Further detail unveiled about scope of ARRS ‘enhanced level’ nurses
NHS England has revealed further details about the role and responsibilities of enhanced level general practice nurses (GPNs), who have this month been added to the additional roles reimbursement scheme (ARRS).
According to the latest Network Contract Directed Enhanced Service (DES), published this week, enhanced level practice nurses will deliver “enhanced clinical care” within a multidisciplinary team, work with patients and families to devise complex care plans, and also provide supervision to trainee and qualified nurse colleagues.
It comes as it was announced last month that “enhanced nurses” would be the latest to be recruited to the ARRS, as part of new GP contract for 2024-25.
The ARRS is a scheme that entitles primary care networks to claim reimbursement for the salaries of certain roles, to support recruitment into multidisciplinary teams within general practice.
The scheme currently funds the salaries of 18 roles, including advanced nurse practitioners, nursing associates, physician associates, dieticians and occupational therapists.
This month, practice nurses working at an enhanced level were added to the ARRS.
Enhanced nurses are registered nurses that hold a level seven or above postgraduate certification or diploma in one or more specialist areas of care, such as wound care, dementia, women’s health or diabetes.
An enhanced nurse works at a level above GPN but below advanced practice nurses and nurse consultants, according to a capabilities framework by Skills for Health.
Examples of enhanced nurse roles cited in the framework included senior practice nurse, nurse practitioner, specialist nurse and nurse manager.
According to the GP contract, the role will “initially be capped” at one enhanced nurse per PCN, or two where the PCN patient list is 100,000 or more.
The Network Contract DES document confirmed that an enhanced nurse will be working at a band 7 level.
PCNs will be able to claim up to £60,401 for the role per year, which increases to £67,369 for outer London and £70,330 for inner London.
These figures cover the whole time equivalent (WTE) salaries of enhanced nurses, as well other costs, such as national insurance and pension.
The document also outlined some of the key responsibilities of enhanced level practice nurses.
Nurses recruited at this level will be expected to work within a multidisciplinary team and deliver “enhanced clinical care” in the context of challenging environments, different models of care delivery, innovation and rapidly evolving technologies.
Enhanced level nurses will work with their teams, patients and families to undertake assessments of patient needs and come up with complex care plans, as well as manage complex interventions.
Meanwhile, these nurses will be expected to evaluate clinical problems using their enhanced clinical knowledge, as well as using enhanced techniques, interventions and equipment to make clinical decisions.
The document also noted that enhanced nurses will be expected to provide supervision to other nurse colleagues, including trainee nursing associates, nursing associates and general practice nurses.
While many nurse leaders have welcomed the expansion of the ARRS in recent years, some have also raised concerns that it does not address the challenges that general practice nurses are facing at work.
The Royal College of Nursing was among those last month calling on PCNs to ensure that enhanced nurses are able to grow and develop within primary care services, rather than just fill workforce gaps.
