• Br J Gen Pract · Nov 2024

    Additional Roles Reimbursement Scheme commissioning 2020-2023: associations with patient experience and QOF.

    • Chris Penfold, Jialan Hong, Peter J Edwards, Mavin Kashyap, Chris Salisbury, Ben Bennett, John Macleod, and Maria Theresa Redaniel.
    • National Institute for Health and Care Research Applied Research Collaboration (NIHR ARC) West, University Hospitals Bristol and Weston NHS Foundation Trust; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol.
    • Br J Gen Pract. 2024 Nov 25.

    BackgroundThe Additional Roles Reimbursement Scheme (ARRS) was introduced by NHS England in 2019 alongside primary care networks (PCNs), with the aims of increasing the workforce and improving patient outcomes.AimTo describe the uptake of direct patient care (DPC)-ARRS roles and its impact on patients' experiences.Design And SettingAn ecological study using 2020-2023 PCN and practice workforce data, registered patient characteristics, the General Practice Patient Survey, and the Quality and Outcomes Framework (QOF).MethodDescriptive statistics with associations were examined using quantile and linear regression.ResultsBy March 2023, 17 588 full-time equivalent (FTE) DPC-ARRS roles were commissioned by 1223 PCNs. PCNs with fewer constituent practices had more DPC-ARRS roles per population (P<0.001), as did PCNs with more FTE GPs per population (P = 0.005). DPC-ARRS commissioning did not vary with age, sex, or deprivation characteristics of practice populations. DPC-ARRS roles were associated with small increases in patient satisfaction (0.8 percentage points increase in patients satisfied per one DPC-ARRS FTE) and perceptions of access (0.7 percentage points increase in patients reporting 'good' experience of making an appointment per one DPC-ARRS FTE), but not with overall QOF achievement.ConclusionThe commissioning of DPC-ARRS roles was associated with small increases in patient satisfaction and perceptions of access, but not with QOF achievement. DPC-ARRS roles were employed in areas with more GPs rather than compensating for a shortage of doctors. Single-practice PCNs commissioned more roles per registered population, which may be advantageous to single-practice PCNs. Further evaluation of the scheme is warranted.© The Authors.

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