What Factors Influence My Salary? A Guide for Primary Care Network Staff

At THC Primary Care, we provide resources for Primary Care Network leaders. However, I recently received a question from a first contact physio wanting to understand what factors influence a network when they make PCN salary decisions. Hence, this is the focus of this blog, which will:

1. Provide you with an overview of the scheme

2. Describe six factors which influence salary decisions

3. Explain why some roles are funded over the top of the reimbursable rate

4. Share some explanations as to why the same roles are offered different salaries

DISCLAIMER: Breaking down the complexities of PCN ARRS pay allocation is not easy; there are many nuances, and every network is different.

Please disregard anything that doesn't resonate.

Let's jump in!

Section 1: What is the Additional Roles Reimbursement Scheme?

The ARRS is a key element of the PCN DES (Primary Care Network Directed Enhanced Service) contract, designed to support the expansion of the primary care workforce. Under this scheme, PCNs can receive funding to employ specific roles.

While the scheme sets maximum reimbursement rates for each role, it's important to understand that these figures represent the maximum amount a PCN can claim back and not the salary that should be offered.

The reimbursable rate also includes funding for:

- Pension contributions

- National insurance contributions

The image below provides an indicative salary for an FCP.

The maximum reimbursement is £65,838.

Total employment costs for an FCP being offered £52,000 is £65,397.80

To access the salary calculator, it can be found within our PCN Members Club

Another important factor to understand is that PCNs receive a fixed ARRS budget.

If they exceed this budget, the surplus will need to be obtained from another funding source, which may not be recurring, or from practices in the network agreeing to top up the required amount for the foreseeable future.

Section 2: What factors influence the salary I am offered?

Your salary is determined by various factors. Some of these include:

1. The culture of the network

2. Practice salary parity

3. Budgeting for staff progression

4. Acknowledgement of experience levels

5. Historical precedent

6. End-of-year recruitment pressure

1. The Culture of the Network

The culture within a Primary Care Network significantly influences how ARRS-funded roles are valued and compensated.

While maximum reimbursable rates set the upper limits, the salary offered often reflects deeper cultural dynamics within the network. The networks that see the practices as an extension of the network and PCN staff as integral team members will have a different approach to deciding salaries from those networks that see the network as a less than favourable engine to support their practice and patient population.

However, lower salaries do not equal a lower perception in value, and this blog will aim to present the other factors that influence salary decisions.

2. Practice Salary Parity

   
   

Some networks are often reluctant to offer ARRS staff higher salaries than their existing practice staff in similar roles, as this could create internal tensions and potentially lead to practice staff seeking to switch to PCN positions.

**Budgeting for Staff Progression:** Some PCNs keep salaries lower to create a financial buffer to allow for future pay increases associated with annual increases and payment for completing certain qualifications. For example, pharmacists may receive an increase on completion of their CPPE course or for those undertaking independent prescribing.

3. Acknowledgement for Experience Levels

   
   

PCNs might start newer practitioners at lower rates if they have limited experience working in primary care.

4. Historical Precedent

   
   

If PCNs started with lower salaries when first implementing ARRS roles, they might be resistant to significant increases to manage expectations moving forward.

5. End-of-Year Recruitment Pressure

   
   

When PCNs rush to recruit because they're worried about losing unused ARRS funding, they might not have enough budget left to offer higher salaries. This "use it or lose it" mentality can lead to roles being created with whatever funding remains, rather than being properly planned and budgeted.

6. 3rd Party Provider Fees

If you are employed by a provider, this will also affect the salary you receive as they may charge the PCN a fee or have on-costs associated with your employment. So again, the maximum reimbursement claimed by the provider for your role will not be the salary you will receive.

Section 3: Why are General Practice Staff and Staff Funded by the Additional Roles Reimbursement Scheme Funded Differently?

PCN ARRS roles and general practice staff are funded through separate mechanisms.

In 2024, general practices received a 6% pay uplift (comprising the initial 2% from April plus an additional 4%), backdated to April 2024, specifically intended to cover GP contractors, salaried GPs, and practice staff pay increases.

This funding flows directly through the GP contract. Even though a 6% pay award was funded, it is at the discretion of the employer to award this.

In contrast, PCN ARRS roles are funded via the PCN DES.

While the maximum reimbursable amounts for ARRS roles increased by approximately 5.6 - 5.7% from October 2024, the overall ARRS budget envelope remained unchanged.

This meant that while PCNs can claim higher reimbursement rates for individual roles, they must manage these increases within their existing fixed budget allocation which did not increase.

For some networks, this has created a challenging balancing act for PCNs, who need to weigh competitive salary offerings against their fixed budget constraints.

This answer also answers the question from PCN colleagues who want to know why they didn't receive a 6% pay increase. However, some networks did award this, as there was room in the budget.

Section 4: Why are some roles funded over the top of the additional roles reimbursement scheme?

Again, there will be many different reasons for this, but ultimately, the practices in the network are in agreement that:

1. There is a significant need for clinical, leadership, or service need.

2. The implication of not having the required expertise is detrimental to the network.

3. The network can afford to and is willing to take the financial risk of supplementing the salary from other funding sources.

Section 5: Why Am I Not Paid the Same as My Other Colleagues?

The employer's organisational structure significantly impacts the salary being offered.

Some ARRS staff are employed directly by practices, some by the network itself, others by federations, some by staffing providers, and others by NHS organisations.

NHS organisations automatically follow the Agenda for Change bandings, and others use this as a guide, while those employed directly by a PCN might have a locally determined salary structure.

This is what creates variations within the same role.

Market conditions at the time of hiring, your negotiation approach, experience level, geographical location, and scope of responsibilities also all contribute to why the same roles are offered different salaries.

Lastly, the absence of a consistent pay structure within the same network explains why identical roles may command different salaries.

This situation isn't unique, and pay rates for all roles in general practices vary significantly.

Please note: Understanding these factors doesn't make pay differences easier to accept, but it helps explain the current reality in primary care networks.

I hope this blog helps.

The Primary Care Network Members Club

With over 60 different items of content exclusive to our members, there is a variety to support our PCN audience.

• Exclusive blogs,

• Masterclasses such as using AI, PCN finances and strategic planning.

• Q&A sessions

• ARRS salary calculator

• Members Forum

• Templates & Downloads

We'd love to have you join our growing community - find out more here.

The Primary Care Network Members Club

Never miss a blog again

Sign up for our FREE newsletter to ensure you never miss a blog, webinar, course details or resource again.

We promise not to spam you!

Find out more about THC Primary Care at www.thcprimarycare.co.uk

And follow us on Linkedin here