Shift PCN recruitment cash to fight COVID-19, say GPs

Restrictions on how primary care networks (PCNs) can spend funding to recruit new staff must be lifted to help practices fill roles needed to fight COVID-19, GPs have warned.

PCN funding flexibility (Photo: Altinosmanaj/Getty Images)
PCN funding flexibility (Photo: Altinosmanaj/Getty Images)

PCN leaders have told GPonline that they are ‘absolutely consumed with service provision and locality planning’ and have no time to recruit and induct staff through the additional roles reimbursement scheme (ARRS) - with one doctor calling it an ‘almost impossible task’.

Delays to workforce strategy planning announced to date have not gone far enough, GPs say, and the requirements feel like an unnecessary ‘tick-box exercise’ during the pandemic.

PCN clinical directors have suggested that the ARRS should be suspended and have urged NHS England to allow networks to use next year’s funding to recruit the staff they need during the pandemic, such as paramedics, nurses and locum GPs.

Primary care recruitment

The BMA has confirmed it is in talks with NHS England to secure additional support to allow practices to 'rapidly recruit', and PCN leaders say they have adapted the roles of ARRS staff already in post to assist with the COVID-19 effort.

NHS chief executive Sir Simon Stevens told MPs this month that the ARRS should continue through the COVID-19 pandemic because staff hired through the scheme would boost the primary care workforce.

However, clinical directors say they don't have any spare time for ARRS recruitment planning. Clinical director of West of Waverley PCN in Surrey Dr Dave Triska, told GPonline that he had stopped this work.

‘The people who would normally be driving [ARRS recruitment] - the clinical directors and associated staff - we are now 100% focused on how we continue to deliver normal services and deal with a pandemic,' he said.

GP workload

‘We don't really have the capability or the capacity to take on additional staff and set up a new set of services. It's a shame, but I just can't really see that's what anyone could in the current climate,' he added.

Dr Triska said that he had expected NHSE to ‘hit the pause button’ on the recruitment scheme to allow GPs to concentrate on COVID-19 work. Although he said that allied healthcare workers would be useful, he suggested that ARRS funding for 2020/21 could be released to allow networks to recruit to roles they desperately needed.

‘I would be very happy if there was a look at funding to support GP staffing levels, because the service has been decimated overnight. We're all coping but we don't know what the future holds at the moment.

‘If we could divert some of our funding at the moment and change what we were doing with it to restaff primary care so that we can support our hospital colleagues to deliver life-saving care, then that's going to be a huge difference.’

NHS funding

Clinical director of Central and Thistlemoor PCN in Peterborough Dr Neil Modha agreed that ARRS funding could be re-routed. He said: ‘I would hope that NHS England would enable practices to get on and recruit whoever they need, whichever skill set that may be.

'For example, this could be a doctor or booking extra locum sessions. I think [giving clinical directors] a freer hand to hire what professionals they need, depending on their specific situation, would be really helpful.'

He added that paramedics could be useful and would help practices to 'sieve out the people' who required hospital care. ARRS funding currently can only be used to hire from a select list of allied healthcare professionals.

Dr Farzana Hussain, clinical director at Newham 1 PCN in London, told GPonline that ARRS recruitment had to be suspended during the outbreak, adding she hardly had 'time to think'.

‘I think [workforce strategy planning] is form filling that really doesn't need to be done right now. Leave us to [work] without saying we need to hire five or six of these staff... we will be able to deliver on all those enhanced services and more because we care about patients.’

Changing roles

Until ARRS funds are freed up or relaxed, Dr Hussain said that she had adapted the role of her social prescriber so they could help out with COVID-19-related work.

‘I've got in touch with some of our charity groups, and our social prescriber is working directly with them. He deals with homeless mums and their children and the food bank. So he is proving really useful because we've deployed him in a very different role,' she said.

BMA GP committee chair Dr Richard Vautrey, said: ‘The need for practices to rapidly recruit is more than ever at the moment. While ARRS funding is important, it is not the only support we should expect as we deal with the COVID-19 outbreak and this is something we are urgently working on with NHS England. Additional support should also come through the return to practice schemes for recently retired GPs.’

Meanwhile, incoming NHS Confederation Chair Lord Victor Adebowale suggested yesterday that PCN underspend rules could be changed to help practices cope with staff absences.

Last week GPonline reported that practices were already reporting staffing crises after clinicians had been forced to stop working to self-isolate with their families.

Around 15,000 doctors have been asked by the GMC to return to practice during the coronavirus outbreak to ease staffing problems and increase capacity.

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