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GP contract changes: Context

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  • Decision has been made based on feedback to solve an immediate issue
  • Issue: GP unemployment amongst recently qualified GPs
  • £82m additional funding nationally for 2024/25
  • Intended to relieve the pressure on employment for this expanded cohort of GP staff
  • In addition to the anticipated recruitment of recently qualified GPs we would expect to take place – and funded through the practice contract in the normal way.
  • Emergency measure and NHS England will work with the Government on longer term solutions to GP unemployment

Following the letter issued to general practice by the Secretary of State on 1 August, Dr Amanda Doyle and Dr Claire Fuller have provided additional information on how the funding and contract changes announced will be implemented:

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NHS England » GP contract changes: government response to Doctors and Dentists Remuneration (DDRB) and the Additional Roles Reimbursement Scheme (ARRS)

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GP ARRS Role: Funding and Reimbursement

How much is the funding for newly qualified GPs?

  • Each PCNs funding for 1 October 2024 to 31 March 2025 equates to £1.303 x weighted average population at Jan 2024. (DES 10.5.4)

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What is the reimbursable salary for a newly qualified GP?

  • £73,113 is listed as the minimum starting salary point for a GP by NHS Employers (including 6% uplift) from 1 April 2024 in the Pay and Conditions Circular published 27 September 2024. The ARRS offer of £92,462 matches that including employer on-costs for NI and pension. (DES Section 10, Table 3c)

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Is the GP funding combined with the existing ARRS Funding? Can the funding for GPs be used for other ARRS roles?

  • The ARRS GP Sum funding will be held separately to the ARRS sum funding for all other roles.
  • Funding is in a separate pot to the rest of the ARRS funds and the additional £82million has gone into national reserves to ensure ringfencing.
  • It will appear as a separate line on the ledger.
  • This funding can only be used for newly qualified GP roles and cannot be supplemented by the existing ARRS funding.

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Can any unclaimed funding be accrued into 2025/26?

  • Unclaimed ARRS GP Sum funding cannot be accrued into 2025/26 so must be utilised by 31 March 2025.

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Is this funding only available in the 2024/25 financial year?

  • Wes Streeting (SoS) has publicly stated that the funding will continue beyond March 2025 - this has not been formally announced yet in policy.

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When will the funding be released to systems?

  • Details to be confirmed shortly by the national team.

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If a PCN underspends their allocation, will this be reallocated to over-spending PCNs?

  • No. All PCNs are capped at 100% with no opportunity for the redistribution or reapportionment of funding.

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GP ARRS Role: Criteria for reimbursement

When can I claim for a newly qualified GP from?

  • The ARRS GP Sum funding can be used within the financial year 24/25 from 1st October 2024 (DES 7.2.6a)
  • The GP must be employed after 1 October 2024

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How is it determined if a GP is ‘newly-qualified’?

  • The cut off is 2 years post CCT (DES 7.3.10 / B19.3) on the start of employment or engagement.
  • The PCN must ensure that the General Medical Practitioner is not beyond the second anniversary of their certificate of completion of training, issued by the General Medical Council, at the start of their employment or engagement.
  • Feedback about newly CCTd GPs being unable to find work is one of the drivers for this addition to the ARRS criteria.

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Can newly qualified GPs already employed by a practice be claimed?

  • The GP cannot have been or be already in substantive employment as a GP within General Practice (in the same practice or another practice) prior to 1 October 2024 for a PCN to claim for them under the ARRS scheme. (DES 7.3.10)
  • There is some flexibility on previous employment – if a GP is with a practice/PCN for a short specific length of time, they can be eligible for the ARRS post. For example, if a practice employed a newly qualified GP for 5 months to cover sick leave in August 2024, they could start to claim for that person under ARRS from 01 October 2024. Where decisions on eligibility may PCNs should seek prior approval with their ICB.

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If a GP is within 2 years of CCT, but is employed as a partner as part of a new recruitment - is this allowed?

  • Yes. There is no reference in the DES to this being restricted to salaried GPs.

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Are there any other criteria for ensuring eligibility for reimbursement?

  • The GP must be on the performers list (DES B19.2) & must be registered with GMC (DES B19.2) & must not be suspended or have any restrictions (DES B19.1)

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Is there a cap to the FTE or headcount of newly qualified GPs that can be claimed for?

  • There is no FTE limit, but there is a funding limit for reimbursement.
  • There is no headcount limit (i.e. as many people as the PCN wishes can be recruited), but claims for all headcounts combined must remain within the total funding cap for the PCN.

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GP ARRS Role: Criteria for reimbursement

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How many sessions is classed as full time?

  • Full time is listed in the documentation as 37.5 hours (10.5.7). How ever a practice manages this in terms of sessions is at their discretion.

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Is there a minimum term that a GP role needs to be recruited for?

