Change for general practice nurses may address pay inequity
GPNs to be included in Additional Roles Reimbursement Scheme, which it is hoped will mean better pay and conditions and boost recruitment in the sector
General practice nurses (GPNs) will be included in the Additional Roles Reimbursement Scheme (ARRS), the government has announced.
The Department of Health and Social Care said GPNs in England will be added to the scheme in next year’s GP contract. The ARRS allows primary care networks (PCNs) to claim reimbursement for the salaries of 17 roles, including nursing associates and advance nurse practitioners, as part of the GP contract funded by the government.
GPNs are not currently included in the scheme, which was introduced in England in 2019 to attract more staff to general practice.
Concerns about pay inequity
GP practices are not part of Agenda for Change (AfC) and do not follow the same pay structure as secondary care colleagues, or ARRS staff who are on AfC equivalent terms and conditions. Concerns have been raised about pay inequity and conditions for GPNs, who have reported having to take on the training and supervision of ARRS staff despite often being paid less but being more qualified.
QNI chief executive Crystal Oldman previously said GPNs reported feeling undervalued and ‘airbrushed out of the picture’ as a result. It is hoped adding GPNs to ARRS will mean their pay and conditions will be aligned with that of ARRS colleagues.
Union wants more detail on pay and conditions
The RCN welcomed the announcement but urged the government to fund the scheme adequately to ensure GPNs’ pay is in line with NHS pay terms and conditions.
RCN director for England Patricia Marquis said: ‘We hope ministers are at last getting the message that filling the significant GPN vacancies through the ARRS brings essential nursing skills and capacity that cannot be replicated by current ARRS roles.
‘There have been longstanding challenges recruiting practice nurses and while we welcome the introduction of GPNs into ARRS, we are keen to see the detail and understand how this will work in practice.
‘We would expect this will help to start to align the pay terms and conditions of all nursing staff employed by general practice to ensure fair and equitable pay, and look forward to seeing nursing pay ringfenced and equal to NHS pay terms and conditions as a minimum.’
ARRS roles have brought challenges in general practice
Research for the Queen’s Nursing Institute highlighted the multiple challenges posed by the introduction of ARRS roles, including GPNs having to train ARRS staff despite being paid less in many cases. Inequitable pay and conditions were highlighted, with ARRS colleagues said to be on higher AfC banded salaries and having more access to professional development.
It also found work done by GPNs before ARRS roles were brought in was being passed on to ARRS staff who were unable to complete it because of a lack of knowledge or skill, the work being out of their scope of practice, unfamiliarity with primary care or regulatory issues.
GPNs were then having to perform ‘rescue work’ by completing the work or training ARRS staff to do it, and expected to support, educate and supervise these roles without extra resources or consultation, the report stated.
Introduction of ARRS roles ‘reinforces the message that nursing isn’t a valued profession’
A nurse quoted in the report said: ‘ARRS roles are paid more than GPNs and have less qualifications, little to no experience, and require support from GPNs earning much less. It reinforces the message that nursing isn’t a valued profession.’
Nurses also called for nursing associates and other similar roles to have a ‘regulated definition’ of scope of practice.
‘Experienced GPNs are feeling pushed out’
One GPN said: ‘ARRS seems to be a “sticking plaster” over the issues that are currently being seen in general practice. Experienced GPNs are feeling pushed out and are underrepresented in the implementation of these roles.
‘Drivers seem to be reduced workforce cost for management and lack of understanding of their own role. Black and white guidelines for general practice for the nursing associate role specifically need to be developed to assist with this.’
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