Diversifying the GP Workforce: Opportunities, Challenges, and Lessons from Practice
Matt Baines
ABSTRACT
Background: General Practice (GP) in the UK is undergoing rapid transformation through workforce diversification, particularly via the Additional Roles Reimbursement Scheme (ARRS) introduced in 2019. This study compares workforce and appointment data from 2019 to 2024, highlighting the impact of ARRS on service delivery.
Methods: We conducted a retrospective observational study comparing two four-week periods (November 2019 and November 2024) at a single UK practice serving ~12,000 patients. Metrics included appointment volumes by clinician type, re-presentation rates within 28 days, and patient satisfaction.
Results: Total appointments increased by 44%, with GP appointments falling by 39% and Advanced Nurse Practitioner (ANP) and ARRS role appointments increasing significantly. Re-presentation rates were lower in ANP and ARRS consultations (8%) compared to GP consultations (14%). Patient satisfaction rose from 88% to 93%.
Conclusion: Diversification improved appointment capacity and maintained patient satisfaction, but raises questions around sustainability, supervision, clinical outcomes, and workforce integration. Ongoing policy review and research are needed to guide safe and effective role development in primary care.