  • The contract can be for less than 6 months, unlike other ARRS roles, in recognition of the October start (DES 7.4.1).
  • The DES states that GPs cannot be claimed if they are to be employed in a temporary capacity i.e. locums and they must be substantively employed. Whilst no specific minimum term requirement, it should meet these criteria.

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What terms should be used when recruiting the newly qualified GP?

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Our PCN has 4 practices, could we split the funding (equating to 8 sessions) so that each practice could recruit a GP on 2 sessions each?

  • Yes if the reimbursable rate and PCN allocation are not exceeded. All other criteria (eg within 2 years post CCT) still apply.

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How should the PCN claim for a newly qualified GP?

  • PCNs claim for the GP role(s) via the ARRS Claims Portal and continue to be paid monthly, one month in arrears. (See screen shot to right). PCNs will be asked to submit the GPs GMC number and CCT date as part of the claim.

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Further FAQs

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Question

Answer

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For a full-time GP reimbursed under the ARRS:GP Scheme, should all 9 sessions be service delivery?

PCNs must ensure that the GP is employed or engaged on terms and conditions which are no less favourable Model terms and conditions – paragraph 50 sets out that ‘…at least four hours per week on an annualised basis shall be protected for activities related to professional development…’

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Does ‘substantively employed as a General Medical Practitioner in general practice previously’ refer to a particular PCN or ICB boundary?

No – this applies to any previous employment as a GP in any practice.

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Is there a requirement for the individual to carry out ‘PCN’ related work given the individual is newly qualified and will have to embed within Practice

A PCN can claim reimbursement by a GP ‘for the delivery of health services’ in line with other roles.

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What does temporary capacity mean in practice? How do you determine this?

The characteristics employment or engagement should be considered based on individual circumstance – including being engaged through a locum agency or working under the Agency Workers Regulations would be an indicator of the arrangement being temporary.

To be considered not of a temporary nature, employment or engagement should be centred around a named individual, providing regular hours, ensuring they can consistently support and complement the existing workforce and be able to meet the defined role requirements.

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Does the ARRS:GP Sum need to be pro-rata?

The Additional Roles Reimbursement GP Sum (£1.303 X PCN Contractor Weighted Population on 1 January 2024) is the sum available from 1 October 2024 - 31 March 2025. No pro-rata is required.

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The ready reckoner referenced in the guidance does not appear to show the new GP ARRS budget.  Has the tool been adjusted to include this amount with the total ARRS allocation?

It is still anticipated that the primary care network (PCN) income ready reckoner will be updated with the 1 October 2024 contract changes.

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Scenarios

Dr A completed GP Training in August 2023. Since then, she has been undertaking locum work.

Eligible for ARRS GP Reimbursement?

Yes, if employed or engaged before August 2025

Dr B completed GP Training in August 2024 and immediately started a salaried position. This was offered in anticipation of the ARRS GP scheme.

No, unless the commissioner provides agreement on an exceptional basis

Dr C completed GP Training in August 2022 and has never held a substantive position.

No, beyond 2nd anniversary of CCT at the start of employment / engagement.

Dr D completed GP Training in February 2024 and was working under a fixed term to cover a maternity leave.

Yes, if employed or engaged before February 2026

Dr E completed GP Training in August 2024 and has been engaged by a locum agency and offered on a 6-month contract for the PCN to engage her for the ARRS scheme

Dependent on specifics – no, if the nature / characteristics are for temporary capacity including being subject to Agency Workers Regulations and engaged as a service.

Updated 14/10/2024

Note: Each scenario assumes all not mentioned criteria are met

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Scenarios

Dr F – completed GP Training in August 2023 and entered Public Health Training. During this time Dr F has provided a locum session at the same GP Practice.

Eligible for ARRS GP Reimbursement?

Yes, if employed or engaged before August 2025.

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Dr G completed GP Training in August 2023 and has been substantively employed in a Trust Grade role in A&E

Yes, if employed or engaged before August 2025.

Drs Ha & He completed GP Training in August 2024; a PCN wishes to substantively employ both for 0.2 FTE.

Yes, if employed or engaged before August 2026. Multiple GPs are permitted.

Dr J completed GP Training in August 2023 and has worked substantively in a different practice to the prospective PCNs member practices

Dr K completed GP Training in August 2024 and has been engaged by a federation and offered on a 6-month contract to the PCN for the ARRS scheme

Dependent on specifics – yes, if not intended to be for a temporary basis and engagement is for the individual

Updated 14/10/2024

Note: Each scenario assumes all not mentioned criteria are met

No, the GP has been substantively employed as a GP in general practice previously

Dr I completed GP Training in August 2023 and has worked substantively as a 0.4 FTE GP. Can the PCN claim for additional sessions to increase Dr I to 0.8 FTE.

No, the GP has been substantively employed as a GP in general practice previously

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