The confirmed inclusion of general practice nurses (GPNs) within the additional roles reimbursement scheme (ARRS) has been cautiously welcomed, but a ‘long journey continues’ to ensure fair pay and conditions for all nursing staff, senior figures have said.
The British Medical Association (BMA) today announced it had accepted government proposals to add practice nurses into ARRS as part of negotiations for the 2025/26 GP Contract.
The new contract – which is yet to be published in full by NHS England – will see practice nurses added to the main ARRS scheme, but limited to those who have not held a previous post in their current primary care network (PCN), or any other member practices, in the last 12 months.
Writing on X Louise Brady, national primary care nursing lead at NHS England, said the confirmed introduction of GPNs into the scheme was a ‘small step change’ in the ‘long overdue’ recognition of practice nurses and their expertise.
However, she warned of ‘wide gaps in equity and parity exist in this scheme, between those nurses who will work in a single practice, and those who choose to work on a neighbourhood footprint across a PCN’.
She suggested a ‘long journey continues’ adding that she wanted to see ‘fairness parity and equity’ for all nursing staff.
Related Article: BMA accepts proposal to add practice nurses to ARRS
‘ARRS nursing roles will create some opportunities for general practice nurses, however the deep-rooted issues of really valuing all of our nursing staff dominate the landscape,’ added Ms Brady.
Discrepancies in terms and conditions and pay between nurses and their salaried GP counterparts must also be addressed, she warned.
‘Without the recognition of the economic, clinical and social value that nurses bring to practices and communities, much long-term condition care will be left undone, and people and communities will struggle for access and continuity,’ said Ms Brady.
‘In summary long term investment into the retention of ALL general practice nurses must be the goal and thus critical outcome the professional needs.’
Separately, Dr Crystal Oldman, chief executive of the Queen’s Nursing Institute (QNI), ‘welcomed’ the addition of GPNs, but noted there were ‘still restrictions’ with the scheme.
She pointed to how a GPN cannot be employed under ARRS within the same PCN as their current job for 12 months.
‘This restriction only applies to GPNs, not other clinicians, and we are concerned that it may unfairly limit the options of GPNs who want to move positions,’ Dr Oldman said.
She argued that GPNs need a ‘greater profile’ in discussions around the GP contract, and noted that the QNI was ‘not consulted as an independent voice’.
‘In reality, GPNs deliver much of the front-line primary health care that the GP contract provides,’ she continued.
In a briefing paper last week, the RCN accused the government of failing to address long-term pay disparities faced by general practice nurses by instead directing funding through the ARRS.
The union warned that the scheme, ‘if implemented badly’, may not fit with the principles or continuity of care and personalised care, as it would require nursing staff to work across multiple practices.
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And it suggested GPNs in ARRS could face ‘unstable employment’, with fixed-term contracts instead of permanent ones.
Also in January, an exclusive white paper published by Nursing in Practice’s publisher Cogora revealed that GP practices across England are struggling to recruit much-needed nurses because they are unable to match salaries given elsewhere.
As part of last year’s contract, the enhanced practice nurse role was added to the ARRS – designed to be a role that delivers ‘enhanced clinical care’ and to act as a ‘clinical role model’ for evidence-based practice.
Nursing associates and advanced nurse practitioners are also already included within the ARRS scheme.
Today, the BMA said it had accepted various proposals from the government that it said will see ‘important revisions made’ to the 2025/26 contract for GPs and PCNs.
The proposals represent a ‘crucial step towards recovery’ for practices in England, the BMA added, and includes an £889m uplift in funding for the general medical services contract.
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According to the BMA, the increase, which is in addition to a £433m investment applied to the contract last autumn, will provide a 7.2% cash growth in contract funding, ‘helping to fund a range of initiatives to support practices’.
Chair of the BMA’s GP Committee Dr Katie Bramall-Stainer said today on BBC Breakfast: ‘We’ve still got a very long journey of recovery to come, and I think the first signs of green shoots that patients will experience is that they will start to get to know their doctor and the staff at their local surgery.
‘Local surgeries aren’t closing, surgeries are advertising for more staff, for more nurses and GPs to provide more appointments. But that’s going to take time, because we’ve got a very long way to go.’
