As part of plans to support an overstretched GP workforce, 20,000 additional healthcare workers will be recruited by PCNs to support GP practices over the next five years using funding provided through the additional roles reimbursement scheme (ARRS). On top of this, a further 6,000 additional roles staff were promised in the incoming Conservative government's election manifesto.
But GPs leading PCNs say extra funding is needed to ensure practices can train incoming social prescribers and clinical pharmacists adequately, and to integrate them within practice teams.
These senior GPs say additional resources would help to pay for locum cover, freeing up GP trainers’ time to work with incoming staff - or cover the cost of hiring external trainers.
Without supplementary funding, PCN leaders fear that training could be inadequate - potentially compromising the safety of care new staff can provide, or driving them to quit.
Primary care integration
Clinical director of Newham Central One PCN Dr Farzana Hussain said extra money was required to allow practices to properly embed staff, admitting her network had been forced to consider spending organisational development money to fund training.
‘As a clinical director with a background in general practice and nurse training, l have put in hours of my own time devising training plans with my additional staff and I’m using my own practice as the test bed to see what works - my salaried GP has had to reduce the number of patients she sees to be available for training but we need to invest in the short term for long-term gains.
‘Training staff is important because it ensures that our additional roles staff have the ability and skills to carry out their tasks safely.’
Dr Hussain warned that practices involved in the 2015 pharmacist pilot scheme, which recruited 490 pharmacists across 658 GP practices, saw staff quit because they were not provided with adequate support. She said the same mistakes could not be made by PCNs this time round.
‘I would like to see training budgets come directly to networks so there can be practical on-the-ground training offered. The GP training model is a good one to follow.’
Under the ARRS, PCNs have been supported to recruit additional healthcare staff during 2019/20 and will be reimbursed 100% of the total salary for social prescribing link workers and 70% for clinical pharmacists.
So far, NHS England has not provided specific funding for the training of these staff, leaving practices with the task of finding extra resources for staff development.
Pharmacist recruitment lead at East Cornwall PCN Mark Stone agreed that practices would benefit from continued operational funding and suggested that PCNs could be put off recruiting if they were not helped to pay for the ‘hidden costs’ of recruitment.
‘We need to ensure that the general practice workforce is fit for propose, staff need to be equipped with the knowledge and the skills to directly take work off the shrinking and overburdened GP workforce.
‘The new additional roles will be used to pay for new staff members who are new to general practice and primary care. This creates a significant training need and, if we get this training support right, then staff will provide safe and effective patient care, if we get this wrong at best they leave, at worst we create safety issues.’
GP leaders have already warned of problems around recruitment of additional roles staff - with ‘unrealistic wage bands’ making it difficult for networks to recruit. Meanwhile, LMCs have called for increased flexibility, and NHS England has warned that PCNs could see funding diverted if they struggled to spend it.