If you have a special interest in menopause care, you may be interested in joining the new Menopause Network across BNSSG for peer support & clinical discussion. The first meeting is coming up on March 20th 7-9pm at Engineers House. Please register your interest.
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Mental Health Practitioners (MHPs)
Slide
Read our Toolkit:
The page below serves as a starting point; for more information, please read our Toolkit for Embedding Mental Health Practitioners (MHPs) in Primary Care.
Questions?
Please contact our Mental Health Profession Lead, Amy Chrzanowski, at amy.chrzanowski1@nhs.net.
Read our Toolkit:
The page below serves as a starting point, but for more information, please read our Toolkit for Embedding Mental Health Practitioners (MHPs) in Primary Care.
Questions?
Please contact our Mental Health Profession Lead, Amy Chrzanowski, at amy.chrzanowski1@nhs.net.
Read our Toolkit:
The page below serves as a starting point, but for more information, please read our Toolkit for Embedding Mental Health Practitioners (MHPs) in Primary Care.
Questions?
Please contact our Mental Health Profession Lead, Amy Chrzanowski, at amy.chrzanowski1@nhs.net.
Read our Toolkit:
The page below serves as a starting point; for more information, please read our Toolkit for Embedding Mental Health Practitioners (MHPs) in Primary Care.
Questions?
Please contact our Mental Health Profession Lead, Amy Chrzanowski, at amy.chrzanowski1@nhs.net.
Read our Toolkit:
The page below serves as a starting point, but for more information, please read our Toolkit for Embedding Mental Health Practitioners (MHPs) in Primary Care.
Questions?
Please contact our Mental Health Profession Lead, Amy Chrzanowski, at amy.chrzanowski1@nhs.net.
Read our Toolkit:
The page below serves as a starting point, but for more information, please read our Toolkit for Embedding Mental Health Practitioners (MHPs) in Primary Care.
Questions?
Please contact our Mental Health Profession Lead, Amy Chrzanowski, at amy.chrzanowski1@nhs.net.
Mental Health Practitioners (MHPs) contribute to the NHSLong Term Plan ambition to develop new and integrated models of primary and community mental health care, offering patients access to specialist support and providing guidance to other clinicians working in the general practice multidisciplinary team (MDT). Practices can employ them as jointly funded ARRS MHPs – in collaboration with Avon & WiltshireMental Health Partnership (AWP), through the Additional Roles Reimbursement Scheme (ARRS) – or as independently employed MHPs (IEMHPs) — please note that the method of employment can impact their core functions.
For more information, please expand the boxes below.
For jointly funded ARRS MHPs:
Through the Additional RolesReimbursement Scheme (ARRS), MHPs can be jointly employed and funded by a PCN and local community mental health service provider (in BNSSG’s case, Avon & WiltshireMental Health Partnership (AWP)). A local service agreement will confirm this arrangement. This jointly funded ARRS MHP role can be taken on by any registered clinician working at Band 5 or above, such as:
Community Mental Health Nurses
Social Workers
Mental Health Occupational Therapists
Main functions of the jointly funded ARRS role:
No exclusion criteria other than under 18 years old and dementia
Combined consultation, advice, triage and liaison function, supported by the local community mental health provider
Working with patients to support shared decision-making about self-management; facilitate onward access to treatment services; provide brief psychological interventions, where qualified to do so and where appropriate and work closely with the PCN MDT to help address wider patient needs
Operating without the need for formal referral from GPs
Being supported through the local community mental health services provider by robust clinical governance structures to maintain quality and safety, including supervision
For independently employed MHPs (IEMHPs):
Practices may choose to employ their own MHPs to allow greater freedom in adapting the role to better fit practice and patient population needs. However, the general concept of the IEMHP role will remain much the same:
Combined triage, consultation, advice, and liaison function
Working with patients to support shared decision making around self-management, and to facilitate onward access to treatment services
Provide brief psychological interventions where qualified to do so and where appropriate
Prescribing and reviewing medication where indicated, and if appropriately qualified to do so
Support with QoF
Exclusion criteria dependent on practice and individual practitioners
It is recommended that MHPs have 2– 5 years‘experience working in mental health before joining the primary care sector, due to the level of autonomy associated with the role.
Additionally, due to the nature of the role and career progression, it is recommended that Band 6+ or equivalent roles – ideally a Mental Health Nurse – are employed in this capacity.
What benefits can Mental Health Practitioners (MHPs) bring?
Mental Health Practitioners (MHPs) can offer a wide range of benefits to patients, practices, and primary care networks (PCNs), though they can differ depending on whether MHP(s) are employed through the Additional RolesReimbursement Scheme (ARRS) or independently. Further details can be found below.
For more information, please expand the boxes below.
For jointly funded ARRS MHPs:
Benefits for patients:
MHPs can help with reducing waiting times
They can help to prevent referral into secondary care
They provide an integrated pathway for patients
They provide access to specialist mental health support
Patients typically report positive experiences with MHPs
Integrated pathways for patients
Access to specialist mental health support
Reduced waiting times
Prevention of referral into secondary care
Positive patient experience
Benefits for PCNs:
MHPs can integrate into and work as part of the multidisciplinary team, in line with the community mental health framework
They can teach other clinicians new skills around managing mental health
They provide a bridge between primary care and specialist mental health providers
Through MHPs, PCNs can draw on a range of mental health service providers
When employed through ARRS, PCNs don’t need to be involved in the recruitment process for MHPs
They’re employed through an innovative model of shared employment
No formal referral process is required
For independently employed MHPs (IEMHPs):
Benefits for patients:
Access to specialist mental health support
Patients typically report positive experiences with MHPs
Patients can have longer appointments for assessing and formulating a treatment plan
Reduced waiting times
Benefitsfor PCNs:
MHPs can integrate into and work as part of the multidisciplinary team, in line with the community mental health framework
They can teach other clinicians new skills around managing mental health
They can help to free up GPs’ time
When employed independently, PCNs have full control over the recruitment process
PCNs can, consequently, develop the role according to their particular patient population and practice needs
What supervision do Mental Health Practitioners (MHPs) need?
Supervision arrangements for Mental Health Practitioners (MHPs) can differ depending on which employment model they’re hired through.
For more information, please expand the boxes below.
For jointly funded ARRS MHPs:
If employed through the Additional RolesReimbursement Scheme (ARRS), then MHPs will receive line management and clinical supervision through Avon & WiltshireMental Health Partnership (AWP).
AWP will also offer lunchtime check-ins with peers from across BNSSG, twice a week
Monthly team meetings will be held by AWP, too
PCNs should still identify a GP Mentor to work with MHPs, however
For more information on the role of a GP Mentor, please click here.
For independently employed MHPs (IEMHPs):
If employed independently, then line management and clinical supervision for MHPs should be provided by a…
GP (a mental health lead would be ideal)
Senior Mental Health Practitioner
Or Nurse Manager
…with the frequency of supervision should be agreed with individual practitioners.
Peer supervision with other MHPs in primary should be encouraged, too, as a means of sharing best practice and supporting retention.
What employment models are there for Mental Health Practitioners (MHPs)?
Mental Health Practitioners (MHPs) can either be employed independently at a practice surgery, in which case the practice will fully fund and oversee the recruitment process; otherwise, they can be employed as a jointly funded ARRS role in collaboration with Avon & WiltshireMental Health Partnership (AWP) through the Additional RolesReimbursement Scheme (ARRS).
Employed through either model, MHPs are a valuable addition to any MDT. You can see the benefits of each model under What are the benefits?
To employ an MHP through ARRS, there are certain criteria that must be met. For instance, as stated the Network ContractDirected Enhanced Service (DES) contract specification 2023 / 2024:
“B14.2. Where a PCN engages one or more Mental Health Practitioners under the Additional Roles Reimbursement Scheme, the PCN must ensure that each Mental Health Practitioner provides the following functions depending on local context, supervision and appropriate clinical governance:
a. mental health advice, support, consultation, and liaison across the wider local health and social care system, including acting as a first point of contact in primary care for patients whose care needs are not suitable for Talking Therapies services;
b. facilitation of onward access to mental and physical health, well-being, and biopsychosocial interventions;
c. provision of brief psychological interventions, where qualified to do so and where appropriate;
d. work closely with other PCN-based roles to help address the potential range of biopsychosocial needs of patients with mental health problems. This will include the PCN’s MDT, including, for example, PCN clinical pharmacists for medication reviews, and social prescribing link workers for access to community-based support; and
e. may operate without the need for formal referral from GPs, including accepting some direct bookings where appropriate, subject to agreement on volumes and the mechanism of booking between the PCN and the provider.”
