The Additional Roles Reimbursement Scheme (ARRS) is one of the most significant workforce initiatives in NHS primary care history. Introduced in 2019 as part of the GP Contract, ARRS funds a wide range of clinical and non-clinical roles within Primary Care Networks — expanding the capacity of GP practices without requiring practices to fund those salaries directly. Understanding how ARRS works, which roles qualify, and how to claim reimbursement efficiently is essential for any PCN Clinical Director or Practice Manager responsible for workforce planning.
What Is the ARRS Scheme?
ARRS provides ring-fenced funding to PCNs to employ additional clinical and support staff, with the intention of relieving pressure on GPs and extending the range of services available to patients. Reimbursement is provided via NHS England through Integrated Care Boards (ICBs), and is managed at PCN level through the Network Contract Directed Enhanced Service (DES).
Each PCN receives an allocation based on its registered list size, calculated using a weighted formula that accounts for deprivation, age profile, and other population health factors. This allocation is updated annually and, critically, unused allocation cannot typically be carried forward — meaning PCNs that fail to recruit promptly risk losing funding they are entitled to.
ARRS-Eligible Roles in 2025
As of 2025, the following roles qualify for ARRS reimbursement. This list has expanded significantly since the scheme launched in 2019, most notably with the addition of qualified GPs and practice nurses under certain qualifying criteria from 2024 onwards:
ARRS does not cover roles already employed by the practice prior to the scheme, nor does it cover GP partners or existing salaried GPs unless they meet the new qualifying criteria introduced in 2024. Always confirm eligibility with your ICB before recruiting — misclassification can result in reimbursement clawback.
How Is ARRS Funding Calculated?
Each PCN's ARRS allocation is determined by its total weighted list size multiplied by a per-patient funding rate set nationally by NHS England. In 2025/26, the indicative per-patient rate is approximately £225 per registered patient, meaning a PCN with 50,000 patients may have an ARRS envelope of around £1.125 million annually.
This allocation funds the full employment costs of ARRS staff — salary, employer National Insurance, employer pension contributions, and in some cases training costs. PCNs do not carry the financial risk of these roles directly; they employ the staff and claim full reimbursement through their ICB on a monthly or quarterly basis.
A single full-time clinical pharmacist typically costs £50,000–£65,000 in salary, plus employment costs. Under ARRS, the full amount is reimbursed. NHS England analysis suggests a clinical pharmacist can release approximately 1,500 GP appointments per year through structured medication reviews and prescribing support alone — making this one of the highest-return investments available to PCNs at zero net cost.
How to Claim ARRS Reimbursement
The claims process varies slightly by ICB, but the general pathway is as follows:
Avoiding ARRS Underspend
ARRS underspend is a persistent problem across England — in most financial years, a meaningful proportion of PCNs fail to utilise their full allocation, often losing funding that cannot be recovered. The primary drivers are slow recruitment, late starts, and insufficient supervision capacity to onboard new staff.
To avoid underspend:
- Start recruiting in Q1 — not Q3 or Q4 when the year is already half gone
- Use interim locum cover to utilise your allocation while permanent recruitment completes
- Maintain a candidate pipeline through relationships with specialist agencies who can move quickly
- Plan supervision capacity in advance so new starters can be onboarded without delay
- Track your allocation vs spend monthly — many PCNs only discover underspend at year-end when it is too late to act
Common ARRS Pitfalls and How to Avoid Them
Recruiting without a clear clinical role — ARRS staff who join without a defined caseload, supervision plan, and integration into the clinical team are routinely underutilised. Define the role in detail before you recruit, not after.
Inadequate supervision — every ARRS role requires appropriate clinical supervision, which takes GP and senior clinical time. Failing to plan for this is one of the most common reasons ARRS roles underperform and create clinical risk. Supervisors must be identified and agreed before the start date.
Poor retention — high turnover in ARRS roles is expensive in recruitment costs and in the loss of trained, experienced clinicians. Invest in induction, professional development, and regular career conversations. ARRS covers employment costs but PCNs can supplement salaries to remain competitive.
Need Help Filling ARRS Roles in Your PCN?
SHR Group specialises in ARRS recruitment across all eligible role types — ANPs, ACPs, Clinical Pharmacists, Paramedic Practitioners, and more. We advise on clinical mix strategy and place pre-verified candidates quickly.