The criteria for employing advanced nurse practitioners (ANPs) through the additional roles reimbursement scheme (ARRS) in GP practices has widened slightly.
However, a controversial NHS accreditation scheme – which has previously been described as ‘discriminatory’ – remains a requirement.
The Network Contract DES for 2025/26 now allows experienced nurses working towards attaining an advanced practice ‘digital badge’ – either through an accredited Master’s programme or via an ePortfolio route – to be eligible for a reimbursed role within general practice.
Previously, only those nurses who had already attained the digital badge were eligible for the scheme.
The digital badge scheme was launched by NHS England through its Centre for Advancing practice in 2022 as a way of evidencing the ‘accredited education and training’ of ANPs in all settings.
It is currently voluntary for all ANPs, other than those seeking employment under the ARRS in general practice.
It can be obtained via two routes: from doing an accredited Master’s programme or via an ePortfolio which includes a 5,000-word essay.
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Over the last year, Nursing in Practice has been reporting the struggles of ANPs in trying to access the digital badge, including lengthy waits to enrol onto the ePortfolio route.
Concerns have also been raised that for the Master’s route, it is largely courses post-2017 that are accredited, meaning ANPs who have done their education before then have to undergo the extensive ePortfolio option if they want to obtain the badge.
Research from the Queen’s Institute of Community Nursing (QICN) into the issue last year warned GP practices risked losing ‘many’ experienced nurses because of the digital badge scheme and that it was both ‘discriminatory’ and causing unnecessary stress among the profession.
This week, those among the profession have said the change in this year’s contract show some improvement, but does not go far enough.
Sandra Dyer, who qualified as a nurse in 1990 and completed her advanced practice Masters in 2015, was told in 2023 that her ARRS ANP role could no longer be funded as she did not have the digital badge.
After this, she tried to access the badge via the ePortfolio route, but then waited between 12 to 18 months until she was offered a place.
‘It’s disappointing to see the digital badge requirement stays in this year’s [contract] despite the impact on the existing workforce identified by the QICN last year,’ she told Nursing in Practice.
‘It seems there is some flexibility with those enrolled and progressing on the digital badge supported e-portfolio now included which is an improvement.’
However, she warned barriers persisted, including ongoing wait times and the need for employer support.
For example, she explained that as she now worked locum shifts, she was unable to get the employer support and supervision that is required as part of the ePortfolio route.
‘It should be recognised that those who have been forced out of clinical practice as an ANP due to the ARRS requirement will face significant challenges on completion of the supported ePortfolio due to the requirement for employer support/supervision,’ she warned.
Chief executive of the QICN Dr Crystal Oldman said she also remained concerned about the digital badge requirement and that she too was aware of the ‘lengthy backlog’ in those trying to access the ePortfolio route.
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‘The significant disappointment for the QICN is that ultimately, the single measure of advanced practice in nursing in general practice continues to be the digital badge and the routes to this are restricted.
‘This will continue to disadvantage those nurses in general practice who have worked at an advanced level for many years, if not decades.
‘There is no route to demonstrate their knowledge, skills and expertise at this level, other than the ePortfolio route which has been shown to be a slow and lengthy process.’
She added: ‘They feel trapped in a system of assessment which is not of their making, but which has at the centre, good intentions of ensuring a consistent and agreed level of advanced practice.
‘However, it has been executed in a way that disenfranchises excellent nurses with years of working at an advanced level.’
Dr Oldman told Nursing in Practice that concerns remained about ‘the very long backlog in the assessments of the ePortfolio route’ and that the QICN hears from nurses working in general practice that this ‘directly impacts on their employment and progression’.
She suggested that opening up ‘another route to assessment’ would have ‘won the hearts and minds of these nurses by recognising their expertise – and kept them in the workforce’.
For example, the QICN has argued that general practice nurses who graduate from universities offering the postgraduate GPN Specialist Practitioner Qualification at an advanced level, endorsed by the QICN, should be included in the ARRS.
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‘It is disappointing that this is not yet the case,’ she said.
‘We will continue to present evidence of this route being the equivalent of an advanced clinical practitioner programme – additionally with a focus on the GPN field of practice.
‘This qualification will, I believe, eventually be included if the ARRS scheme continues. It is certainly understood within the nursing profession to be equivalent of advanced clinical practice.’
What does the Network Contract DES for 2025/26 say about requirements for ANPs under ARRS?
For advanced practitioner nurses to be employed through the ARRS, they must have either:
- Graduated from a Centre for Advancing Practice accredited MSc advanced practice programme or completed the Centre’s ePortfolio (Supported) Route; both pathways enable eligibility for an ‘Advanced’ digital badge issued by the Centre for Advancing Practice, demonstrating recognised educational and experiential preparation in advanced practice; or
- Enrolled as a trainee on a Centre for Advancing Practice accredited MSc advanced practice programme linked with subsequent guaranteed progression onto a reimbursable advanced practitioner nurse role on completion of training; or
- Enrolled on and progressed past the initial Learning Needs Analysis (LNA) stage of the Centre for Advancing Practice ePortfolio (supported) Route, linked with subsequent guaranteed progression onto a reimbursable advanced practitioner nurse role on completion of the ePortfolio process.