“B14.3. A PCN must ensure that the postholder is supported through the local community mental health services provider (or by the employer of the postholder, where the local community mental health services provider has subcontracted the service to another organisation) by robust clinical governance structures to maintain quality and safety, including supervision where appropriate.”
What characteristics and training / qualifications should Mental Health Practitioners (MHPs) have?
Please find information on what you should look out for when employing an MHP below:
Personal Characteristics
The Avon & Wiltshire Mental Health Partnership (AWP) suggests that MHPs should have the following personal characteristics:
Ability to diplomatically challenge inaccurate assumptions and perceptions
Comprehensive experience in educating and training the mainstream workforce, particularly non-specialist mental health workers
Effective active listening skills, enabling the reframing and testing of understanding
Effective verbal communication skills, which can be put to use with people at all levels (even when an assertive approach is needed)
Effective written communication skills, with experience of compiling and sorting notes and reports, establishing statistical data, and analysing information
In-depth working knowledge of secondary specialist mental health services, the wider health and social care community, and the third sector
Possesses a detailed understanding of the relevant legal frameworks / legislation, including CPA process, the Mental Health Act, the Mental Capacity Act, and safeguarding
Substantial experience in assessing risk and producing risk management strategies
Well-versed with Microsoft Office, and willing to embrace new technology and processes
Well-versed with national drivers and policies, and with legislation affecting patients and service users
Please note:the above information is drawn from AWP‘s job description for a Band 6 mental health practitioner — it should, therefore, not be considered an exhaustive list, for all situations.
For further information, please consult NHSHealth Careers‘ guidance on required personal characteristics and skills by clicking here.
Training and Qualifications
It is recommended that MHPs have significant post-qualification experience of working in mental health field prior to join the primary care sector. Available job descriptions suggest between 2 – 5 years‘ of experience, on account of the level of autonomy associated with the MHP role in primary care.
The Avon & Wiltshire Mental Health Partnership (AWP) suggests that MHPs should have the following training and educational qualifications:
A professional qualification in mental health, equivalent to a registered RMN (mental health nurse), registered social worker, or registered therapist.
In-depth working knowledge of secondary specialist mental health services and the wider health and social care community, as well as the third sector.
Comprehensive experience in educating and training the mainstream workforce, particularly non-specialist mental health workers.
Substantial experience with assessing risk and producing risk management strategies.
Current registration with a professional body (ideally the Nursing and Midwifery Council (NMC)), and a commitment to CPD
If you wish to employ through the Additional RolesReimbursement Scheme (ARRS), any registered clinician working at Band 5 or above can take on the role, including:
The Specialist Mental Health Practitioner role will help people over 18 years old, who are accessing support through primary care, to define achievable goals and access local community resources. Areas of focus will include:
Those with mental health needs that do not meet the access criteria for IAPT (Improving Access to Psychological Therapies provided through Vita Health) and do not meet the access criteria for secondary care.
People with serious or significant mental illness (SMI) who are supported within recovery services and relatively stable in secondary care mental health services, who could be cared for within primary care.
Those diagnosed with, or presenting with traits of, personality disorder who will benefit from being signposted to services who can best meet their needs
Younger adults with SMI (17-25years) particularly those transitioning between children’s and adult services
Older adults with complex presenting issues
First contact with primary care
MH Job description Outline Doc
The above information was sourced from the following:
While the exact scope of the role and job description should be agreed between the mental health support worker and their PCN, broadly speaking, the role is qualified to:
Engage in shared decision making and support patients to make decisions about self-management
Support patients in accessing treatment services
Provide brief evidence-based psychological interventions for patients ineligible for IAPT, where such interventions can be safely offered outside of a multidisciplinary mental health team
Work closely with other PCN-based roles to address wider patient needs (e.g., PCN clinical pharmacists for medication reviews, and social prescribing link workers for access to community-based support)
Operate without the need for formal referral from GPs (including accepting direct bookings where appropriate, subject to agreement on volume and booking mechanism between the practitioner and PCN)
Fulfil a consultation, advice, triage, and liaison function, backed by the local community mental health provider through robust clinical governance structures, maintaining quality and safety standards
As stated above, this should not be considered an exhaustive list.
For more information on the scope of practice of this profession, please consult AWP’s job description below:
AWP's Job Description
Provided by AWP, this job description offers a role summary, lists the role’s duties, and provides a template person specification.
From April 2021 onward, mental health support workers can be employed through the Additional Roles Reimbursement Scheme (ARRS). 50% of the funding will be provided by the local provider of community mental health services, and 50% by the PCN itself (this amount can be reimbursed through the ARRS, however).
The maximum reimbursable amount is still to be decided, however. We hope to have more information over the coming months.
For more information:
BMA's Supporting General Practices in 2021 / 22 update
Hosted by the British Medical Association (BMA), this document from January 2021 provides an update on expansions to the Additional Roles Reimbursement Scheme (ARRS), including the provision of mental health support workers.
Are there any requirements to receive ARRS funding?
As noted under ‘Is funding available for them?‘, mental health support workers (MHSWs) can be reimbursed via the Additional Roles Reimbursement Scheme (ARRS). However, to be eligible for this funding, there are requirements that MHSWs must adhere to.
For instance, as stated in Annex B of the Network Contract Directed Enhanced Service contract specification 2021 / 22:
“B14.2. Where a PCN engages one or more Mental Health Practitioners under the Additional Roles Reimbursement Scheme, the PCN must ensure that each Mental Health Practitioner has the following key responsibilities, in delivering health services:
provide a combined consultation, advice, triage and liaison function, supported by the local community mental health provider;
work with patients to:
i. support shared decision-making about self-management;
ii. facilitate onward access to treatment services; and
iii. provide brief psychological interventions, where qualified to do so and
where appropriate;
work closely with other PCN-based roles to help address the potential range of biopsychosocial needs of patients with mental health problems. This will include the PCN’s MDT, including, for example, PCN clinical pharmacists for medication reviews, and social prescribing link workers for access to community-based support; and
may operate without the need for formal referral from GPs, including accepting some direct bookings where appropriate, subject to agreement on volumes and the mechanism of booking between the PCN and the provider.
For more information:
Network Contract DES contract specification 2021 / 22
Provided by NHSE / I, this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.
Please find below two example job descriptions, one for jointly funded ARRS MHPs and one for independently employed MHPs (IEMHPs).
For jointly funded ARRS MHPs:
Provided by Avon & WiltshireMental Health Partnership (AWP), this job description offers a role summary, lists the role’s duties, and provides a template person specification.
Produced by Amy Chrzanowski, our Mental Health Profession Lead, this job description offers a role summary, lists the role’s duties, and provides a template person specification.
“How would you risk assess and safety plan with a patient who is experiencing thoughts of self-harm and suicide?”
“Appointment times are shorter in primary care: how do you envisage you will adapt to this?”
“What challenges do you think you may encounter coming from secondary care into primary care?”
How do you look after your own wellbeing?
Finance & DES-supported roles
Overview of the role
AfC TBC 2021/22
TBC 2021/22
Mental Health Practitioners – including Improving Access to Psychological Therapy (IAPT) – to be included in the scheme from April 2021 – Awaiting further advice and guidance.
E-learning for health link
The above info on financing of the MHSW role can be found on the e-learning for health website:
The following information concerns the DES role requirements for Mental Health Support Workers, and full details can be found in the Network Contract DES link below.
B.14. Mental Health Practitioners B14.1. The mental health practitioner role may be undertaken by any registered clinical role operating at Agenda for Change Band 5 or above including, but not limited to, a Community Psychiatric Nurse, Clinical Psychologist, Mental Health Occupational Therapist or other clinical registered role, as agreed between the PCN and community mental health service provider.
