Overview
The Additional Roles Reimbursement Scheme (ARRS) was introduced to support Primary Care Networks (PCNs) to expand their workforce and develop multidisciplinary teams that meet the needs of their local population. ARRS aims to improve access to general practice, increase capacity and support the delivery of new models of care.
Alongside clinical and personalised care roles, the 2026/27 Network Contract DES introduced additional flexibility for commissioner-agreed ARRS roles that support local service and workforce priorities.
These roles do not typically provide direct patient care but play an important role in supporting service delivery, workforce development, transformation and operational improvement across primary care.
‘From within the allocated Additional Roles Reimbursement Sum, the PCN may also recruit other direct patient care, non-nurse, and non-doctor Multi-Disciplinary Team (MDT) roles, if agreed with the commissioner’ (NHS England Network Contract DES 2026/27)
Scope of Practice
Role Responsibilities
Non-direct patient care roles may support a wide range of activities across Primary Care Networks and general practice, including:
- Service transformation and redesign
- Workforce planning and development
- Quality improvement initiatives
- Population health management programmes
- Project and programme management
- Data analysis and business intelligence
- Operational improvement and efficiency
- Education, training and workforce support
- Neighbourhood and integrated working initiatives
The responsibilities of individual roles will vary depending on local priorities, workforce requirements and commissioning arrangements.
Examples of Local Workforce Needs
Other Non-Direct Patient Care Roles may support Primary Care Networks to address local challenges such as:
- Workforce planning and retention
- Education and training coordination
- Quality improvement programmes
- Service redesign and transformation
- Population health management initiatives
- Data and intelligence projects
- Neighbourhood development and integration
- Access improvement programmes
- Operational efficiency projects
- Delivery of PCN strategic priorities
The specific role, title and responsibilities should be determined by local need and commissioner agreement.
Entry Requirements
Entry requirements will vary depending on the nature of the role and local service need.
Employers should ensure individuals possess the knowledge, skills and experience required to undertake the responsibilities of the post.
Depending on the role, this may include:
- Degree-level education or equivalent experience
- Project or programme management experience
- Workforce development expertise
- Leadership and change management skills
- Quality improvement experience
- Data analysis and reporting skills
- NHS or public sector experience
DES Requirements
When considering a role proposed by the PCN a commissioner may require that the PCN provides information to assure the commissioner that the role:
- is additional to those already working in the PCN’s practices;
- is demonstrably different to other roles available for reimbursement through the Additional Roles Reimbursement Scheme;
- has a clear scope of practice and appropriate training to support its delivery;
- fits with local care pathways/services and does not duplicate existing provision, save where the PCN can demonstrate a clear local need for the role; and
- is being reimbursed at a rate that is commensurate with its scope of practice
PCNs should focus on identifying the challenge they are seeking to address before determining the most appropriate role design.
Training and Development
Training and development requirements will vary according to the role, responsibilities and organisational priorities.
Individuals may benefit from development opportunities relating to:
- Leadership and management
- Quality improvement methodologies
- Project and programme management
- Population health management
- Workforce planning
- Organisational development
- Digital transformation
- Data analytics and business intelligence
A development plan should be agreed with the postholder and reviewed regularly.
Additional Training and Career Development
Individuals working in non-direct patient care roles may choose to undertake additional education and development opportunities to enhance their expertise and support career progression within primary care, integrated care systems and wider NHS organisations.
Supervision Requirements
Effective supervision is essential to support professional development, role effectiveness and high-quality service delivery.
Supervision may take a number of forms:
- Line management supervision – regular support to provide direction, oversight and performance management.
- Professional supervision – support from an experienced colleague or subject matter expert to develop knowledge and skills.
- Project or programme supervision – oversight and guidance relating to specific workstreams, projects or transformation programmes.
Individuals should have access to appropriate support, development opportunities and regular review processes to enable them to fulfil their role effectively.
Recruitment Information
Primary Care Networks (PCNs) employing or engaging staff through the Additional Roles Reimbursement Scheme (ARRS) should ensure the individual meets the current NHS England eligibility and role requirements for the role.
Before recruiting to an Other Non-Direct Patient Care Role, PCNs should ensure they can demonstrate the local need for the role, how it differs from existing reimbursable ARRS roles, and how it will support delivery of PCN priorities and patient services.
ARRS Funding
Where eligible, reimbursement for Other Non-Direct Patient Care Roles may be available through the Additional Roles Reimbursement Scheme (ARRS) in line with current NHS England guidance and commissioner approval processes.
Please note that ARRS eligibility criteria, reimbursement arrangements and role requirements may change. Employers should always refer to the latest NHS England guidance.
Resources
The resources within this section are intended to support the recruitment, onboarding and development of non-direct patient care roles within primary care and PCN teams.