The additional roles recruitment scheme (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.
The initiative aims to bring a mixture of professionals into the general practice, such as pharmacists and social prescribers, to create additional capacity for GPs to focus on patients with complex care needs - PCNs can recruit up to 21 extra staff by 2024.
However, RCGP chair Professor Martin Marshall has warned that the government looks set to miss this target by some way, with only around 40% of the intended cohort - or 10,000 staff - having been recruited at the halfway point.
Concerns around the scheme come after GPonline reported last December that it was falling short by thousands of staff - and come after an admission from health and social care secretary Sajid Javid last November that the government is ‘not on track’ to deliver another manifesto pledge to recruit 6,000 extra GPs by 2024.
Professor Marshall argued that efforts need to be 'stepped up' to meet the ARRS target, warning that general practice teams are ‘working to their limits’. He added that the profession did not have the personnel to manage the ‘ever-growing need for care’.
Data from 78% of around 1,250 PCNs in England published by NHS Digital last September show that 8,415 FTE staff had been recruited through the ARRS since it began in July 2019. Analysis by GPonline suggests that nationwide, the number of FTE staff recruited by PCNs is around 10,750.
Professor Marshall said staff recruited through the ARRS were crucial to helping to free up extra GP capacity and stressed the profession could not afford for the government to miss another recruitment target amid ‘intense pressures’.
He said: ‘While progress in meeting [the ARRS] target is better than the GP target, it’s still slow and very concerning that this could be another promise that won’t be met. With around 9,400 people recruited so far, progress is being made but efforts need to be stepped up to catch up and meet the target.
‘The impact of not having enough staff in general practice is being felt acutely both by GPs and our team members who are in the profession and working to their limits, and our patients who are facing longer waits for the care they need. Meeting this target – and the GP target – will be vital to addressing this.
'In general practice, we want to be able to provide the high-quality care that our patients deserve. However, we simply do not have enough GPs and members of the wider practice team to manage the ever-growing need for care, and unfortunately, we are seeing this impact on some patients, with burgeoning waiting lists to access GP services.’
PCN leaders have insisted a lack of time during the pandemic and a shortage of suitable staff to recruit mean they have hired fewer recruits than they would have expected at this stage and have asked for increased flexibility around the scheme.
Professor Marshall added that intense workload and workforce pressures were ‘taking their toll’ on GP teams, with some staff in new roles were already feeling burned out or thinking of leaving.
He added: ‘General practice is the backbone of the NHS, carrying out the bulk of NHS patient contacts and in turn alleviating pressures across the service. 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, which aren’t included in this target - to ensure patients can continue to receive high-quality and personalised care from their GP practice.'
GPonline reported last September that tens of millions of pounds in recruitment funding went unclaimed in 2020/21 - with as much as two-thirds of available funding unclaimed in some areas - and could be lost to the profession.
Some GPs have called for the funding to be redirected to core general practice funding to avoid it being wasted - and to allow networks more flexibility to employ the staff they need. The BMA has previously labelled large amounts of unspent funding as ‘very concerning’.
BMA chair Dr Farah Jameel said the NHS workforce was being 'stretched beyond imagination' as she argued the government needed to buck up its ideas to deliver on creating extra workforce capacity for the profession.
She said: 'While the government pledged to recruit 26,000 additional roles in general practice by 2024, this plan was based on modelling in a pre-pandemic world. We now know that in the last year alone 27,000 NHS workforce have voluntarily resigned. We are currently presiding over a large scale workforce exodus in response to burnout, low morale, and moral injury.
'Patient safety has become compromised and if workforce numbers continue to deplete, safety will only worsen in months and years to come. The government must commit to a new workforce strategy that seeks to address the current day and incoming challenges. We need a plan to retain and recruit more family doctors.'
A DHSC spokesperson said: 'We are on target to recruit 26,000 new staff to support GPs' surgeries, including pharmacists, physiotherapists, dieticians and occupational therapists.
'The new recruits will be a core part of local primary care teams, reducing pressure on general practice and ensure patients can see or speak to the right clinician.
'We have invested £530m to expand GP capacity during the pandemic, on top of £1.5bn until 2024 and we have a record number of GPs in training this year, with 4,000 accepting places.'