B14.2. Where a PCN engages one or more Mental Health Practitioners under the Additional Roles Reimbursement Scheme, the PCN must ensure that each Mental Health Practitioner has the following key responsibilities, in delivering health services: a. provide a combined consultation, advice, triage and liaison function, supported by the local community mental health provider; b. work with patients to: i. support shared decision-making about self-management; ii. facilitate onward access to treatment services; and iii. provide brief psychological interventions, where qualified to do so and where appropriate; c. work closely with other PCN-based roles to help address the potential range of biopsychosocial needs of patients with mental health problems. This will include the PCN’s MDT, including, for example, PCN clinical pharmacists for medication reviews, and social prescribing link workers for access to community-based support; and d. may operate without the need for formal referral from GPs, including accepting some direct bookings where appropriate, subject to agreement on volumes and the mechanism of booking between the PCN and the provider. B14.3. A PCN must ensure that the postholder is supported through the local community mental health services provider by robust clinical governance structures to maintain quality and safety, including supervision where appropriate
Network Contract DES document
More can be read on the MHSW role des on page 93 of the following document:
Toolkit for Embedding Mental Health Practitioners (MHPs) in Primary Care
Compiled by Amy Chrzanowski, our Mental Health Profession Lead, in collaboration with Avon & WiltshireMental Health Partnership (AWP), this toolkit is intended to support practices in embedding Mental Health Practitioners (MHPs) into their multidisciplinary team (MDT).
Provided by Avon & WiltshireMental Health Partnership (AWP), this job description offers a role summary, lists the role’s duties, and provides a template person specification.
Produced by Amy Chrzanowski, our Mental Health Profession Lead, this job description offers a role summary, lists the role’s duties, and provides a template person specification.
Supervision Requirements for Mental Health Practitioners (MHPs) in Primary Care
Compiled by Amy Chrzanowski, our Mental Health Profession Lead, in collaboration with Avon & WiltshireMental Health Partnership (AWP), this toolkit is intended to support practices in embedding Mental Health Practitioners (MHPs) into their multidisciplinary team (MDT).
The role for occupational therapists in primary care and GP surgeries is growing. Government policies are expanding teams in primary care across the UK to reduce the pressure on GPs and improve patient care. Please watch the video below for further details:
Occupational Therapists in Primary Care
Produced by RCOT, this video expands on the roles of OTs in Primary Care
What can an Occupational Therapist do?
AfC 7
Max reimbursable amount over 12 months (with on cost) – £53,724
Occupational therapists (OTs) support people of all ages with problems resulting from physical, mental, social, or development difficulties. OTs provide interventions that help people find ways to continue with everyday activities that are important to them. This could involve learning new ways to do things or making changes to their environment to make things easier. As patients’ needs are so varied, OTs help GPs to support patients who are frail, with complex needs, live with chronic physical or mental health conditions, manage anxiety or depression, require advice to return or remain in work and need rehabilitation so they can continue with previous occupations (activities of daily living).
For a full outline of role description please see below:
Occupational therapists in primary care are experts in the management of complex patient’s, groups and communities’ occupational participation needs for example in home and health management, education, work, social participation, and leisure activities.
Occupational therapists can work as First Contact Practitioners, providing personalised, biopsychosocial interventions from initial clinical assessment, intervention, and evaluation for agreed patient groups. They work collaboratively with the Primary care multi-disciplinary team (MDT) across pathways and systems, including digital delivery, to meet the needs of patients and carers, and provide occupational therapy leadership across clinical practice, education, and research.
Alongside other AHPs in primary care, three key occupational therapy “superpowers” have emerged while new pilots’ trial, for example, social care and paediatric occupational therapists in primary care.
Frail older adults
Use of frailty indexes to identify people needing a proactive approach
Rapid crisis response to prevent hospital admission or to speed discharge.
Assessment and interventions to ensure people can cope at home, including support for carers.
Short term rehabilitation interventions and referral on to specialist services if indicated
Use of digital and assistive technology to ensure safety at home.
People with mental health problems
Risk assessment for acute distress,
Personalised care plans for self-management,
Patient activation to achieve personal goals,
Social prescribing, and signposting or referral onto recovery support and services.
Working age adults with employment difficulties
Vocational rehabilitation
Use of AHP Health and Work report in place of GP fit note for sick pay
Tailored, specific advice about workplace modifications.
Fran Hill, one of the occupational therapists involved in the trial explains more:
“Myself and two occupational therapy colleagues are based across three sites of a GP practice in Southampton where we run Occupational Therapy Led Vocational Clinics to help people with mental health and/or musculoskeletal problems remain in work. We are trialling the use of the Allied Health Professions Advisory Fitness for Work Report (AHP Fit Note).
“We offer the service in different ways either by telephone, face to face or using online platforms using a stepped care model. People receive initial brief self-management support, followed by individualised work capacity advice. By the final contacts, if required, we suggest adjustments that could be made to their working environment; we might liaise with their employer; and provide rehabilitation. All three steps help to join services by providing an AHP Fit Note that helps to facilitate the relationship between the individual and their GP and employer.
“We are really excited to be part of the trial as using a holistic, recovery-focussed vocational model is what occupational therapists are particularly skilled at. Assessing the person, the demands of the job and the working environment is what occupational therapists are trained to do.”
Occupational therapists are able to use their dual training to reduce the burden on primary care, working with individuals and their employers to enable people to return to work. The GP practice originally involved in the pilot in Solent NHS Trust had previously been part of an innovative occupational therapy emerging placements pilot run by Juliet Truman, an occupational therapy lecturer at the time from Southampton University, the practice had been very impressed by the wide skill base demonstrated by an occupational therapy student on placement at the surgery via Southampton University and the local HEE training hub. This made them a natural choice when deciding where to trial the new vocational clinics which will conclude in 2020.”
The pilot is being fully evaluated throughout the trial to assess the extent to which the initiative is contributing to improving outcomes, people’s experience; supporting the cost-effective delivery of care; and developing a rewarding and fulfilling job role for occupational therapists. The learning and data from the work will be used to support the extension of the primary care work alongside work to develop the extension of the ‘FIT Note’ from 2020.
What should Clinical Supervision do I need to provide?
Clinical supervision within the context of new/emerging roles or in a new clinical setting, involves regular supervision within practice, and includes, particularly in primary care, a debrief (usually daily) to ensure patient and practitioner safety. This short type of daily debrief is common for GPs too. It should provide good-quality feedback to help with safely managing practitioner and patient uncertainty. Clinical supervision should help to build
confident capability, clinical reasoning, and critical thinking. It also includes WorkplaceBased Assessment (WPBA) to assess the application of knowledge, skills, and behaviours
in Primary Care. The WPBA allows for a portfolio of triangulated evidence against the appropriate framework. Clinical supervision is mainly formative but there may be a
summative element (see appendix 12.1)
For further information please see link below Page 32 of the HEE FCP document:
Health Education England (HEE) in conjunction with RCOT and clinicians who work in primary care have produced a roadmap for occupational therapists who are First Contact Practitioners (FCPs), Advanced Practitioners (AP) or who would like to work towards this level of practice.
This CPD opportunity supports FCP and AP job roles and development of the profession. It forms part of a suite of roadmaps for AHPs working at level 7 – Level 8 of the RCOT Career Development Framework. You can find the roadmap and support material here.
The roadmap includes information about:
Primary Care educational pathways
National standards and frameworks for occupational therapists
The required knowledge, skills, and attributes
Moving into primary care
How to build a portfolio using the roadmap templates
Supervision requirements
Training resources
In the roadmap, the Advanced Clinical Practice Capabilities for Primary Care Occupational Therapy, were devised by a Skills for Health/HEE multi-disciplinary Steering Group with representation from Wales, Northern Ireland, Scotland, and England. The Steering group, with expert patient experience, clinicians and academics was fundamental in ensuring the accuracy of the capabilities, which were then further refined following public consultation. All contributions to the development of the roadmap and capabilities are gratefully acknowledged.
Where a PCN employs or engages an Occupational Therapist under the Additional Roles Reimbursement Scheme, the PCN must ensure that the Occupational Therapist:
a. has a BSc in or pre-reg MSc in Occupational Therapy under a training programme approved by the Royal College of Occupational Therapists;
b. is a registered member of the Health and Care Professionals Council (HCPC);
c. is able to operate at an advanced level of practice; and
d. has access to appropriate clinical supervision and an appropriate named individual in the PCN to provide general advice and support on a day to day basis, in order to deliver the key responsibilities outlined in section B10.2.
