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How To Manage Your Additional Role Reimbursement Scheme (ARRS) Provider

Updated: Oct 28, 2023

I have written many times about the importance of a service contract review.


Because, in every Primary Care Network I have ever supported, they typically commission at least one staffing provider to deliver some of their Primary Care Network services. Often, these services aren't really managed. After the initial onboarding period, the services and the people delivering these services are just left, and communication only takes place when there is something wrong.

It's important to regularly review the services you offer to your patients. By doing so, you can ensure the network's services are;

  • Meeting the needs of your patients

  • Providing value for money

  • Supporting you to achieve the PCNs targets and network requirements

A service review is also a valuable tool for ensuring that your PCN remains responsive to your growing Primary Care Network and not just reactive to the risks and issues that arise.

This blog is for you if you;

  • Are new to the PCN and want to increase your understanding of the services in place

  • Are looking to establish a monthly or quarterly review

  • Would like an example of what a service report could look like

how to manage your additional role reimbursement scheme (ARRS) provider

Getting Started

If you are new to the PCN, we recommend you identify the roles in place across your network and who provides their employment.

For the roles provided by a staffing agency or a commissioned service, you will need to review the contract, service level agreement or MOU.

In this document, you are looking to understand;

  • When the contract started

  • The duration of the contract

  • The services specification

  • Roles and responsibilities

  • How operational issues are managed

  • Key contacts

  • How annual leave and sickness is managed

  • The payment schedule and what falls in and outside the

  • additional reimbursable rate

  • How pay increases are introduced and the notice period associated with this.

You may also want to see standard operating procedures.


Because the Primary Care Network is accountable for the services they provide to its patients, and you need to be assured that everything is in place.

Schedule a contract review

If you are new to the network (Manager or Clinical Director), this is the perfect opportunity to introduce yourself. If you are not new and you haven't spoken with the provider in a while, it's simply a good opportunity to check-in.

In this meeting, you will want to cover:

1. Progress to date, which ideally provides an overview of the past 3 months so we can look for trends

2. What is working well?

3. Feedback from the team delivering the services

4. Feedback from the network regarding the services

5. Areas for development

In our blog, How to get the most from your Primary Care Network Services, I highlighted Pure Physiotherapy as the gold standard when it comes to providing a contract review meeting after I had the pleasure of attending a meeting with them.

(I came across Pure Physio, a few years ago as many of our PCN clients use them. I highly recommend them, so much so they have been featured on our podcast, The Business of Healthcare three times! Click below to download the episodes.

They produce an easy-to-read dashboard of their performance which frames the meetings.

Through this report, we can see

• The source of referral

• The appointment type

• The body part

• Appointment utilisation at PCN and practice level

• The age range of the patient

• The outcome of the appointment

• Further advice and guidance on where to access support

Pure Physiotherapy Data Reporting

Having this report enables us to make decisions based on the data and not our personal preferences or biases.

We can also quickly corroborate this report with the network's clinical system if we need to check anything further.

Because Pure Physio can provide remote and face-to-face appointments, we can flex the provision according to our needs, and they move fast when we need to make slight alternations to the service.

Ideally, your provider will have provided you with a report like the one provided by Pure Physio, but if not, ask if they can make some alterations, so you get the information that you need.

The importance of soft intelligence

Along with hard data, soft intelligence is also important.

  • How are the team finding working in the network?

  • What feedback has been provided by patients and the practices?

  • Do they feel supported?

  • Do they have everything they need?

Whether people are employed directly by the PCN or via a third party, they are part of your team, and happy staff will mean happier patients.

Frequently asked questions

Who needs to be in the contract review?

Ideally the:

• PCN Manager

• The Clinical Lead or Lead Practice Manager

• The lead from the provider

It's always nice if a member of the delivery team can attend the meeting too so we can hear success stories and issues first-hand.

How often does a contract review need to take place?

Once a quarter, if the service is running relatively smoothly with a monthly utilisation report received via email.

If the service needs improvement, you may need to meet more frequently.

What are the pros and cons of hiring a contracted service?

The Pro's

  1. They are experts in their field

  2. They typically work with multiple networks and have amassed the best ways of working to help them deliver an excellent service

  3. They manage the recruitment process

  4. They hold the recruitment risk

  5. They have a large staffing pool to draw on

  6. They can quickly increase or decrease the provision to best suit your network

  7. They manage CPD requirements for their workforce

  8. They can hit the ground running quickly

  9. Many providers are used to delivering the service remotely; this is a huge benefit for PCNs who find it hard to recruit due to their location

  10. If your member of staff doesn’t quite align with your network, the provider can provide a more suitable person

  11. Holiday cover is provided

The Con's

  • A managed service will require a greater financial investment

  • If the service is remote, networks need to ensure out of sight does not mean out of mind

  • Sometimes staff are switched around to meet the needs of their service and not your PCN. It's rare, but it has happened.

We hope this helps!


About The Author

Tara Humphrey

Tara and Team THC provide project and network management and training to Primary Care Networks. Between our training programmes, facilitation and interim network programmes, we have now supported over 120 PCNs!

Tara has an MBA in Healthcare Leadership and Management, is published in the London Journal of Primary Care, is the author of over 250 blogs also hosts The Business of Healthcare Podcast.

Find out more about THC Primary Care at

Follow Tara on Twitter


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