A total of £430m is available through the additional roles reimbursement scheme (ARRS) in 2020/21 to hire staff to support general practice, including physios, pharmacists and occupational therapists.
But clinical directors leading PCNs have stressed that millions of pounds could be lost to general practice if they are unable to recruit staff. They say that a lack of 'headspace' due to heavy workload and a shortage of people available to fill ARRS roles is making it difficult to spend available resources.
GPs argue that spending rules should be relaxed to let them use surplus funds and strengthen in other areas ahead of the winter - including making physical improvements to premises or upgrading practice equipment.
In August NHS England released details of how practices can claim back additional costs incurred during the pandemic, including reimbursement for staff cover. But GPs continue to dip into their own pockets to ensure that services run smoothly and are safe.
Watford GP Dr Simon Hodes suggested that funding should be relaxed to allow practices to recruit to any roles they need, or make general improvements to improve patient care.
He said: ‘My heart sinks to be honest. We’re in a pandemic and there’s a pot of money there which is earmarked for certain things, but there’s no flexibility to be able to spend it on other things.
‘We’ve all invested in perspex screens, digital thermometers and other things - in our practice we’ve ripped up the carpets and put in laminate flooring to aid infection control. We’ve done it because we want a safe environment for the patients, but all of that is invisible.
‘Millions of pounds of funds that GPs could be using for new kit, for example blood pressure monitors, dermatoscopes - things that actually directly impact on patient care or make a practice COVID-secure. Or if practices need extra locums over winter or any staff, leaders should be saying: “Here you go, use the money from that”.’
Primary care staff
At present PCNs can use ARRS funding to recruit from a list of 11 roles in 2020/21, with NHS chiefs adding chief nursing officers and nurse associates in August after calls for increased flexibility.
But the BMA this month asked NHS England to permit practices to spend recruitment monies 'on any staff requirements... including those not within the current scope of the ARRS’. This was part of a wider list of demands to ease pressure on general practice during the pandemic.
BMA GP committee chair Dr Richard Vautrey said general practice was coming under increasing pressure as demand for services grows and COVID-19 cases increase.
'GPs are growing increasingly frustrated at not being able to access the funding they need to respond to the pandemic, while seeing funding they are entitled to potentially being lost.
'Many are in this difficult position with a double whammy of existing ARRS funding not be able to be spent due to the challenges of recruitment at this time, and additional funding needed for the pandemic response not being provided by NHS England and CCGs.
'It is crucial that PCNs are supported as much as possible to enable workforce recruitment and that funding that is an entitlement for practices and PCNs is spent as such and, where this is just not possible, there needs to be flexibility on how it can be spent so, at the very least, it is not lost.'
On 13 October, 17,234 positive COVID-19 tests were confirmed - taking average daily cases over the past seven days to 14,973. The number of deaths recorded in England on 13 October was 124 - the highest since early June.