The Impact of ARRS Roles on Reducing Pressure in General Practice and Improving Patient Care.
By Dr Natalie Jones.
Primary care across England continues to face unprecedented demand: rising long-term conditions, increased complexity, workforce shortages and widening health inequalities. Yet amidst these pressures, the Additional Roles Reimbursement Scheme (ARRS) is emerging as one of the most transformative developments in the delivery of general practice.
Through ARRS, Primary Care Networks (PCNs) have the flexibility to recruit from 17 different professional roles, including social prescribers, dietitians, occupational therapists, care coordinators, paramedics, clinical pharmacists, and more. These professionals are expanding access to care, supporting prevention, strengthening clinical management and enabling a more holistic approach to wellbeing.
In my research exploring patient perspectives on the ARRS workforce, several themes came through strongly: professionalism, compassion, knowledge of local communities, and a powerful ability to signpost, advocate and guide people through complicated health and social systems.
Together, these roles are improving patient experience, delivering measurable clinical impact, and easing pressure on general practice.
Tailoring Teams to Local Needs
One of ARRS's greatest strengths is its adaptability. Rather than a one-size-fits-all model, PCNs can build teams that reflect the realities of their patient populations.
In areas with high diabetes prevalence, dietitians are supporting lifestyle management, medication review, and targeted intervention.
In communities with frailty, complex aging or high care needs, paramedics or occupational therapists can deliver proactive home support and reduce hospital dependency.
Where loneliness, financial hardship or social vulnerability are widespread, many PCNs are investing in social prescribers, health coaches and care coordinators.
This flexibility ensures that care is not only clinically effective, but also socially and culturally relevant. Instead of expecting patients to fit into rigid service structures, the team adapts around the person.
Listening to Patients and Carers: What They Told Us
Interviews with patients and carers highlighted the human impact of ARRS roles. While clinical skills were respected and valued, what people talked about most often was time, empathy, and relationships.
“My life is full now” Emma’s story
Emma, living with isolation, anxiety and low confidence, was supported by both a Social Prescriber and a Health & Wellbeing Coach. With their guidance, she began volunteering, joined local community groups, and gained the motivation to build positive routines.
For her, the impact was transformational:
“My life is full now. I’m making up for lost time.”
Emotional scaffolding during loss
John, recently bereaved and struggling with the practical and emotional consequences, explained how the support he received was life-saving:
“Without these people here, I wouldn’t be here, I would be six feet under.”
His case speaks to a wider truth: ARRS roles frequently offer the listening ear, emotional support and proactive intervention that stretched traditional models have struggled to provide.
Advocacy and Signposting: Navigating the System
In many interviews, patients described ARRS professionals as connectors — the people who opened doors when systems were too complex, overwhelming or unresponsive. They coordinated, chased, persisted and championed.
Hamza’s experience stands out. Living with young children in unsafe, poor-quality housing, he found help through a Care Coordinator who simply refused to give up:
“She just wouldn’t stop. She went everywhere until something was done to help us.”
Her persistence eventually secured the repairs and support his family needed.
These examples show that ARRS roles don't just influence clinical outcomes, they tackle the wider determinants of health, housing, loneliness, financial stress, and mental wellbeing, often underpinning the conditions people bring to general practice.
Measuring ARRS Success: The Metrics That Matter
Real stories help us understand human value. But to assess ARRS impact long-term, we also need measurable indicators.
From evaluation work and wider NHS goals, several key metrics emerged:
Improved access to care
Shorter waits, more appointment routes, and a broader mix of expertise.Patient satisfaction
High levels of positive feedback about communication, support and continuity.Health outcomes
Improvements in diabetes control, mental wellbeing, physical activity and nutrition.Reduced GP workload
Redistribution of tasks means GPs can focus on complex cases and diagnostic decision-making.Better care coordination
Especially for vulnerable, multi-agency or non-English speaking patients.Prevention and self-management
Increased uptake of community exercise, peer support groups and lifestyle programmes.Equity of access
Targeted help for those most at risk of falling through gaps in the health system.
A logic model developed as part of the research framework also identified six domains of impact, spanning clinical outcomes, system efficiency, patient experience and professional development. These domains provide a structure for future data collection, evaluation and service design.
Looking Ahead: Embedding ARRS for Sustainable Change
The ARRS workforce is still young, and learning is ongoing. But the early signs are deeply encouraging.
Patients feel more heard, supported and empowered.
GPs are finding space to focus on complex clinical needs.
PCNs are building richer multidisciplinary teams that are able to respond to the multiple dimensions of health.
Communities are benefitting from a more proactive, personalised and connected model of care.
If we continue to invest in ARRS roles, ensuring supervision, integration, training and evaluation, the benefits will only deepen.
Above all, these roles remind us of the core purpose of primary care: not just treating illness, but supporting people to live well, feel connected, stay independent, and thrive in their communities.
As one patient told me:
“They saw me as a person first , not just a condition.”
If ARRS can help embed that principle across the country, then it represents one of the most meaningful shifts in NHS general practice in decades.
For more information about ARRS roles and the multidisciplinary team, visit NHS England » Expanding our workforce.https://www.england.nhs.uk/gp/expanding-our-workforce/