Responses to our latest poll indicate that the Additional Roles Recruitment Scheme (ARRS) is proving a real pain for GPs.

ARRS funding looks to broaden healthcare staffing provision in primary care, with roles such as social prescribers and ‘first contact practitioner’ physios. But practices are being asked to recruit roles that some feel don't meet immediate needs, and to do this at one of their busiest times ever.

“The problem has been the restrictive nature of it,” said user @J_bagpuss “No roles suitable to deliver the care home DES this year. Roles we could really use like MH [mental health] staff not there.”

“We are mid-pandemic, 2nd wave, cases rising & being asked to do all the 'usual' while trying to recruit & train up new roles into a team,” said Dr Simon Hodes. “Something has to give.”

So investment in the workforce is welcome, it became clear why less than half of the money for additional roles had been spent last year, according to Pulse. And for some, there is a deadline on spending the money.

As GP partner Ben said: “That leaves us with the option of (a) not spending the money but being reminded for now and evermore we failed to spend it OR (b) spend it on a role that may be of value in years to come but will require huge support / training at a time when primary care has virtually no capacity.”

Pulse editor Jaime Kaffash wrote how this was ARRS about face; flexibility is needed to help deal with current needs. Dr Hodes subsequently came up with some excellent ideas on how to use the funding wisely, in his article for GPOnline on how the ARRS could be given a much-needed kick.

It may yet change. Contributors to the debate included NHS England’s Dr Nikita Kanani, who confirmed data was helping massively towards identifying workforce needs. “It helps for longer term planning nationally too (roles and geographical need).”

NHS England’s director of primary care improvement Robert Varnam also chipped in, referencing how some larger GP partnerships and federations were investing in managers to help mobilise the workforce.

With debate on the issue on the NHS England radar, the ARRS may yet adapt. Let us hope it can give GPs the flexibility they want and need to respond to the needs of their local populations.

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