B10.2. Where a PCN employs or engages one or more Occupational Therapists under the Additional Roles Reimbursement Scheme, the PCN must ensure that each
Occupational Therapist has the following key responsibilities, in
delivering health services:
a. assess, plan, implement, and evaluate treatment plans, with an aim to increase patients’ productivity and self-care;
b. work with patients through a shared-decision making approach to plan realistic, outcomes-focused goals;
c. undertake both verbal and non-verbal communication methods to address the needs of patients that have communication difficulties;
d. work in partnership with multi-disciplinary team colleagues, physiotherapists and social workers, alongside the patients’ families, teachers, carers, and employers in treatment planning to aid rehabilitation;
e. where appropriate, support the development of discharge and contingency plans with relevant professionals to arrange on-going care in residential, care home, hospital, and community settings;
page 88
f. periodically review, evaluate and change rehabilitation programmes to rebuild lost skills and restore confidence;
g. as required, advise on home, school, and workplace environmental alterations, such as adjustments for wheelchair access, technological needs, and ergonomic support;
h. advise patients, and their families or carers, on specialist equipment and organisations that can help with daily activities;
i. help patients to adapt to and manage their physical and mental health long-term conditions, through the teaching of coping strategies; and
j. develop, implement and evaluate a seamless occupational therapy support service across the PCN, working with community and secondary care where appropriate, and aimed at continuously improving standards of patient care and wider multi-disciplinary team working.
B10.3. The following sets out the key wider responsibilities of Occupational Therapists:
a. provide education and specialist expertise to PCN staff, raising awareness of good practice occupational therapy techniques; and
b. ensure delivery of best practice in clinical practice, caseload management, education, research, and audit, to achieve corporate PCN and local population objectives.
Read the full contract details here:
Network Contract DES
Network Contract DES sets out the guidelines for the ARRS roles of which Occupational therapists’ are explained in full on page 87 of the following document:
From April 2020, this role will be reimbursed at 100% of actual salary plus defined on costs, up to the maximum reimbursable amount of £53,724 over 12 months.
"HWBCs work alongside people to coach and motivate them through multiple sessions, supporting them to self-identify their needs, set goals, and help them to implement their personalised health and care plan."
Source: HEE's Health and Wellbeing Coach Role Overview
As part of the PCN multidisciplinary team (MDT), health and wellbeing coaches (HWBCs) use their coaching skills to support patients and service users with lower levels of patient activation in becoming active in reaching their self-identified health and wellbeing goals.
As part of their work, HWBCs will:
Work alongside health, social care, community, and voluntary sector providers and MDTs
Provide education and specialist expertise to health staff, thereby improving their skills and understanding of personalised care and behavioural approaches
Raise awareness within a primary care network (PCN) of tools that enable shared decision making (SDM)
HWBCs carry out their role using a non-judgemental approach, supporting patients to self-identify existing issues and encouraging proactive prevention of new illnesses. This approach requires strong communication and negotiation skills, in order to promote personal choice and positive risk-taking, while addressing potential consequences and ensuring patients take accountability for their decisions, chosen based on what matters to them.
For more information:
NHSE / I's Page on HWBCs
Provided by NHS England & NHS Improvement (NHSE / I), this short page serves as an introduction to the role of health and wellbeing coaches (HWBCs).
Health and wellbeing coaches (HWBCs) can bring the following benefits to patients and PCNs.
For patients:
Increased levels of patient activation and of preventative behaviours / self-management
Overall improvement in health outcomes
Additional time to address patient goals on an individual level, providing more support for them to pursue their own health goals
Shown to improve two-way communication and partnership working
For PCNs:
Increased patient activation can enable fewer visits to general practice, reducing demand for practice services
Reported increase in job satisfaction amongst healthcare staff
Less waste on account of unnecessary tests and medication
Long-term, sustained benefits relating to cost reduction and service development
For more information:
NHSE / I HWBCs in Yeovil Case Study
Provided by Health Education England (HEE), this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of health and wellbeing coaches (HWBCs).
According to NHS England & NHS Improvement (NHSE /I), primary care networks (PCNs) should ensure that health and wellbeing coaches (HWBCs) have regular access to clinical / non-managerial supervision with both a GP and other relevant health professionals. This is to assist with the emotional impact of their work and guide them on how to effectively deal with patient risk factors.
NHSE / I have also stated that all primary care networks (PCNs) should ensure their HWBCs have access to four-day health coaching training, including access to a health coaching supervisor who can directly supervise the HWBCs.
It should be noted that health coaching supervision is different from clinical and caseload supervision and one-to-one line management.
For more information:
NHSE / I Welcome Pack for HWBCs
Provided by NHS England & NHS Improvement (NHSE / I), this document serves as a welcome pack for health and wellbeing coaches (HWBCs) starting employment in a primary care network.
NHS England & NHS Improvement (NHSE / I) have compiled an induction guide for health and wellbeing coaches (HWBCs) joining a primary care network. This twenty one-page document includes links to an assortment of resources and covers the following topics:
What is personalised care?
What can HWBCs do?
What support should be available for HWBCs?
And more…
For more information:
NHSE / I Welcome Pack for HWBCs
Provided by NHS England & NHS Improvement (NHSE / I), this document serves as a welcome pack for health and wellbeing coaches (HWBCs) starting employment in a primary care network.
NHS England & Improvement (NHSE / I) have, in their health and wellbeing coach (HWBC) welcome pack, compiled a list of available support structures and mechanisms — including an online learning community, accessible by contacting:
Included in their induction guide for social prescribing link workers (SPLWs), NHS England & NHS Improvement (NHSE / I) have compiled a list of ongoing support and resources, including:
According to Health Education England (HEE), a health and wellbeing coach (HWBC) is required to provide one-to-one coaching support for people with one or more long-term conditions, adhering to what is important to them, with the aim of:
Improving people’s knowledge, confidence and skills-levels of ‘patient activation’
Empowering people to improve their health outcomes and sense of wellbeing
Preventing unnecessary reliance on clinical service
Providing interventions such as self-management education and peer support
Supporting people to establish and attain self-identified goals
Working with the social prescribing service to support the triaging of referrals that connect people to the right intervention / community-based activities which support their health and wellbeing
To work as part of a multidisciplinary, multi-agency team to promote health coaching, and to be ambassadors for personalised care and supported self management, modelling the coaching approach in their work
This is not an exhaustive list, however.
For more information, please read:
HEE's Health and Wellbeing Coach Role Overview
Provided by Health Education England (HEE), this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of health and wellbeing coaches (HWBCs).
As health and wellbeing coaches (HWBCs) are included on the additional roles reimbursement scheme (ARRS), funding is available for them; from April 2020, this role can be reimbursed at 100% of actual salary plus defined on-costs, up to the maximum reimbursable amount of £35,389 over 12 months.
For more information:
HEE's Health and Wellbeing Coach Role Overview
Provided by Health Education England (HEE), this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of health and wellbeing coaches (HWBCs).
What characteristics, training / qualifications, and competencies should they have?
Health Education England (HEE) advocates that health and wellbeing coaches (HWBCs) should have the following skills and competencies:
Able to work within a biopsychosocial model, using a range of tools and techniques to enable and support people, such as agenda setting, goal setting, problem solving
Active and empathic listening
Appropriate use of problem-solving and goal follow-up across sessions to maintain and increase activation
Being responsive and sensitive to the needs and beliefs of the client
Building trust and rapport
Collaborative goal setting
Creating and maintaining a safe and positive relationship
Developed skills to further develop their health coaching through ongoing practice, reflection, and planning as reflective practitioners
Effective questioning
Knowledge and recognition of the core concepts and principles of personalised care, shared decision making, patient activation, health behaviour change, self-efficacy, motivation, and assets-based approaches
Managing and making effective use of time
Managing resistance to change and ambivalence
Providing supportive challenge
Setting and maintaining appropriate boundaries
Shared agenda setting
Shared follow-up planning
Structuring conversations using a coaching approach
Structuring programme and sessional goals
Understanding and applying the health coaching approach and mindset
Using simple health literate communication techniques
For more information:
HEE's Health and Wellbeing Coach Role Overview
Provided by Health Education England (HEE), this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of health and wellbeing coaches (HWBCs).
Are there any requirements to receive ARRS funding?
As noted under ‘Is funding available for them?‘, health and wellbeing coaches (HWBCs) can be reimbursed via the Additional Roles Reimbursement Scheme (ARRS). However, to be eligible for this funding, there are requirements that must be adhered to.
For instance, as stated in Annex B of the Network Contract Directed Enhanced Service contract specification 2021 / 22:
“B4.1. Where a PCN employs or engages a Health and Wellbeing Coach under the Additional Roles Reimbursement Scheme, the PCN must ensure that the Health and Wellbeing Coach:
is enrolled in, undertaking or qualified from appropriate health coaching training covering topics outlined in the NHS England and NHS Improvement Implementation and Quality Summary Guide, with the training delivered by a training organisation listed by the Personalised Care Institute;
adheres to a code of ethics and conduct in line with the NHS England and NHS Improvement Health coaching Implementation and Quality Summary Guide;
has formal individual and group coaching supervision which must come from a suitably qualified or experienced individual; and
working closely in partnership with the Social Prescribing Link Worker(s) or social prescribing service provider to identify and work alongside people who may need additional support, but are not yet ready to benefit fully from social prescribing
For more information:
Network Contract DES contract specification 2021 / 22
Provided by NHSE / I, this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.
