%0 Journal Article
%T Additional Roles Reimbursement Scheme commissioning 2020-2023: associations with patient experience and QOF.
%A Penfold C
%A Hong J
%A Edwards PJ
%A Kashyap M
%A Salisbury C
%A Bennett B
%A MacLeod J
%A Redaniel T
%J Br J Gen Pract
%V 0
%N 0
%D 2024 Jun 27
%M 38936883
%F 6.302
%R 10.3399/BJGP.2024.0083
%X <B>BACKGROUND: </B>The Additional Roles Reimbursement Scheme (ARRS) was introduced by NHS England in 2020 alongside Primary Care Networks (PCNs) with aims of increasing the workforce and improving patient outcomes.<BR><B>OBJECTIVE: </B>Describe the uptake of direct-patient care (DPC)-ARRS roles and its impact on patients' experiences.<BR><B>METHODS: </B>Ecological study using 2020-2023 PCN and Practice workforce data, registered patient characteristics, the General Practice Patient Survey, and the Quality and Outcomes Framework (QOF).<BR><B>METHODS: </B>Descriptive statistics with associations examined using quantile and linear regression.<BR><B>RESULTS: </B>By March 2023, 17,714 FTE DPC-ARRS roles were commissioned by 1,223 PCNs. PCNs with fewer constituent practices had more DPC-ARRS roles per population (p<0.001) as did PCNs with more FTE GPs per population (p=0.012). DPC-ARRS commissioning did not vary with age, proportion female or deprivation of practice populations. DPC-ARRS roles were associated with small increases in patient satisfaction (0.8 percentage points increase in patients satisfied per one DPC-ARRS FTE) and perceptions of access (0.7 percentage points increase in patients reporting 'good' experience of making an appointment per one DPC-ARRS FTE), but not with overall QOF achievement.<BR><B>CONCLUSIONS: </B>The commissioning of DPC-ARRS roles was associated with small increases in patient satisfaction and perceptions of access, but not with QOF achievement. DPC-ARRS roles were employed in areas with more GPs rather than compensating for a shortage of doctors. Single practice PCNs commissioned more roles per registered population, which may be advantageous to single practice PCNs. Further evaluation of the scheme is warranted.