Additional Roles Reimbursement Scheme

To support PCNs, the Additional Roles Reimbursement Scheme (ARRS) provides funding for 26,000 additional roles to create bespoke multi-disciplinary teams. Primary care networks assess the needs of their local population and, working with local community services, make support available to people where it is most needed.

While the ARRS provides some exciting opportunities it also presents challenges around provision of induction, supervision, integration and ongoing professional development. Training Hubs can provide support and information about local networks and leads, and if we don’t know the answer we can often help connect you to people who do so please do get in touch.

Find out more on each of the ARRS roles via the links below:

For those working in primary care networks and CCGs, recruitment support and guidance for ARRS roles is available from your local Training hubs and additional resources are  available on FutureNHS

Do you have clinical staff that may be eligible to become advanced practitioners?

The additional role reimbursement scheme (ARRS) currently allows PCNs to appoint to one advanced practitioner. If you have yet to appoint an advanced practitioner but would like to support a member of staff to become eligible to practice as an advanced practitioner, please signpost them to the Supported ePortfolio Route. All advanced practitioners claiming ARRS funding should be on the advanced practice register with the centre for advancing practice.

The online application form will be available via the Advanced Practice website from Monday 13 December 2021 and will remain open until late January 2022. An opportunity to apply for the advanced practice course route will become available in March 2022. Details will follow.

Further information:

The Centre for Advancing Practice Supported ePortfolio Route is designed to enable Practitioners to evidence that they meet the advance practitioner requirements described in the Multi-professional framework for advanced clinical practice in England (MPF).

Currently, individual’s would normally evidence this by successfully completing a Centre accredited Advanced Practice Programme. The Supported ePortfolio Route will provide an alternative route, by mapping knowledge and skills to the MPF using the Centre’s ePortfolio.

Please see below list of ARRS roles and click on each one to find out more:

Clinical pharmacists work in primary care as part of a multidisciplinary team in a patient facing role to clinically assess and treat patients using expert knowledge of medicines for specific disease areas. They work with and alongside the general practice team, taking responsibility for patients with chronic diseases and undertaking clinical medication reviews to proactively manage people with complex medication use, especially for the elderly, people in care homes and those with multiple conditions.

Find out more about Clinical Pharmacist – Primary Care Careers

Pharmacy technicians play an important role within general practice and complement the more clinical work of clinical pharmacists, through utilisation of their technical skillset. Working within primary care settings allows the pharmacy technician to apply their acquired pharmaceutical knowledge in tasks such as audits, discharge management, prescription issuing, and where appropriate, informing patients and other members of the primary care network (PCN) workforce. Work is often under the direction of clinical pharmacists as part of the PCN pharmacy team.

Find out more about Pharmacy Technician – Primary Care Careers (

First Contact Physiotherapists (FCP) are qualified independent clinical practitioners who can assess, diagnose, treat, and manage musculoskeletal (MSK) problems and undifferentiated conditions and, where appropriate, discharge a person without a medical referral. FCPs working in this role can be accessed directly by patients, or staff in GP practices can refer patients to them to establish a rapid and accurate diagnosis and management plan to streamline pathways of care.

Find out more about First Contact Physiotherapists – Primary Care Careers (

Dietitians are healthcare professionals that diagnose and treat diet and nutritional problems, both at an individual patient and wider public health level. Working in a variety of settings, including primary care, with patients of all ages, dietitians support changes to food intake to address diabetes, food allergies, coeliac disease, and metabolic diseases. Dietitians also translate public health and scientific research on food, health, and disease into practical guidance to enable people to make appropriate lifestyle and food choices.

To find out more about the role of a dietitian in primary care, visit the Health Education England website.

Podiatrists are healthcare professionals that have been trained to diagnose and treat foot and lower limb conditions. Podiatrists provide assessment, evaluation, and foot care for a wide range of patients, which range from low risk to long-term acute conditions. Many patients fall into high risk categories such as those with diabetes, rheumatism, cerebral palsy, peripheral arterial disease, and peripheral nerve damage.

Occupational therapists (OTs) support people of all ages with problems resulting from physical, mental, social, or development difficulties. OTs provide interventions that help people find ways to continue with everyday activities that are important to them. This could involve learning new ways to do things or making changes to their environment to make things easier. As patients’ needs are so varied, OTs help GPs to support patients who are frail, with complex needs, live with chronic physical or mental health conditions, manage anxiety or depression, require advice to return or remain in work and need rehabilitation so they can continue with daily activities.

A paramedic in primary care can recognise and manage the deteriorating patient and can manage patients with long term conditions, minor injuries, and minor illness. They can also support patients who require wound care, have fallen, have MSK problems, and have urinary tract or respiratory infections. Paramedics can supply a range of medicines through PGDs, including antibiotics and analgesics.

Paramedics can support PCNs in responding to on the day demand by offering Hear and Treat telephone triage or undertaking home visiting. They can also support PCNs to improve access to care by seeing minor ailments and injuries in surgery. Paramedics can support PCNs with the delivery of Enhanced Health in Care Homes and overall their intervention should reduce the need for admission to hospital.

The nursing associate is a new support role in England that bridges the gap between healthcare support workers and registered nurses to deliver hands-on, person-centred care. Nursing associates work with people of all ages in a variety of settings in health and social care, including general practice.

The ARRS expanded in October 2020 to include both nursing associates and trainee nursing associates. Over 2020/21, 5,000 FTE nursing associates will be trained and available to work across the wider system, with a further 7,500 being trained each following year. Figures show that of those qualified, there are already 100 FTE nursing associates working in primary care.

Social Prescribing Link Workers give people time and focus on what matters to the person as identified in their care and support plan. They connect people to community groups and agencies for practical and emotional support and offer a holistic approach to health and wellbeing, hence the name ‘social prescribing’.

Social prescribing enables patients referred by general practice, pharmacies, multi-disciplinary teams, hospital discharge teams, allied health professionals, fire service, police, job centres, social care services, housing associations and voluntary, community and social enterprise (VCSE) organisations get the right care for them.

Link workers typically work with people over 6-12 contacts (including phone calls and face to face meetings) over a three-month period with a typical caseload of up to 250 people, depending on the complexity of people’s needs.

More information about social prescribing can be found in the personalised care section of our website.

Care coordinators provide extra time, capacity, and expertise to support patients in preparing for clinical conversations or in following up discussions with primary care professionals. They work closely with the GPs and other primary care colleagues within the primary care network (PCN) to identify and manage a caseload of identified patients, making sure that appropriate support is made available to them and their carers (if appropriate), and ensuring that their changing needs are addressed. They focus on the delivery of personalised care to reflect local PCN priorities, health inequalities or at risk groups of patients. They can also support PCNs in the delivery of Enhanced Health in Care Homes.

More information coming soon…