The role of ARRS in the NHS 10 Year Plan

With the launch of the 10-Year Plan: Fit for the Future (‘the Plan’), there’s a renewed emphasis on community-based and preventative care. Although the Plan does not name the Additional Roles Reimbursement Scheme (‘ARRS’) explicitly, ARRS staff are central to its success and play a vital role in reshaping the delivery of Primary Care.

With this in mind, what should employers and PCNs be thinking about, as the new Plan unfolds?

Q: How does the ARRS align with the new NHS strategy?

A: The ARRS is a cornerstone of the NHS’s strategy to reshape Primary Care by providing targeted funding to PCNs, to recruit a wide range of clinical and non-clinical professionals. The aim is to improve patient access, reduce pressure on GPs, and promote preventative and community-based care.

These objectives align closely with the 10-Year Plan, which seeks to consolidate care within local communities, and reduce reliance on hospital services. ARRS staff are key to maximising health improvement opportunities during patient contact interactions. A prime example is the launch of the UK’s first 24/7 Neighbourhood Mental Health Centre in East London. This initiative demonstrates the kind of integrated, multidisciplinary approach that ARRS roles are designed to support.

Q: What impact will the NHS 10-Year Plan have on ARRS roles?

A: The Plan reinforces the importance of community care and preventative strategies, where ARRS staff are already making an impact. With the development of Neighbourhood Health Centres, ARRS roles will become more embedded in local care models. These roles bring diverse expertise and allow PCNs to tailor services to meet the specific needs of their populations, making healthcare more accessible and responsive.

The Plan’s emphasis on reducing administrative burden and freeing up staff time will likely benefit ARRS roles. For instance, innovations like robotic automation for dispensing medication at Junction Pharmacy allows Pharmacists to focus on patient-facing care and deliver additional services by reducing manual, administrative workload.

Q: How will the funding of ARRS roles be affected?

A: ARRS roles are reimbursed through dedicated funding, which enables PCNs to strengthen their clinical teams and meet patient needs more effectively. Under the 10-Year Plan, there is a strategic shift in funding away from hospital-centric care, and towards community-based services.

The 2025/26 ARRS budget includes a substantial £889 million increase, giving PCNs greater flexibility to recruit based on local demand. Funding is now allocated based on population needs and size, ensuring that urban areas can improve access, rural communities can enhance preventative care, and regions can build more efficient, multidisciplinary teams.

This funding is currently delivered through Direct Enhanced Service (‘DES’), but there is significant uncertainty around how ARRS roles will be funded in the future, with the Single Neighbourhood Provider (‘SNP’) contract expected to replace the DES. This would be more locally controlled, focusing on ‘Neighbourhoods’ rather than PCNs. This change could impact how ARRS roles are hosted and funded, especially for externally hosted roles where hosting agreements may need to be reviewed.

Q: What challenges might ARRS staff face?

A: One emerging challenge is the fragmented nature of ARRS employment. Staff may be employed by GP Practices, Federations, or third-party providers, which can lead to inconsistencies in employment rights, benefits, and access to NHS terms and conditions. As ARRS roles become more embedded in Neighbourhood Health Centres, lines of accountability may blur.

There are practical concerns with the risk of funding changes and/or role restructuring. As ARRS staff often work across multiple practices, dividing funding and/or employment responsibilities could lead to the risk of a redundancy situation.

Additionally, the new NHS Workforce Standards coming in April 2026 will still need complying with, even if ARRS staff are not directly employed by NHS Trusts, and are more community based.

Q: What can PCNs do to prepare?

A: The question of where ARRS funding will come from remains largely unanswered and so it is a watch and wait scenario. Nevertheless, PCNs must still proactively prepare for these potential changes. Given this lack of clarity, it is important that PCNs understand where and how their ARRS staff are employed. If ARRS staff are outsourced, it is important to know where liability is held and what the potential termination rights and risks are. By conducting a strategic review of external agreements and seeking legal advice, PCNs can ensure that they are system-ready ready for this transition, as and when it occurs.