According to Health Education England (HEE), sample job descriptions and recruitment packs have been developed by NHS England & Improvement (NHSE / I).
An example job description from NHSE / I is linked below.
For more information:
NHSE / I's Sample JD and Interview Questions
Provided by NHS England & Improvement (NHSE / I), this document offers a sample job description and interview questions.
What are the benefits of employing a Health & Wellbeing Coach?
Health and wellbeing coaches (HWBCs) can support patients in making positive choices for their health and wellbeing; consequently, they can lead healthier lives and will be less likely to require the services of health and care centres, reducing the burden of ill-health in the patient population.
Any sample case studies?
NHS England & NHS Improvement (NHSE / I) have provided the following case study on the effects of health and wellbeing coaches (HWBCs) on patients with long-term conditions in Yeovil.
A South Somerset GP interviewed as part of the case study had the following to say:
“What’s different is probably the perception of what is possible and permissible. We feel in control rather than being an island under attack retreating from the relentless onslaught of demand on one side and reduction in provision on the other.”
For more information:
NHSE / I HWBCs in Yeovil Case Study
Provided by Health Education England (HEE), this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of health and wellbeing coaches (HWBCs).
Provided by Health Education England (HEE), this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of health and wellbeing coaches (HWBCs).
Provided by Health Education England (HEE), this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of health and wellbeing coaches (HWBCs).
"Link workers give people time and focus on what matters to the person as identified through shared decision making or personalised care and support planning. They connect people to community groups and agencies for practical and emotional support. ."
Source: NHS England's Social Prescribing Summary Guide
Social prescribing link workers (SPLWs) serve in a non-clinical capacity to help patients and service users take control of their health and wellbeing; they support individuals in creating a shared plan based on ‘what matters’ to them, and to help them connect with local community and voluntary groups and build up their confidence.
Additionally, SPLWs assist local community groups and services in becoming more accessible and sustainable, and support the formation of new ones. They are employed for their listening skills, empathy, and ability to support others.
SPLWs work with a wide range of people, including:
Those who are lonely or isolated
Those who need support with their mental health
Those with complex social needs
Those with one or more long-term conditions
For more information:
Induction Guide for Social Prescribing Link Workers
Provided by NHS England & NHS Improvement (NHSE / I), this document serves an induction guide for social prescribing link workers (SPLWs) starting employment in a primary care network.
Diagram sourced fromNHSE / I’sInduction Guide for Social Prescribing Link Workers
Why a Social Prescribing Link Worker?
One in five GP appointments focus on wider social needs[1], rather than acute medical issues. In areas of high deprivation, many GPs report that they spend significant amounts of time dealing with the consequences of poor housing, debt, stress and loneliness. Social prescribing and community-based support is part of the NHS Long Term Plan’s commitment to make personalised care business as usual across the health and care system and to bring additional capacity into the multi-disciplinary team. This approach aims to reduce pressure on clinicians, improve people’s lives through improved and timely access to health services and strengthen community resilience, meeting the needs of our diverse and multi-cultural communities.
Social prescribing enables all primary care staff and local agencies to refer people to a link worker and supports self-referral. Working under supervision of a GP, link workers give people time and focus on what matters to the person, as identified through shared decision making or personalised care and support planning. They will manage and prioritise their own caseload in accordance with the health and wellbeing needs of their local population, and where required discuss and/or refer people back to other health professionals and GPs in the PCN. They also connect people to local community groups and agencies for practical and emotional support. Link workers work within multi-disciplinary teams and collaborate with local partners to support community groups to be accessible and sustainable and help people to start new groups and activities.
Social prescribing can support a wide range of people, including (but not exclusively) people:
with one or more long term conditions
who need support with their mental health
who are lonely or isolated
who have complex social needs which affect their wellbeing.
There is emerging evidence that social prescribing can lead to a range of positive health and wellbeing outcomes for people, such as improved quality of life and emotional wellbeing.[2] Whilst there is a need for more robust and systematic evidence on the effectiveness of social prescribing,[3] social prescribing schemes may lead to a reduction in the use of NHS services,[4] including GP attendance. 59% of GPs think social prescribing can help reduce their workload.[5]
[1] Citizens Advice policy briefing (2015), A very general practice: How much time do GPs spend on issues other than health?
[3] Bickerdike, L., Booth, A., Wilson, P.M., et. Al. (2017), Social prescribing: less rhetoric and more reality. A systematic review of the evidence, BMJ Open 2017;7: e013384. doi: 10.1136/bmjopen-2016-013384
[4] Polley, M. et al. (2017), A review of the evidence assessing impact of social prescribing on healthcare demand and cost implications. London: University of Westminster
Principally, social prescribing link workers (SPLWs) can help to ease the workloadand release time for GPs and general practice nurses (GPNs), by consulting with patients that do not have an immediate need for medical or nursing attention. In fact, 1-in-5 patients come to practice appointments with a non-clinical issue, which SPLWs can also be better-equipped to deal with.
There is evidence that social prescribing can lead to a number of positive health and wellbeing outcomes, including a better quality of life and emotional wellbeing. When implemented properly, SPLWs can support patients and service users in easily connecting with an assortment of local groups and services, including (but not limited to):
Hospital discharge teams
Fire services
Police services
Job centres
Social care services
Housing associations
Voluntary, community, and social enterprise (VCSE) organisations
What is their scope of practice?
Below is a list of but some of a social prescribing link worker’s (SPLW) key tasks, quoted from NHSE / I’sSocial Prescribing Summary Guide.
For a fuller account of their scope of practice, please be sure to consult the guide itself, linked below.
Promoting social prescribing, its role in self-management, and the wider determinants of health
Build relationships with key staff in GP practices within the local Primary Care Network (PCN), attending relevant meetings, becoming part of the wider network team, giving information and feedback on social prescribing
Be proactive in developing strong links with all local agencies to encourage referrals, recognising what they need to be confident in the service to make appropriate referrals
Work in partnership with all local agencies to raise awareness of social prescribing and how partnership working can reduce pressure on statutory services, improve health outcomes and enable a holistic approach to care
Provide referral agencies with regular updates about social prescribing, including training for their staff and how to access information to encourage appropriate referrals
Seek regular feedback about the quality of service and impact of social prescribing on referral agencies
Be proactive in encouraging self-referrals and connecting with all local communities, particularly those communities that statutory agencies may find hard to reach
Meet people on a one-to-one basis, making home visits where appropriate within organisations’ policies and procedures. Give people time to tell their stories and focus on ‘what matters to me’. Build trust with the person, providing non-judgemental support, respecting diversity and lifestyle choices. Work from a strength-based approach focusing on a person’s assets
Be a friendly source of information about wellbeing and prevention approaches
Help people identify the wider issues that impact on their health and wellbeing, such as debt, poor housing, being unemployed, loneliness and caring responsibilities
NHSE / I Social Prescribing and Community-Based Support Summary Guide
Provided by NHS England & NHS Improvement (NHSE / I), this document is intended to outline what good social prescribing looks like and assist in implementing it.
Social prescribing link workers (SPLWs) are one of the Additional Roles Reimbursement Scheme (ARRS) roles, and therefore PCNs can receive funding for employing them.
According to NHS England & NHS Improvement (NHSE / I), PCNs will be able to receive reimbursement for 100% of the role’s actual full-time equivalent salary, plus employer on-costs (NI and pension) and a contribution.
Provided by NHS England & NHS Improvement (NHSE / I), this document is intended to outline what good social prescribing looks like and assist in implementing it.
Social Prescribing Link Workers give people time and focus on what matters to the person as identified in their care and support plan. They connect people to community groups and agencies for practical and emotional support and offer a holistic approach to health and wellbeing, hence the name ‘social prescribing’.
Social prescribing enables patients referred by general practice, pharmacies, multi-disciplinary teams, hospital discharge teams, allied health professionals, fire service, police, job centres, social care services, housing associations and voluntary, community and social enterprise (VCSE) organisations get the right care for them.
Link workers typically work with people over 6-12 contacts (including phone calls and face to face meetings) over a three-month period with a typical caseload of up to 250 people, depending on the complexity of people’s needs.
