The Effects of the Additional Roles Reimbursement Scheme (ARRS) staff in England on Prescription Patterns and Patient Satisfaction

Abstract

Background: In 2019, the Additional Roles Reimbursement Scheme (ARRS) was introduced in England as a crucial component of the government’s manifesto pledge to enhance access to general practice. The primary objective was to recruit 26,000 extra personnel through new roles into general practice. Aim: This study aimed to analyse the effects of ARRS staff on prescription rates and patient satisfaction. Design and Setting: The study was a retrospective panel data analysis combining data from the General Workforce Minimum Dataset and National Health Service (NHS) Digital datasets about primary care practices and their activity from 2018 until 2022. The study included data from more than 6000 general practices. Methods: A linear regression analysis was conducted to determine the association between ARRS staff and prescription rates and patient satisfaction, controlling for patient and practice characteristics. Results: The results showed that ARSS roles tend to be more frequent in larger general practices, with fewer full-time general practitioners per patient, and with more overseas trained general practitioners. The use of ARRS staff was significantly associated with lower prescription rates (β=-0.52, p<0.000) and higher patient satisfaction (β=3.2, p<0.000), after controlling for patient and practice characteristics. Conclusion: This study suggests that ARRS has the potential to have a positive role in primary care, notably through reduced prescription rates and improved patient satisfaction. Further research is needed to explore the long-term effects of ARRS on primary care, including patient outcomes and health care costs, and the potential barriers to its implementation.