The Additional Roles Reimbursement Scheme (ARRS) has materially expanded the primary care workforce in the UK. The initial phase focused on recruitment and headcount growth. In 2025/26, the strategic conversation has shifted towards a more complex challenge: workforce optimisation.
With a complex funding landscape and persistent operational pressures, the focus for Primary Care Networks (PCNs) is no longer on recruitment alone, but on maximising the clinical and economic value of these roles. This system-wide shift presents challenges and opportunities, not only for PCN leadership but also for pharmaceutical and medtech organisations seeking to partner with primary care. This analysis provides a guide to navigating the current landscape.
While headlines may suggest static funding, the reality for PCN budgets in 2025/26 is more nuanced. Overall, the total investment into the GP contract, which includes PCN funding, saw a significant uplift of £889 million. Most key PCN funding streams have risen, though the picture is mixed.
The ARRS-specific funding per weighted patient increased by approximately 4.4% (from an effective £25.50 in 2024/25 to £26.631 in 2025/26). There have also been further uplifts to cover pay raises for ARRS staff. Other core PCN funding streams, such as the Enhanced Access Payment (+£0.452 per patient) and the Care Home Premium (+£3.053 per bed), have also increased. However, smaller streams like the Capacity and Access Support Payment saw minor decreases. This complex financial picture requires PCNs to be highly strategic in maximising operational efficiency.
The scheme continues to reimburse a broad spectrum of roles designed to create a multidisciplinary team (MDT) environment in general practice. Key reimbursed ARRS roles include:
Effective deployment of this workforce is now the central objective.
ARRS is not an isolated funding stream. It is a core workforce delivery mechanism for achieving the UK government's long-term strategic health goals, from its initial conception to its current role.
The original 2019 NHS Long Term Plan set out a transformative vision for a more proactive, integrated, and community-focused health service. While this foundational plan did not mention the ARRS acronym, it mandated the creation of PCNs supported by multidisciplinary teams. The ARRS, introduced in the GP contract reform immediately after, was the specific funding stream created to make this happen. In this respect, ARRS was the engine of that original vision, providing the fuel and framework to build the teams required to shift care out of hospitals and manage population health effectively.
The new 'Fit for the Future' 10-Year plan, released in July 2025, builds upon this foundation to address today's most urgent challenges. ARRS is a proven asset for delivering on this new plan's key priorities, including:
The government's life sciences vision, as stated in its Life Sciences Sector Plan released on the 16th July 2025, aims to position the UK as a global hub for health innovation. The ARRS-enabled primary care model is a cornerstone of the infrastructure needed to achieve this.
The primary hurdle for many PCNs is the effective operational integration of new roles into established general practice workflows while maintaining robust clinical governance.
Successful integration requires deliberate workforce planning that addresses fundamental operational questions:
Without a clear framework, new roles risk operating in silos, leading to underutilisation and diminished return on investment.
A critical component of the ARRS framework is the provision of adequate clinical supervision. Many ARRS professionals require supervision from a senior clinician with specific expertise relevant to their field. The capacity of GP Partners to provide this is often limited. A failure to implement a structured supervision model introduces clinical risk and is a documented factor in staff attrition.
This governance challenge extends to partnerships with external providers. PCNs must ask critical questions: Does the provider have an adequate governance structure for investigating significant events? Are they CQC registered? Is there a clear framework for PCN, GP, and provider teams to hold joint clinical governance meetings to ensure seamless and safe patient care?
The structural changes introduced by ARRS extend beyond the NHS. For industry partners, understanding this new landscape is important for effective collaboration.
The expansion of roles like Clinical Pharmacists and Physician Associates creates a new dynamic for market access and medicines optimisation.
As primary care continues its shift from analogue to digital, the role of medtech becomes more critical. For the medtech industry, ARRS creates both a new user base and a business case for specific technology solutions.
High staff turnover remains a threat to the long-term success of the ARRS. Workforce stability is achieved through strategic investment in staff development and culture.
Long-term retention is linked to the availability of clear career pathways. PCNs that succeed in this area provide structured opportunities for Continuing Professional Development (CPD), mentorship from senior clinicians, and a transparent framework for progression.
To mitigate the risk of professional isolation, ARRS-funded staff should be fully integrated into the PCN's clinical and social fabric. This is achieved through their inclusion in all relevant clinical governance meetings, MDT discussions, and strategic planning sessions. A 'one team' culture is a key driver of retention.
To justify continued investment and inform future strategy, PCNs should consider ways to demonstrate the impact of their ARRS-funded workforce using quantifiable evidence.
While activity data (e.g., appointment numbers) is easy to collect, it provides limited insight into value. A more sophisticated approach focuses on a combination of quantitative and qualitative outcomes:
This data provides a robust evidence base for discussions with the Integrated Care Board (ICB) and NHS England.
The 2025/26 ARRS landscape requires a move from tactical recruitment to strategic workforce optimisation. As the delivery mechanism for key objectives within both foundational and current national health strategies, its success could define success for broader objectives. For PCNs, this means focusing on integration, governance, and value demonstration.
For the pharmaceutical and medtech industries, the ARRS framework could provide an avenue for building value-based partnerships with primary care. Navigating these complex workforce dynamics requires specialist expertise, making a strong case for strategic workforce partners like CHASE, who can support all stakeholders in achieving their objectives within this evolving ecosystem.
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