Although these are not strict as a guide, relevant experience might include the following:
Worked with people with support needs previously in a key worker/ case manager type role and those who have a broad understanding of the wider determinants of health
Supported and motivated people to make changes in their lives, helping the person to make plans based on what matters to them
What patients would be suitable to be referred to a SPLW?
Social prescribing works for a wide range of people, including people:
with one or more long-term conditions
who need support with their mental health
who are lonely or isolated
who have complex social needs which affect their wellbeing.
From a GP perspective practice teams should consider those patients that are frequent attenders with often unexplained physical symptoms, social isolation, mental health difficulties, and poorly controlled long-term conditions.
What’s the difference between social prescribing and active signposting?
“Active signposting” schemes generally involve existing staff in general practices, libraries and other agencies providing information to signpost people to community groups and services, using directories and local knowledge. They offer a light touch approach which works best for people who are confident and skilled enough to find their own way to community groups.
Social prescribing is different in that it focuses its support on people who lack the confidence or knowledge to approach other agencies or to get involved in community groups on their own. The personalised support of social prescribing link workers gives people time and confidence to work on the underlying issues which affect their health and wellbeing.
A primary care navigator helped John to get his life back and address his ongoing health and social needs
Case study summary
John’s Primary Care Navigator talks about how he accessed a social prescribing primary care navigator via his GP after the death of his mum and losing his job. After working out what matters to John she was able to help him address his critical health, mental and financial issues, including now accessing benefits and services he was entitled to and other medical support.
John is in his mid 60’s. He lives alone in a two bedroom flat situated in a tower block, which was left to him by his mother who sadly died in 2013. Since then, John’s health had deteriorated. As well as poor control of his chronic diseases he then began to suffer from depression after the loss of his mother and being made redundant.
John was referred to the primary care navigator via his GP to see if we could help him in anyway. At first John was reluctant to engage with the primary care navigator as he felt embarrassed and lost and at an all-time low. We asked John if he would like to pop in for an informal chat, we made this on a regular basis. We began to build a relationship of trust and John began to communicate to us with ease.
He had cared for this mother and his benefits were all stopped when she died, to the point that he could not buy food. John suffered mentally and financially.
Over a period of eight months, we worked alongside foodbanks, The Salvation Army, The Green Doctor, Age UK and Citizens Advice Bureau and worked hard to make sure he could access the benefits and services he was entitled to. This enabled us to support John with food, clothes, paying off debts and energy efficient items for the home.
We also supported John in benefit advice and eventually won his appeal to unblock his benefit of £50 so he could feed himself. We then provided providing crucial medical information which helped to unlock another benefit and the funding was then backdated. It also now entitled him to other benefits too.
All this meant that he could now continue to live in his own house and look after himself. His health has improved and is now in control. John now looks forward to his weekly meet at the local Luncheon Club.
John keeps thanking us for all we did for him but if we did not have access to social prescribing then it would not have been possible to achieve what has been done. John knows that we will always be available if he needs us.
The following ‘day in the life’ was sourced from a case study from another social prescribing organisation (see web link below):
AS PART OF ELEMENTAL’S MISSION TO SHINE A LIGHT ON SOCIAL PRESCRIBING AND HIGHLIGHT ALL THE GREAT WORK TO THAT TAKES PLACE ACROSS THE FORWARD THINKING AND INSPIRING ORGANISATIONS THAT WE WORK WITH, OUR NEW ‘DAY IN THE LIFE OF’ FEATURE AIMS TO RAISE AWARENESS OF THE PEOPLE ON THE GROUND THAT ARE EMPOWERING COMMUNITIES AND CHANGING LIVES THROUGH SOCIAL PRESCRIBING.
In our first feature, Rachel Studzinski, SPRING Social Prescribing Development worker for Health in Mind, a mental health and wellbeing charity in Scotland, explains more about her role as a link worker
ABOUT SPRING
The SPRING social prescribing programme is a community led and holistic approach to wellbeing in the Scottish Borders. My role is to support people to identify what is important to them and how they can make positive changes in their lives to achieve their goals through accessing local services, groups and activities.
No two days are ever the same, and I split my time between working from the different Health in Mind offices in our communities and getting out and about to talk to as many people as possible about social prescribing and how our programme can support a wide range of people working in health and wellbeing.
For example, I have been working with midwives in the area to raise awareness of our programme and its potential to support new mums with some of the challenges they face.
CREATING A SOCIAL PRESCRIBING CULTURE
This awareness raising work is really important because I spend a lot of my time trying to track down the right people in the NHS. There is a real communication job to do with social prescribing for anyone trying to reach in and we know that to tackle this need to go out into the community and not wait for people to come to us.
It’s so vital that we have NHS professionals on board to deliver social prescribing to its full potential, and to do that we need to create a new mindset that really understands how the social model can complement and enhance medical models.
The NHS might be the gateway, but it’s all about bridging the gap between statutory and non-statutory services, this is where the success to social prescribing lies and we need to work hard to create this culture.
We are lucky in the Borders that there’s a lot of support for social prescribing in the NHS, but we know that this is not a nationwide experience and I think the sector needs to work to avoid the ‘postcode lottery’ effect where it’s an option available to some but not others.
WORKING WITH GP PRACTICES
A large part of my work involves working with GP practices as this is the primary route of our referrals to the programme.
We have 13 GP practices signed up at the moment, with two more coming on board in the next few months. Some practices refer more than others, but all referrals come to us through Elemental’s social prescribing platform, which makes it so quick and easy for us.
We receive referrals through the Elemental system directly from the GP in real time, enabling me to respond quickly and set up appointments within a week.
TAKING TIME TO ASSESS PEOPLE’S NEEDS
The first step in any social prescribing referral is to go and meet the patient and have an hour to an hour and a half assessment where we look at each area of their life to identify where they want support and what they want to change in their lives. While this part of the assessment is fairly clinical at this stage, it’s important because this is what translates back for statutory services.
Once that is completed, I always add a personal goal in, which can be anything from ‘I would like to feel less isolated’, to ‘I would like to feel more confident’. Then we work together to do a smart goal around that which enables us to find the right social prescribing activity for them.
Once we have an idea of what they are looking for we can start to suggest things that are happening in their areas for them to try. As a link worker I see my role as facilitating what the social prescription might be, but really empowering the individual to choose the activities that work for them, whether that’s learning something new, ice skating, swimming or even sky diving!
SEEING THE DIFFERENCE
The most rewarding part of my role is seeing people thrive as they go through the programme.
For example, a lady I have been working with was referred to the programme for weight management after she’d been to different wellbeing teams who thought that they’d done all they could and after assessing her diet, felt that she needed to be referred into exercise classes.
However, through our referral we realised her needs were completely different. Through my initial assessment we identified that she had been diagnosed with arthritis and had a history of depression. She had been prescribed steroids which were causing her to gain weight, which was impacting on her confidence and triggering her depression. This in turn was affecting her relationship with her husband and her son. It was a real cyclical effect that was causing her to feel isolated.
She realised that she needed to change this cycle so together we developed her plan and I was able to look at activities to support her. She felt that she couldn’t go to the gym because of the pain it caused her knees, so I suggested swimming.
Getting a swimming costume was a big deal for her because of her body image challenges and it took us two or three weeks to overcome that, through lots of reassurance and text message conversations, and I was delighted when she text me one day to say she’d got a costume in the brightest colour she could find!
From there, we went swimming together. By the end of the 12 interventions that SPRING offered, she’d reached 76 lengths and was reporting that she’d lost five pounds, had started gardening at home again which she’d previously had to stop because of the pain caused by her arthritis, and found that her relationships were improving.
She was also able to walk longer distances before experiencing pain, particularly when shopping.
For me, this is a shining example of social prescribing in action.
THE FUTURE OF SOCIAL PRESCRIBING
The future is bright for social prescribing and link workers have a pivotal role to play in enabling it to fulfil its potential.
Developing partnerships will continue to be crucial, particularly in the voluntary sector where resources are tight. This is something that we need to continue to focus on, as well as developing that culture change within the NHS, whilst not losing sight of the fact that social prescribing must always be community led to be successful, whatever the pathway.
Volunteering is also an area at SPRING that I am working to develop. I’ve realised that I can’t fit every personality type of people that might be referred to us, and we need to continue to offer people diversity, and so I am currently recruiting volunteers to support this, which is proving a big success.
The more we can raise awareness of the real difference that community led social prescribing initiatives can make, the more lives we’ll be able to change and I’m really excited for what lies ahead for our work.
