Effect of Additional Roles Reimbursement Scheme roles on prescription patterns and patient satisfaction in England: a retrospective panel data analysis

Background In 2019, the Additional Roles Reimbursement Scheme (ARRS) was introduced in England as a crucial component of the government’s manifesto pledge to enhance access to general practice. The primary objective was to recruit 26 000 extra personnel through new roles into general practice.

Aim To analyse the effects of ARRS staff on prescription rates and patient satisfaction.

Design and setting A retrospective panel data analysis combining data from the General Workforce Minimum Dataset and NHS Digital datasets about primary care practices and their activity from 2018 to 2022. The study included data from >6000 general practices.

Method A linear regression analysis was conducted to determine the association between ARRS staff and prescription rates and patient satisfaction, controlling for patient and practice characteristics.

Results The results showed that ARRS roles tend to be more frequent in larger general practices, with fewer full-time GPs per patient, and with more overseas trained GPs. The use of ARRS staff was significantly associated with lower prescription rates (β = −0.52, P<0.001) and higher patient satisfaction (β = 3.2, P<0.001), after controlling for patient and practice characteristics.

Conclusion This study suggests that the ARRS has the potential to have a positive role in primary care, notably through reduced prescription rates and improved patient satisfaction. Further research is needed to explore the long-term effects of the ARRS on primary care, including patient outcomes and healthcare costs, and the potential barriers to its implementation.