The Spring issue of Nursing in Practice looks at the impact of the additional roles reimbursement scheme (ARRS) on general practice nurses.

Nursing in Practice: The scheme shaking up nursing

The GP nurse was one of the first ‘additional roles’ in general practice, with their evolution over the past 60 years. Today, the ARRS is having a significant impact in further expanding the general practice workforce. Now, a wide range of healthcare professionals - such as pharmacists, physician assistants, occupational therapists and dieticians - are working alongside nurses and GPs in the care of patients.

In the recent edition of Nursing in Practice, we asked general practice nurses how these recent changes are affecting them.

Marilyn Eveleigh, nurse and chair of Nursing in Practice’s advisory panel, believes the government’s ARRS scheme could help take general practice ‘to another level’. At the same time, she argues that nurses should have been more closely involved in the growth of the scheme from the outset.

Some GPNs told Nursing in Practice that, without action, the rapid influx of new roles and changes to working practices could jeopardise their own role in the longer term. 

The Royal College of Nursing’s (RCN) UK professional lead for primary care, Heather Randle, commented: ‘From a GPN point of view, ARRS threatens to dilute the role. Patients may be getting a diabetic check by one person; a pharmacy review with another, but this is forgetting the unique role the practice nurse does so well.’

Nurses are quick to defend the importance of preserving a holistic nursing approach in general practice, with Ms Randle saying: ‘Sometimes, for example, an inhaler might be better for the patient’s symptoms, but they might not be able to afford it. It’s those nuances of general practice we’re losing.’ 

What are the solutions to these issues? We suggest a range of possible actions: including making sure that the direction of senior nurses is in place at PCN level; ensuring there is sufficient training for those joining new roles; and taking steps to improve understanding of different health professionals’ roles and approaches.

Also, in this print edition of Nursing in Practice we examine key clinical topics of potential changes to the childhood immunisation schedule, mental health and COPD, cow’s milk protein allergy, syphilis, and weight loss. We feature an exclusive interview with RCN president, Sheilabye Sobrany, who reflects on nursing leadership, strikes and the ongoing pay dispute, and were pleased to meet practice nurse of the year, Janette Morgan.

More content from Nursing in Practice can be found at, via the Nursing in Practice app, and on social media.