Integration of Additional Roles in UK General Practice: A Scoping Review Protocol

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Background: The NHS Additional Roles Reimbursement Scheme (ARRS) has supported the expansion of multidisciplinary teams in primary care to improve access to general practice. However, guidance on implementation and integration of additional roles remains limited and findings on impact are mixed. Aim: To systematically map the extent, nature, and characteristics of evidence on the implementation, integration and impact of additional roles embedded in or formally linked to NHS general practice in the UK; and to identify knowledge gaps. Design and Setting: A scoping review of published and select grey literature relating to additional roles in UK general practice and general practice-linked community/social-care services. Method: The review will follow Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidance. We will search bibliographic databases and targeted grey literature sources for records published since 2015. Eligible participants include additional roles specified in the NHS England 2025/26 Primary Care Network (PCN) Directed Enhanced Service (DES) contract, as well as analogous roles delivering services in general practice in Scotland, Wales, and Northern Ireland. All study designs will be considered, as well as evidence syntheses and key grey literature sources. Two reviewers will independently screen records in Rayyan. Data extraction will capture study design, context, role characteristics, outcomes achieved, and implementation considerations. Results will be narratively synthesised and mapped. Conclusion: This scoping review will provide a comprehensive overview of the current evidence on additional roles in UK general practice, highlighting what is known about their integration and impact, to inform future research, evaluation, policy development, and workforce planning.

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