Additional Roles Reimbursement Scheme uptake, patient satisfaction, and QOF achievement: an ecological study from 2020-2023

Chris Penfold*, Jialan Hong, Peter Jonathan Edwards, Mavin Kashyap, Chris Salisbury, Ben Bennett, John MacLeod, Theresa Redaniel

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

2 Citations (Scopus)

Abstract

Background:
The 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.

Aim:
To describe the uptake of direct patient care (DPC)-ARRS roles and its impact on patients’ experiences.

Design and setting:
An 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).

Method:
Descriptive statistics with associations were examined using quantile and linear regression.

Results:
By 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.

Conclusion:
The 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.
Original languageEnglish
Pages (from-to)e35-e42
Number of pages8
JournalBritish Journal of General Practice
Volume75
Issue number750
Early online date27 Jun 2024
DOIs
Publication statusPublished - 26 Dec 2024

Bibliographical note

Publisher Copyright:
© The Authors.

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