Additional Roles Reimbursement Scheme uptake, patient satisfaction, and QOF achievement: an ecological study from...

Area of Science:

• Primary Care Workforce Development
• Healthcare Policy and Management
• Patient Experience Research

Background:

• The Additional Roles Reimbursement Scheme (ARRS) was launched by NHS England in 2019 to expand the primary care workforce.
• The scheme aimed to improve workforce capacity and enhance patient outcomes within primary care networks (PCNs).

Purpose of the Study:

• To evaluate the adoption rate of direct patient care (DPC)-ARRS roles within PCNs.
• To assess the impact of DPC-ARRS roles on patients' overall experience and satisfaction.

Main Methods:

• Ecological study design utilizing data from 2020-2023.
• Involved analysis of PCN and practice workforce data, patient demographics, the General Practice Patient Survey, and Quality and Outcomes Framework (QOF) data.
• Employed descriptive statistics, quantile regression, and linear regression to examine associations.

Main Results:

• By March 2023, 17,588 full-time equivalent (FTE) DPC-ARRS roles were commissioned across 1223 PCNs.
• PCNs with fewer practices and higher GP FTE per population commissioned more DPC-ARRS roles.
• DPC-ARRS roles correlated with a small increase in patient satisfaction (0.8 percentage points per FTE) and appointment access perceptions (0.7 percentage points per FTE), but not QOF achievement.

Conclusions:

• DPC-ARRS role commissioning showed a positive association with patient satisfaction and perceived access, but not with QOF performance.
• The study indicated that DPC-ARRS roles were more prevalent in areas with higher GP numbers, rather than solely addressing GP shortages.
• Single-practice PCNs demonstrated higher DPC-ARRS role commissioning per capita, suggesting potential benefits for these structures. Further evaluation is recommended.