ARRS staff that have been recruited, with data missing from around 15% of networks. But the number of PCNs reporting has increased since data first started to be collected.

Retired GP Dr James Kingsland, who championed the primary care homes (PCHs) model on which PCNs are based, labelled the ARRS ‘a clunky way’ to expand services and suggested there should be more flexibility around the roles networks can hire.

A King’s Fund report also said that PCNs will fail to reduce pressure on general practice and deliver on the NHS long-term plan unless GPs are given greater support to integrate ARRS staff into surgeries.

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