The Additional Roles Reimbursement Scheme If we don’t use it…. Will we lose it?

At THC Primary Care, we create resources for primary care leaders, and we were recently asked to share our opinion on the Additional Roles Reimbursement Scheme and how we plan to manage this for the remainder of the financial year.

In this blog, we will provide 5 considerations to help you manage your ARRS funding, which centre around:

1️⃣ Why networks should recruit based on the population and service needs and not simply because the money is there.

2️⃣ Paying salaries that are underpinned by a pay rise policy.

3️⃣ The importance of forecasting your workforce spend.

4️⃣ Utilising companies who can deliver services for you if you are unable to recruit.

5️⃣ Maximising funding by developing projects.

Let's jump in!

At THC, we manage multiple Primary Care Networks across different Integrated Care Systems, and as always, there are various approaches to managing end-of-year spend.

• If you don’t use it in some areas, you lose it.

• In others, they let networks use the underspend from other networks on a non-recurrent basis.

• More recently, networks were encouraged to max out their allocation as this would affect their 24/25 allocation.

I believe the latest message being shared, which shouldn’t be overly surprising, is that the 24/25 allocation will be based on your network population list size, just like in previous years.

Whilst there is a lot of uncertainty and different interpretations when it comes to maximising the Additional Roles Reimbursement Scheme, my advice has always been:

Suggestion 1: Recruit based on the population and service needs of the network and not simply because the money is there.

When you recruit roles just to spend the allocation, it's not uncommon for this to result in conflict or roles recruited without clear direction or support.

In our experience, when networks recruit roles without planning the workload/need, this often leads to an unorganised induction and can cause disengagement from all parties involved.

Suggestion 2: Pay staff underpinned by a pay rise policy, which is fair and transparent.

It's important to pay staff a fair and competitive salary. Paying staff the minimum will leave staff feeling undervalued, causing poor morale and resentment, and ultimately, network members will leave.

Overpaying staff will also result in frustration and resentment from other network members, especially when the performance of the individual is felt not to meet the required standard and can put a strain on the network and practice budgets, leading to financial instability.

Feedback from ARRS shows they would like to be on the agenda for change contract. Whilst this is not always possible, having agreed policies with the network will hopefully assure the ARRS staff there is a chance for progression and other benefits.

Check out a pay rise policy in this blog here.

Suggestion 3: Forecast your workforce spend

My approach to forecasting can be found in the blog titled Strategic Workforce Planning in your Primary Care Network (Understanding the Investment Required).

In this blog, I share some principles to aid your strategic workforce planning, so your Primary Care Network and system can better understand the investment required moving forward.

If you think / know you are going to max out your budget, I highly recommend you start forecasting the potential overspend to your network.

If you are under budget this year and have planned for increases next year, this is also important to communicate.

I would also meet with the ICB to discuss this. It may not make any difference, but I would still do this, and if other networks in your ICB deploy the same approach, this may strengthen your position.

Suggestion 4: If your network is struggling to use their additional roles reimbursement allocation and there is a clear service need, utilise organisations that can provide the service for you.

Commissioning services will enable you to maximise your ARRS within the year without the ongoing recruitment costs.

If you are a regular blog reader, you know I champion Pure Physio for First Contact Physios and Primary Care Analytics if you need digital transformation support.

There are lots of other organisations providing pharmacists, dietitians and social prescribing. Just ask your neighbouring PCNs who they would recommend.

Suggestion 5: Get involved in projects

Another way to maximise your ARRS fund is to utilise this by delivering a project. Other funding sources can also contribute to this.

Be proactive and demonstrate there is a need for additional staff. You never know; it could be a project that could turn into an ICB-wide contract.

Partaking in projects is also a good way to get staff members involved and provide them with exciting and new challenges.

Lastly.....

I encourage our networks to maximise their spending, leaving room for a pay increase next year.

If roles exceed the top, I would use my forecasting tool to understand how much money is needed, and then I would start to work out how this could be funded. Plan A will always be that the system pays, but we do need a plan B and probably a plan C.

I hope this helps.

For additional blogs and resources on all things ARRS - please visit our dedicated webpage https://www.thcprimarycare.co.uk/arrs for further information.

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About the Author

Tara and Team THC provide project and network management and training to Primary Care Networks. Between our training programmes, facilitation and interim network programmes, we have now supported over 120 PCNs.

Tara has an MBA in Healthcare Leadership and Management, is published in the London Journal of Primary Care, is the author of over 200 blogs, and also hosts The Business of Healthcare Podcast.

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