Rachel Studzinski, Health in Mind, SPRING Social Prescribing Development Worker
Rachel is passionate about equality and supporting social change that drives equality. She is the Health in Mind, Spring Social Prescribing Development Worker in the Scottish Borders. Heer role involves working collaboratively with primary care to offer non-medical interventions to patients.
What characteristics, training / qualifications, and competencies should they have?
There are no formal qualifications or competencies required to become a social prescribing link worker (SPLW). However, it is recommended that one has the following:
An understanding of the wider determinants of health, including social, economic, and environmental factors, and their effect on individuals, communities, and families
Demonstrable commitment to professional and personal development
Experience of partnership / collaborative working, and of building relationships across a variety of organisations
Experience of working directly in a community development context, adult health and social care, learning support or public health / health improvement (including unpaid work)
Knowledge of the personalised care approach
NVQ Level 3, Advanced level or equivalent qualifications or working towards (recommended by NHS, but entirely up to local partners whether or not this is included, so you may want to check)
Training in motivational coaching and interviewing, or equivalent experience
Additionally, NHS Careers recommend that SPLWs possess the following characteristics:
Excellent listening and communication skills
Empathy
Emotional resilience
Open-mindedness
A willingness to work as part of team
Good IT and record keeping skills
A willingness to undertake training and develop skills
For more information:
NHS Health Careers: Social Prescribing Link Worker
The NHS Health Careers page on social prescribing link workers (SPLWs).
Are there any requirements to receive ARRS funding?
As noted under ‘Is funding available for them?‘, social prescribing link workers (SPLWs) can be reimbursed via the Additional Roles Reimbursement Scheme (ARRS). However, to be eligible for this funding, there are requirements that SPLWs must adhere to.
For instance, as stated in Annex B of the Network Contract Directed Enhanced Service contract specification 2021 / 22:
“B3.3. Where a PCN employs or engages one or more Social Prescribing Link Workers under the Additional Roles Reimbursement Scheme or sub-contracts provision of the social prescribing service to another provider, the PCN must ensure that each Social Prescribing Link Worker providing the service has the following key responsibilities in delivering the service to patients:
as members of the PCN’s team of health professionals, take referrals from
the PCN’s Core Network Practices and from a wide range of agencies to
support the health and wellbeing of patients;
assess how far a patient’s health and wellbeing needs can be met by
services and other opportunities available in the community;
co-produce a simple personalised care and support plan to address the
patient’s health and wellbeing needs by introducing or reconnecting
people to community groups and statutory services, including weight
management support and signposting where appropriate and it matters to the person;
evaluate how far the actions in the care and support plan are meeting the
patient’s health and wellbeing needs;
provide personalised support to patients, their families and carers to take
control of their health and wellbeing, live independently, improve their
health outcomes and maintain a healthy lifestyle;
develop trusting relationships by giving people time and focus on ‘what
matters to them’;
take a holistic approach, based on the patient’s priorities and the wider
determinants of health;
explore and support access to a personal health budget where
appropriate;
manage and prioritise their own caseload, in accordance with the health
and wellbeing needs of their population; and
where required and as appropriate, refer patients back to other health
professionals within the PCN.”
For more information:
Network Contract DES contract specification 2021 / 22
Provided by NHSE / I, this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.
As noted in the Network Contract Directed Enhanced Service contract specification 2021 / 22, a primary care network (PCN) should provide a GP supervisor for the social prescribing link worker(s) (SPLWs).
NHS England & NHS Improvement (NHSE / I) elaborate on the specifics of this supervision in their induction guide, as follows:
“Your PCN will appoint a GP supervisor to provide direct supervision for your work. They will meet you regularly, provide line management, address any issues or concerns and help you to succeed in the role. This will include ensuring that you can raise patient-related concerns (such as abuse, domestic violence, or other safeguarding issues) and can refer individuals back to other health professionals as relevant, for further support, review or monitoring.
Where social prescribing link workers are employed by a partner ‘social prescribing provider’ agency, the GP supervisor will still be required. In this arrangement, the GP supervisor will also need to involve the partner organisation in regular progress updates about your role, enabling clear lines of accountability, effective, seamless, joint working and problem-solving challenges together.”
The guide also adds, separate from having a GP supervisor, that:
“As well as the ongoing support you will receive from the GP supervisor, you should have regular access to clinical or non-managerial supervision both with your GP supervisor and other relevant health professionals within the PCN. This ‘clinical’ or non-managerial supervision will help you to manage the emotional impact of your work and be guided by clinicians on dealing effectively with patient risk factors.”
For more information:
Induction Guide for Social Prescribing Link Workers
Provided by NHS England & NHS Improvement (NHSE / I), this document serves an induction guide for social prescribing link workers (SPLWs) starting employment in a primary care network.
Conveniently, NHS England & NHS Improvement (NHSE / I) have put together an induction guide for social prescribing link workers joining a primary care network. This seventeen-page document can signpost you to a range of resources and covers the following topics:
Why does social prescribing matter?
Who do you work for — and what is a primary care network?
What will be you be doing as a social prescribing link worker?
And more…
For more information:
Induction Guide for Social Prescribing Link Workers
Provided by NHS England & NHS Improvement (NHSE / I), this document serves an induction guide for social prescribing link workers (SPLWs) starting employment in a primary care network.
NHS England & NHS Improvement (NHSE / I) have, in their social prescribing link worker (SPLW) induction guide, compiled a list of available support structures and mechanisms — including an online learning community, accessible by contacting england.socialprescribing@nhs.net.
The Hub's SPLW Lead
Our Profession Lead for Social Prescribing Link Workers (SPLWs) is Jeannie Morrice, here to provide a point of contact for this role, help set objectives and career goals, and to keep you in the loop with SPLW-related work.
Jeannie can be contacted at jeannie.morrice@nhs.net using the button below.
NHSE / I Services
Included in their induction guide for social prescribing link workers (SPLWs), NHS England & NHS Improvement (NHSE / I) have compiled a list of ongoing support and resources, including:
NHSE/I run fortnightly webinars on hot topics for SPLWs, accessible via FutureNHS. There is also a page signposting further training e.g. in personalised care, mental health & wellbeing, safeguarding and children & young people: https://future.nhs.uk/socialprescribing/view?objectID=22956656
Training & Support from the BNSSG Training Hub:
BNSSG Training Hub has worked with the 6 locality VCSE anchor organisations to create peer support groups for SPLWs. All BNSSG PCN link workers have been invited to attend their local group. The peer support groups started in summer 2020 and are currently running once a month. Please contact sarah.ballisat@nhs.net for more information
The BNSSH Training Hub have a SPLW Professional Lead to support SPLWs working in primary care in BNSSG and their employing PCNs. Our SPLW Lead is Jeannie Morrice, jeannie.morrice@nhs.net
Please note the BNSSG Training Hub are hoping to provide an accredited 2-day health coaching course from Spring/Summer 2022
Initial Support
See technical annexe for induction
Previous experience required?
There are no set entry requirements for this role because your life experience, personal qualities and values are generally more important than qualifications.
Some employers may ask for basic numeracy and literacy plus some IT skills and relevant work experience. Some may also require a qualification at level 3.
Once in a role, you will receive training and development to support you.
Below is the Network DES particulars for the SPLW role:
The Network Contract DES provides reimbursement for three personalised care roles based in primary care: Social Prescribing Link Workers, Health and Wellbeing Coaches and Personalised Care Coordinators. These roles form a resource for GPs and other primary care professionals to provide an all-encompassing approach to personalised care. In the context of the COVID-19 outbreak, these roles can also play a vital role in maintaining the health and wellbeing of those otherwise at risk of loneliness and social isolation. A single point of access is required for these roles to ensure that people receive the right support at the right time and to reduce the burden on general practice. This would generally be via the Social Prescribing Link Worker(s) who work with the other two roles to triage referrals.
8.5.2. A PCN’s Core Network Practices must identify a first point of contact for each Social Prescribing Link Worker, Health and Wellbeing Coach and Care Coordinator, in order to provide general advice and support, and (if different) a GP to provide supervision. This can be one or more named individuals within the PCN. Individual and group coaching supervision for the Health and Wellbeing coach role must also be available from a suitably qualified or experienced health coaching supervisor.
8.5.3. A PCN’s Core Network Practices must ensure the Social Prescribing Link Worker(s), Health and Wellbeing Coach(es) and Care Coordinator(s) can discuss patient related concerns and be supported to follow appropriate safeguarding procedures (e.g. abuse, domestic violence and support with mental health) with a relevant GP. This GP may be the patient’s named accountable GP, or another GP within the relevant Core Network Practice as appropriate.
