The 25/26 PCN DES and the expanded Additional Roles Reimbursement Scheme (ARRS)

At THC Primary Care, we provide resources to primary care network leaders.

The PCN DES for 25/26 was released on March 27th.

In our blog, PCN DES 2025/26 | Will It Cover the National Insurance Increase?, we looked at the money and affordability of the ARRS.

Now, let’s look at the expansion of the additional roles reimbursement scheme, and keep reading to see our brand new PCN Roles Navigator.

Let's jump in!

Teal graphic with text: "Primary Care Network Contract DES 2025/26. The Expanded Additional Roles Reimbursement Scheme." Background shows papers.

In the PCN DES 2025/26, the additional roles reimbursement scheme increased.

The table below presents a comparison from 24/25.

	Role	Included in 2024/25	Included in 2025/26
1	Clinical Pharmacist	✅	✅
2	Pharmacy Technician	✅	✅
3	Physician Associate	✅	✅
4	Apprentice Physician Associate	✅	✅
5	First Contact Physiotherapist	✅	✅
6	First Contact Dietitian	✅	✅
7	First Contact Podiatrist	✅	✅
8	First Contact Occupational Therapist	✅	✅
9	Paramedic	✅	✅
10	Care Coordinator	✅	✅
11	Health and Wellbeing Coach	✅	✅
12	Social Prescribing Link Worker	✅	✅
13	General Practice Assistant	✅	✅
14	Digital and Transformation Lead	✅	✅
15	Mental Health Practitioner (Adult)	✅	✅
16	Mental Health Practitioner (Children & Young People)	❌	✅
17	Nursing Associate / Trainee Nursing Associate	✅	✅
18	General Medical Practitioner (Newly Qualified)	✅ (pilot)	✅
19	New to General Practice Nurse	❌	✅
20	Experienced General Practice Nurse	❌	✅
21	Enhanced Practice Nurse	✅	✅
22	Consultant Nurse (Primary Care)	❌	✅
23	Healthcare Support Worker	❌	✅
24	Advanced Practitioner – Pharmacist	✅	✅
25	Advanced Practitioner – Nursing	✅	✅
26	Advanced Practitioner – AHP (e.g., Physio, OT, Dietitian)	❌	✅
27	Advanced Practitioner – Paramedic	❌	✅
28	Advanced Practitioner – Mental Health	❌	✅
29	Advanced Practitioner – Consultant Nurse (Primary Care)	❌	✅

There is no cap on the headcount of each ARRS role, but your cap is your funding envelope.

Each PCN has a set ARRS funding allocation based on the PCN-adjusted population.

PCNs can recruit as many roles as they like within  their maximum reimbursable amount (Section 7.3.2) of the DES 25/26.

Roles must be "additional" to existing workforce
Must meet specific training and qualification requirements
Require appropriate clinical supervision

Social Prescribing

If a PCN has not recruited a Social Prescriber directly, for example, by subcontracting the service instead of employing directly, it can claim up to £200 per month (or £2,400 annually) for each full-time equivalent (WTE) SPLW allocated to the PCN. The £200 monthly contribution should be included when calculating the overall annual reimbursement max cap.

Mental Health Practitioner (MHP) Funding

Adult MHPs: The first receives 50% funding. With agreement from the commissioner and provider, additional MHPs can receive 100% reimbursement.

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The PCN Roles Navigator

Want to see the minimum requirements of each role?

Using the PCN Roles Navigator, you'll find a concise overview of role requirements directly sourced from PCN DES 2025/26.

Restrictions to note

The Additional Roles Reimbursement Scheme (ARRS) for Primary Care Networks (PCNs) in 2025/26 has key guidelines:

🛑 No Backfilling of Existing Staff: PCNs cannot use ARRS funding to replace existing staff.

🛑 No Claiming for Recent Staff: PCNs cannot claim reimbursement for nurses who have worked in the network in the past 12 months unless you are giving them a promotion for specialist roles.

🛑 Promotion Exception: PCNs can claim reimbursement for nurses promoted to specialist roles, supporting career progression.

✅ Roles must be "additional" to existing workforce

Concerns

We understand that many people are concerned about the introduction of the increasing roles within the scheme and its potential impact on existing workforce arrangements.

There are understandable anxieties about how these new roles might override current staffing models, particularly the potential implications for established team structures and existing healthcare professionals.

The Uncomfortable Truth

The uncomfortable truth is that your PCN's needs may be changing, and the addition of new roles to the ARRS provides an opportunity for networks to pursue a different workforce strategy based on their needs.

This isn't the case for all networks, though.

Protective Mechanisms in the Contract

For those with concerns, these shouldn't be dismissed, and the following provisions are designed to address any potential workforce impact.

Auditing and Verification

Section 10.2.4 of the contract explicitly states that "The commissioner will be responsible for post-payment verification. This may include auditing the PCN's claims to ensure that they meet the requirements of the Network Contract DES."

Preventing Misrepresentation

Section 7.2.7 clearly discusses the consequences of misrepresentation:

"A failure to submit information or the provision of inaccurate workforce information is a breach of the Network Contract DES Specification and may result in commissioners withholding reimbursement pending further enquiries.

Reimbursement claims will be subject to validation and any suspicion that deliberate attempts have been made to subvert the additionality principles will result in a referral for investigation as potential fraud."

Maintaining Workforce Baseline

The contract provides specific protections for existing workforce levels. Section 7.2.3 outlines that if a PCN's baseline workforce reduces during the period from 1

April 2020 to 31 March 2026, "the PCN will be subject to an equivalent WTE reduction in workforce funding under the Network Contract DES Additional Roles Reimbursement Scheme."

These provisions do create genuine obstacles to recruitment; however, the overall strategy, regardless of personal opinion, is designed to draw more roles into primary care.

The Elephant In The Room

The ARRS scheme now includes additional roles, which is positive. However, with only a 4.4% overall increase in the ARRS budget, the funding sadly doesn't allow networks already at the top of their budget to benefit greatly from this change.

If you want an estimate of the financial entitlements for 25/26, please check out: https://www.thcprimarycare.co.uk/pcnfinances2526

We hope this helps.

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North Shropshire Primary Care Network

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About Us

THC Primary Care is an award-winning healthcare consultancy specialising in Primary Care Network Management and the creator of the Business of Healthcare Podcast. With over 20 years in the industry, we've supported more than 200 PCNs through interim management, training, and consultancy.

Our expertise spans project management and business development across both private and public sectors. Our work has been published in the London Journal of Primary Care, and we've authored over 250 blogs sharing insights about primary care networks.