Recruiting GPs via the Additional Roles Reimbursement Scheme

By Matthew Okey

Using your ARRS funding 

In October 2024, funding was made available supposedly for the hiring of 1,000 newly and recently qualified GPs. It was meant to be an instant yet effective sticking plaster that helped out-of-work GPs fresh out of their vocational training schemes find jobs. However, as we enter a new financial year and with the ARRS funding allocated to recruit these GPs now looking like a more long-term feature, it warrants a look back at the effectiveness of the scheme so far.

Figures being published this month will paint a pretty dreary picture – just a fraction of the 1,000 positions supposed to be created by this funding were filled. In real terms, it’s likely less than half of those 1,000 positions were even offered in the first place.

It’s been an imperfect approach clouded with ambiguity, and PCNs were unsure how best to utilise their funding and how to employ these GPs, given they’ve never employed them in this capacity before.

So, what went wrong, and why should we be more optimistic about a better return on the Government’s investment in 2025/2026? First, let’s look at the issues.

PCNs and practices were given less than a week’s notice on the eligibility criteria before the funding went live.

General practice isn’t the fastest-moving sector at the best of times when it comes to change, and expecting an instant uptake is a level of optimism that even I, an experienced recruiter, would struggle to match.

This hadn’t been done before.

Again, with little notice, PCNs weren’t sure how to use these GPs – should they employ them as a PCN resource working across numerous locations? Would that be beneficial to a newly qualified GP who typically needs more support in the early stages of their career? If they were to base them at one practice, how would they ensure fairness within the PCN and that each practice received its fair share? What if their funding only allowed for 4 sessions and they were a 3-site practice? How would they come up with a workable working pattern?

The salary offered was incredibly poor.

The Government used the BMA’s own minimum recommended salary and funded that very figure, but not a penny more. This worked out to a sessional rate of just over £8,000 a session – a figure not seen in most parts of the country since perhaps 2017/2018, with the market rate closer to £10,500/11,000 a session for a newly qualified GP in late 2024. Understandably, newly qualified GPs, though struggling to find work, were reticent to take up these posts while they were still looking for more attractive options.

There are also real regional differences in the job market to consider.

Areas like Birmingham and Manchester have been far more adversely affected by the crash of the GP job market than more rural areas like Devon and Cornwall, which were quieter than normal in 2024 but still buoyant when compared to the bigger cities.

The allocation of funding didn’t take this into account, though, with PCNs just given an equal share of funding based on their list size. This meant that areas where there were lots of GPs looking for positions had a disproportionate number of positions to offer compared to those in more rural areas. The problem with a national approach is that it assumes the situation on the ground is the same everywhere. Would a more regional model, where ICBs allocated funding based on population density, have been more effective? Perhaps.

With all that in mind, though, there are real reasons for optimism too. Let’s look at some of those:

What was unknown and ambiguous in October is much less so now in April.

Practices and PCNs have, for the most part, got their head around the initiative, and GPs are now seemingly being hired en masse using this funding.

Through a little bit of trial and error, as well as peer feedback, most PCNs are now employing these GPs in more sensible fashions.

Most GPs being funded by ARRS now seem to be based at just one practice, two at the most, ensuring more continuity in the crucial early stages of their career. Most of those who tried something more novel, such as having a GP work solely in the PCN frailty team, for example, have come to the realisation that it doesn’t really work, and ARRS-funded GPs are best suited to normal practice work.

For smaller PCNs, common sense is taking precedence, and perhaps a lead practice is being allocated the GP, with that practice then giving up some of their other ARRS entitlement to the other practices, such as more Pharmacist or ANP hours. Consensus on the best way forward within a PCN is generally being found, whereas back in December and January, puzzlement was the order of the day.

There’s also more money available to recruit GPs now that the whole ARRS budget can be used on GPs if so desired.

I still think it unlikely that 1,000 positions will ever be created by this funding. However, what I do think will happen is that more practices will take advantage of it and at least part-fund new GP hires, given there’s no cap on the number of GPs a PCN can employ via ARRS. The actual amount they can pay GPs has also increased, making the roles more attractive to GPs, if only slightly.

Finally, there is more of a feeling of permanence to the funding, which is giving practices and PCNs the confidence that was missing in October through March.

GPs are being hired on longer-term contracts and even permanently, with the likelihood of the funding now being taken away very slim (after all, ARRS funding has only increased since its introduction, and that is up).

Is ARRS Funding A flop?

In summary, therefore, was the scheme a bit of a flop initially? I wouldn’t argue with you if you said yes. Will it still be a lightning rod for criticism? Probably, yes. Is it still a good thing that will ultimately help lots of GPs find positions they might have struggled to find otherwise? Also, yes.

It’s not perfect, but general practice rarely is. What general practice is, though, is resilient and, when needed, progressive. I have every confidence that the Government will be able to claim a win when they review this funding for 2026/2027, and while more experienced salaried GPs and locum GPs will bemoan the fact they are excluded from this funding (again, it’s not perfect), newly qualified GPs have found themselves without work through no fault of their own, and the Government is acting to help them. Credit where credit is due.

That said, would I scrap the scheme tomorrow and dump all the money into the Global Sum instead?

Absolutely.

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