Primary Care Workforce Quarterly Update, 30 September 2022, Experimental Statistics

The sources listed below provide an overview of the different data sources used in the production of this publication

• • PCN workforce taken from NWRS quarterly
  • General Practice workforce taken from NWRS (month to align with final month of PCN NWRS quarter)
  • General Practice workforce taken from NWRS (Q4 2018/19) to calculate baseline for the collated figures analysis
  • Approved ARRS Claims data (most recent month data to align with PCN NWRS quarter)
  • Latest ePCN ODS reference data
  • Role reference table
  • Geographic lookup (PCN>Sub-ICB Location>ICB>region) 

We plan to expand and include further data sources which would add to our understanding of GPs providing primary care services in other settings as sources become available and mature.

Data from the PCN and General Practice NWRS extracts are used to create a combined NWRS figure for the following staff groups:

• • DPC
  • Nurses
  • Administrative staff
  • GPs

In addition, for the DPC staff group, ARRS claims data are used to produce a collated figure. NWRS contains data on a wider range of job roles than the ARRS scheme data making comparisons only available for roles with the scheme. However, the collated figures tables contain data for all DPC roles. For any DPC roles falling outside of ARRS the FTE values will be taken directly from NWRS.

Background

PCNs submit claims for ARRS staff using an online portal, which Integrated Care Boards (ICBs) are responsible for approving based on guidance set out in the Network Contract Directed Enhanced Service (PCN DES) https://www.england.nhs.uk/gp/investment/gp-contract/network-contract-directed-enhanced-service-des/

A PCN is entitled to funding as part of the Network Contract DES to support the recruitment of new additional staff to deliver health services. The new additional staff recruited by a PCN or provided under contract as a service from a third-party organisation are referred to in this Network Contract DES Specification as “Additional Roles” and this element of the Network Contract DES is referred to as the “Additional Roles Reimbursement Scheme”. To receive the associated funding, a PCN must show that the staff delivering health services for whom funding is requested, comply with the principle of “additionality”. Additionality is measured on a baseline of staff supporting a General Practice as taken at 31 March 2019 against six of the reimbursable staff roles – clinical pharmacists, social prescribing link workers, first contact physiotherapists, physician associates, pharmacy technicians and paramedics. A PCN baseline will not be established for other ARRS roles however, the additionality principles still apply.

There are some limitations on the numbers of staff in particular roles which PCNs can claim for – see the DES for further detail. ICBs take this into account when approving claims.

ARRS roles

The following job roles are covered under the ARRS scheme. Note there are other job roles within PCNs which are not covered by this scheme, Healthcare Assistants for example.

• Clinical Pharmacist
• Pharmacy Technician
• Social Prescribing Link Worker
• Health and Well-being Coach
• Care Co-ordinator
• Physician Associate
• First Contact Physiotherapist
• Dietician
• Podiatrist
• Occupational Therapist
• Nursing Associate
• Trainee Nursing Associate
• Paramedic
• Mental Health Practitioner (bands 5-8a)
• Advanced Practitioners (Clinical Pharmacists, Physiotherapists, Dietitians, Podiatrists, Occupational Therapists and Paramedics).
• Digital and transformation lead
• General practice assistant

Further detail on the ARRS claims data

PCNs submit claims via a portal administered by The North of England Commissioning Support Unit (NECS). The claims are then reviewed for approval by ICBs, and PCNs are then reimbursed for approved claims. The Network DES sets out expectations of the responsibilities of PCNs and ICBs in this process. NECS send monthly extracts of the claims data to NHS England and NHS Improvement Primary Care Workforce team. The data is currently sent in Excel format, but work is underway to set up an API to replace this.

There is currently no defined national schedule for the submission and approval of ARRS claims and it is acknowledged that some claims are made and approved retrospectively. For example, ARRS data for March may not be submitted until later months. As such, the figures presented cannot be considered to represent the entire picture of staff in post and should be considered an under-count.  Early-stage work, lead by NHS England and NHS Improvement, is underway to support and encourage timely submission and approval of ARRS claims.

ODS codes are incorrect or missing for approximately 7% of claims and so are not included in the analysis, therefore potentially leading to further undercount.

Baseline

ARRS claims can only be made for additional staff recruited since March 19. Therefore monitoring tends to consider changes net of the baseline.

General practice workforce data reported through the NWRS are used to establish that baseline.