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Durham slashes PCNs’ ARRS top-up budget to meet targets

Durham slashes PCNs’ ARRS top-up budget to meet targets
By Jess Hacker
22 May 2023

Exclusive A group of GP networks is set to lose over half a million pounds worth of ARRS budget because the ICB can no longer afford to pay it, Healthcare Leader has learned.

North East and North Cumbria ICB’s County Durham Place is expecting to cut more than £525,000 from an annual top-up to County Durham PCNs’ Additional Roles Reimbursement Scheme budget.

Through the annual top-up – first agreed by the now defunct NHS County Durham CCG in November 2019 – PCNs in the area were typically granted a funding boost of 10.5% of the total ARRS budget allocation.

For 2023/24, this would see the 13 PCNs handed a share of £1.5m in addition to their £15m total allocation.

But a letter – penned by Sarah Burns, director of place for County Durham (17 May) and seen by sister title Pulse PCN – has now stated that the ICB, and therefore the County Durham Care Partnership Board, do not expect to be able to afford the top-up fee.

The Care Partnership Board has instead agreed to reduce its contribution year-on-year from 10.5% to 7% to 3.5% until it cancels the payment outright in 2025/26.

The cut will see PCNs lose £525,000 for the 2023/24 financial year.

The letter said: ‘Since the CCGs were abolished and transitioned into ICBs from July 2022, there is now an NHS England expectation that regional ICBs should reduce their overhead costs by 30% from 2024/25. It is not yet clear what the long-term impact of this could be in terms of Place budget allocations but there is an expectation that Place should begin to make budget savings from this financial year.

‘With year-on-year non-recurrent budget slippage now unlikely, NENC ICB is unlikely to be able to afford to continue to pay the PCN ARRS top-up contribution fee, or full contribution in its current presentation.’

When the top-up was first introduced in 2019 to address the associated costs incurred from hiring ARRS staff, it was valued at around £300,000.

It was initially planned to be reviewed in April 2020, but this was delayed by the pandemic.

The contribution was seen as an enabler to ‘exponential recruitment of ARRS roles’ with the understanding that it would encourage County Durham PCNs to recruit ARRS staff and therefore benefit the wider system.

However, a post-ICB transition review, intended to benchmark Durham’s ARRS hiring against other places (former CCGs) found ‘several NENC ICB Places employing more ARRS roles per weighted 1,000 population’., the letter said.

Also in her letter, Ms Burns said that the continued 10.5% top-up would impact their ability to invest in other areas of system integration, such as its local quality improvement incentive scheme, LIASE.

The new GP contract for 2023/24 has scrapped a number of Investment and Impact Fund (IIF) and Quality Outcomes Framework (QOF) indicators, with previously nationally incentivised targets likely needing to be addressed in these local schemes, the letter said.

Pulse PCN has contacted North East and North Cumbria ICB for comment.

The Government yesterday hailed PCNs for employing over 26,000 new staff under ARRS, realising its manifesto commitment.

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