PCNs to miss out on tens of millions of pounds as pandemic hits recruitment

General practice in England could miss out on tens of millions of pounds in funding with some primary care networks (PCN) expecting to underspend on recruitment by up to a fifth, GPonline has learned.

PCN funding (Photo: Andy Andrews/Getty Images)
PCN funding (Photo: Andy Andrews/Getty Images)

A total of £430m is available to PCNs in 2020/21 - around £344,000 per network - to recruit staff from a list of 10 roles through the additional roles reimbursement scheme (ARRS). The average PCN is expected to employ around 21 extra staff by 2023/24.

Clinical directors leading PCNs have said that they could fail to spend between 5% and 20% of their funding in the current financial year because of a shortage of available staff to hire and a lack of time to plan recruitment.

Last June PCNs reported to CCGs on the amount of funding they intended to use by March 2021, with neighbouring PCNs then able to bid for surplus cash. But GPonline understands that it is still uncertain what will happen to any remaining recruitment funding that is not spent by the end of March.

Staff recruitment

NHS Confederation PCN Network director Ruth Rankine has called for ICS workforce leads to support PCNs with their workforce plans to ensure practices can make full use of money available through the ARRS.

Co-clinical director of Wokingham North PCN in Berkshire Dr Rupa Joshi said that her network had continued recruiting through the pandemic, but had currently been unable to spend 20% of their budget. She said: ‘We have done our best to recruit additional staff, recently recruiting four care co-ordinators, two pharmacy technicians, one pharmacist and a first contact physio (FCP).

‘We have managed to allocate all our funding to positions but we have not quite used it yet as we need to recruit pharmacists. We’ve been too busy to look at this for the moment but we have a meeting this week to plan. PCNs also wish to collaborate for recruitment, but a consensus has not been reached for oncosts, which are much higher than the ARRS reimbursement,’ she added.

Clinical director of Whitewater Loddon PCN near Basingstoke in Hampshire Dr Tim Cooper also said that his PCN would probably use around four fifths of their allocated sum.

Additional roles funding

‘We currently haven’t recruited into further roles using the ARRS. We recruited quite heavily during the summer and are now just considering next steps. What we desperately need clarity on is the funding available from April, particularly around new roles,' he said.

‘Everyone is thinking about managing the inevitable tidal wave of help that will be needed after this COVID wave. Having the ability to consider the funding envelope for mental health workers for example  would be invaluable and timely,' he added.

However, clinical director of the Grand Union PCN in Watford Dr Kevin Barrett said his network was ‘pretty close’ to reaching its maximum limit following the recruitment of care co-ordinators and using funding to pay for additional staff overtime in recent months.

NHS England guidance makes clear that PCNs should use 100% of their ARRS funding by the end of March, with CCGs supporting practices to do this. It also states that CCGs will be expected to share funding across PCNs where networks have failed to make full use of their funding, but it does not specify what this money can be spent on.

Workforce planning

Ruth Rankine told GPonline that recruitment was strong in some areas, with networks using money to boost workforce capacity. But she insisted PCNs needed extra support to make full use of funding. She said: ‘Recruitment has been variable. In some cases people have made really good progress, in others there has been less progress. People are using their workforce at the minute to manage the dayjob and focus on the vaccination programme. But it’s a difficult time to bring on new staff.

‘Those PCNs who were further ahead anyway will probably spend close to all of their funding. I think for the other networks, who were potentially struggling with recruitment or still weren’t clear of what their workforce plan looked like, it could potentially be more [than 10-20%] that they haven’t spent.

‘PCNs need to complete workforce plans… and it’s another thing for clinical directors and managers to do - they don’t necessarily have the expertise either. ICS system workforce leads should be supporting PCNs, like we’ve seen in Manchester, around their workforce planning.’

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