Nursing workforce: general practice nurses must be part of ARRS
Including general practice nurses on the Additional Roles Reimbursement Scheme would help prevent them from feeling devalued and deskilled
The Queen’s Nursing Institute (QNI) was cautiously optimistic that the Additional Roles Reimbursement Scheme (ARRS) would help build and develop the nursing workforce in primary care, but is disappointed that general practice nurses (GPNs) are not included. As the nursing role is not ‘new’ and GPNs are not considered ‘additional’, the role does not fit the criteria of the scheme.
There are 17 multidisciplinary ARRS roles in primary care and GPNs are reporting that they are taking on the induction, training and supervision of the newly appointed practitioners alongside GPs. The resources required to support this substantial amount of additional work have not been considered in the funding, planning and implementation of the ARRS.
General practice nurses are at risk of being demoted and deskilled by new roles
GPNs are reporting feeling undervalued and airbrushed out of the picture, while continuing to be the experts in long-term conditions, delivering urgent care and running minor injuries clinics, providing expert wound care and managing the national screening and immunisation programmes.
There is evidence of pharmacists appointed under the ARRS being asked to take over GPN clinics, without experience of the context of care or the nursing expertise. GPNs are at risk of being demoted and deskilled by the new roles.
The QNI has asked NHS England to include GPNs in the next iteration of the ARRS, to help attract and retain nurses in general practice. There is an opportunity now to capitalise on the new standards for GPN education and the new apprenticeship route, providing a clear career pathway in developing the required clinical skills within a framework of advanced practice.
We will gather wider data on the impact of the ARRS on nurses working in general practice, seeking out examples of where the implementation has worked well and where GPNs have faced significant challenges. A QNI survey, led by Alison Leary, targeted specifically at GPNs will be crucial in providing evidence of the impact of the scheme on the nursing workforce and we can work from there to pinpoint improvements.
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