For PCN Clinical Directors and Practice Managers, ARRS funding has been transformational — but only for networks that approach it strategically. Too many PCNs continue to treat ARRS recruitment as a reactive, ad hoc exercise: identifying a gap, placing a job advert, and hoping for the best. The result is persistent underspend, high turnover, and ARRS staff who are underutilised or poorly integrated. This guide sets out a strategic approach to PCN workforce planning that maximises ARRS value and builds a genuinely sustainable clinical team.
Start with Patient Need, Not Job Titles
The most common mistake in ARRS workforce planning is starting with the available roles rather than with the clinical need of the patient population. The right question is not "which ARRS roles can we recruit for?" but "what are our highest-volume, highest-risk clinical demands, and which roles are best placed to address them?"
A PCN with a large elderly population in care homes has fundamentally different needs to a network in a young, urban area with high same-day access demand and a significant mental health caseload. Before any recruitment, analyse your patient data, GP appointment types, referral patterns, and QOF performance — and let that analysis drive your role decisions.
The Optimal Clinical Mix: A Framework
Most PCNs of 30,000–50,000 patients benefit from a diversified ARRS team across four core workforce areas:
A full-time clinical pharmacist releasing 1,500 GP appointments per year — at a GP consultation cost of approximately £45 — represents £67,500 of capacity released annually, at zero direct cost to the PCN under ARRS. Across a typical PCN ARRS allocation, a well-planned clinical mix can release the equivalent of 2–3 full GP sessions per week.
Recruitment Timelines: Plan for the Real World
ARRS underspend is consistently driven by one factor above all others: recruitment that starts too late. Most PCN Clinical Directors underestimate how long it takes to move from "we need an ANP" to "our ANP starts on Monday." Realistic timelines are:
Supervision: The Foundation Everything Rests On
Every ARRS role requires appropriate clinical supervision, and every PCN that has struggled with ARRS performance has, at its root, a supervision problem. Before recruiting any ARRS clinician, answer these questions unambiguously:
- Who will supervise this role? Name a specific clinician, not "a GP partner."
- How much time will supervision require per week? A new ANP in their first three months may need two to three hours of case review and mentoring per week.
- Is the supervisor clinically and contractually equipped to provide this supervision? Supervising an ACP with a paramedic background requires different skills to supervising a nurse practitioner.
- How will you compensate the supervisor for their time? Adding supervision to an already full GP workload without recognition or protected time is a direct route to burnout.
PCNs that recruit ARRS staff without a named supervisor, dedicated supervision time, and a structured induction plan consistently report the same outcomes: the clinician is underutilised, GP partners become resentful of the added complexity, and the role turns over within 12 months. Plan supervision before you recruit — not after the new starter arrives.
Retention: The Most Underinvested Priority
High turnover in ARRS roles is far more expensive than most PCNs account for. Direct recruitment costs, agency fees, the management time of a new hiring process, and the clinical disruption of an empty role typically add up to six to twelve months of the departing clinician's salary. Yet most PCNs invest heavily in recruitment and almost nothing in retention.
Working with a Specialist Agency
For many PCNs, the fastest route to solving immediate ARRS gaps — while longer-term permanent recruitment completes — is working with a specialist primary care recruitment agency. SHR Group maintains an active network of ARRS-eligible ANPs, ACPs, clinical pharmacists, and paramedic practitioners across England, and can often place pre-verified candidates significantly faster than a standalone job advertisement process.
Agencies can also advise on role eligibility, help you sense-check your role specifications against ARRS requirements, and provide interim locum ARRS cover that counts toward your allocation while permanent recruitment is underway.
Need Help Building Your ARRS Team?
SHR Group works with PCN Clinical Directors on strategic workforce planning — advising on clinical mix, ARRS funding windows, and sourcing pre-verified candidates from our active network across England.