8.5.4. Supporting guidance providing further information to help PCNs employ or engage Social Prescribing Link Workers, Health and Wellbeing Coaches and Care Co-ordinators is available at: a. Social prescribing link workers
Below is the Network DES particulars for the SPLW role:
The Network Contract DES provides reimbursement for three personalised care roles based in primary care: Social Prescribing Link Workers, Health and Wellbeing Coaches and Personalised Care Coordinators. These roles form a resource for GPs and other primary care professionals to provide an all-encompassing approach to personalised care. In the context of the COVID-19 outbreak, these roles can also play a vital role in maintaining the health and wellbeing of those otherwise at risk of loneliness and social isolation. A single point of access is required for these roles to ensure that people receive the right support at the right time and to reduce the burden on general practice. This would generally be via the Social Prescribing Link Worker(s) who work with the other two roles to triage referrals.
8.5.2. A PCN’s Core Network Practices must identify a first point of contact for each Social Prescribing Link Worker, Health and Wellbeing Coach and Care Coordinator, in order to provide general advice and support, and (if different) a GP to provide supervision. This can be one or more named individuals within the PCN. Individual and group coaching supervision for the Health and Wellbeing coach role must also be available from a suitably qualified or experienced health coaching supervisor.
8.5.3. A PCN’s Core Network Practices must ensure the Social Prescribing Link Worker(s), Health and Wellbeing Coach(es) and Care Coordinator(s) can discuss patient related concerns and be supported to follow appropriate safeguarding procedures (e.g. abuse, domestic violence and support with mental health) with a relevant GP. This GP may be the patient’s named accountable GP, or another GP within the relevant Core Network Practice as appropriate.
8.5.4. Supporting guidance providing further information to help PCNs employ or engage Social Prescribing Link Workers, Health and Wellbeing Coaches and Care Co-ordinators is available at: a. Social prescribing link workers – https://www.england.nhs.uk/publication/social-prescribing-link-workers
Induction Guide for Social Prescribing Link Workers
Provided by NHS England & NHS Improvement (NHSE / I), this document serves an induction guide for social prescribing link workers (SPLWs) starting employment in a primary care network.
NHSE / I Social Prescribing and Community-Based Support Summary Guide
Provided by NHS England & NHS Improvement (NHSE / I), this document is intended to outline what good social prescribing looks like and assist in implementing it.
"Care Coordinators play an important role within a PCN to proactively identify and work with people, including the frail/elderly and those with long-term conditions, to provide coordination and navigation of care and support across health and care
services. "
What ongoing support is available for care coordinators?
What are care coordinators?
Care coordinators work as part of the general practice multidisciplinary team (MDT) to identify people in need of proactive support; this could mean, as a examples, people living with frailty or with multiple long-term physical and mental health conditions. Care coordinators will work with these patients on a 1-2-1 basis, building trusting relationships, listening closely to what matters to them, and helping them to develop a personalised care plan.
As part of this work, care coordinators will review people’s needs and help to connect them with the services and support they require, whether that’s within the practice or elsewhere – for example, community and hospital-based services. They may support people in preparing for or following up clinical conversations they have with healthcare professionals, to enable them to be actively involved in managing their care and supported to make choices that are right for them.
They will work closely with social prescribing link workers and health and wellbeing coaches, referring people to them and also receiving referrals in return.
For more information:
NHSE / I Welcome Pack for Care Coordinators
Provided by NHS England & NHS Improvement (NHSE / I), this document serves as a welcome pack for care coordinators starting employment in a primary care network.
Surrey Training Hub have helpfully condensed the benefits provided by care coordinators, as follows:
Care coordinators are the patient’s go-to person if their needs change or if something goes wrong with service delivery: the care coordinator ensures that there are no gaps in the patient’s service provision, as many elderly and disabled people with highly complex needs struggle to coordinate with all the relevant services directly on their own
Care coordinators help improve patient education and understanding, and overall better health outcomes
They can help patients in avoiding unnecessary appointments, procedures, and tests, andto feel more empowered and actively engaged in their treatment
A more seamless service provision significantly decreases the risk of the patient deteriorating and thereby reduces the overall cost of care, and the likelihood that additional interventions will be needed in future
By identifying high-risk patient populations before they incur costlier medical intervention, employers can begin to reduce both practice expenses and total NHS costs
Employers can gain access to additional data that can reveal practice population health levels and risks; care coordinators glean information about patients’ treatment histories, medication adherence, new symptoms, and management of chronic conditions
For more information:
Surrey Training Hub Role Overivew
This is Surrey Training Hub’s overview for the care coordinator role.
According to Health Education England (HEE), a care coordinator should undertake the following activities, as part of their role:
Proactively identifying and working with a cohort of people to support their personalised care requirements
Supporting people to use decision aids in preparation for a shared decision making conversation
Bringing together a person’s identified care and support needs and exploring their options to meet these into a single personalised care and support plan, in line with person-centred service plan (PCSP) best practice
Helping people to manage their need, answering their queries, and supporting them to make appointments
Supporting people to take up training and employment, and to access appropriate benefits where eligible
Raising awareness of shared decision making and decision support tools and assisting people to be more prepared to have a shared decision making conversation
Ensuring that people are well-informed, to help them make choices about their care
Supporting people to understand their level of knowledge, skills, and confidence (Patient Activation Measure*) when engaging with their health and wellbeing, including through use of the patient activation measure
Assisting people to access self-management education courses, peer support, or interventions that support them in their health and wellbeing
Exploring and assist people to access personal health budgets where appropriate
Providing coordination and navigation for people and their carers across health and care services, alongside working closely with social prescribing link workers, health and wellbeing coaches, and other primary care roles
Supporting the coordination and delivery of multidisciplinary teams (MDTs) within PCNs
For more information:
HEE Care Coordinator Role Overview
Provided by Health Education England (HEE), this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of care coordinators.
As care coordinators are included on the additional roles reimbursement scheme (ARRS), funding is available for them; from April 2020, this role can be reimbursed at 100% of actual salary plus defined on-costs, up to the maximum reimbursable amount of £29,135 over12 months.
For more information:
HEE Care Coordinator Role Overview
Provided by Health Education England (HEE), this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of care coordinators.
Neither Health Education England (HEE) nor NHS England & Improvement (NHSE / I) presently have any case studies on care coordinators. Please stand by for an update.
What characteristics, training / qualifications, and competencies should they have?
Please find information on what you should look out for when employing a care coordinator below:
Training and Qualifications
Health Education England (HEE) state in their care coordinator role overview that:
“Care Coordinators require a strong foundation in enabling and communication skills as set out in the core curriculum for personalised care. These can be achieved via a two day health coaching skills course, as set out here.”
“Care coordinators should also access statuary and mandatory training, including but not limited to:
Principles of information governance, accountability and clinical governance
Maintenance of accurate and relevant records of agreed care and support needs
Identify when it is appropriate to share information with carers and do so
The professional and legal aspects of consent, capacity, and safeguarding“
Essex Primary Care Careers also suggest that, while the specifics may vary based on the exact post, care coordinators should have the following:
Diploma / HNC (e.g., in social work, occupational therapy, mental health) and / or NVQ Level 3 Business Admin
ECDL or equivalent
Completed Welfare Rights Training
Strong IT and administration skills, ideally including experience in the use of databases
Relevant experience of, as examples, working with healthcare professionals, social care or as part of a multi-disciplinary team within general practice, to achieve improved patient health outcomes, may be advantageous
Experience of the delivery of personalised care to a range of different patients
Knowledge of the types of care and support needs and how to access support and services for patients
For more information, please click here to read Essex Primary Care Careers’ page on care coordinators.
Skills and competencies
Health Education England (HEE) advocates that care coordinators should have the following skills and competencies:
Active and empathic listening
Effective questioning
Building trust and rapport
Shared agenda setting
Collaborative goal setting
Shared follow-up planning
Using simple health literate communication techniques such as teach-back
Structuring conversations using a coaching approach
Knowledge of the core concepts and principles of personalised care, shared decision making, patient activation, health behaviour change, self-efficacy, motivation, and assets-based approaches
For more information, please click here to read HEE’s role overview.
Any example job descriptions?
Neither Health Education England (HEE) nor NHS England & Improvement (NHSE / I) presently have any template job descriptions for care coordinators. Please stand by for an update.
Any sample interview questions?
Neither Health Education England (HEE) nor NHS England & Improvement (NHSE / I) presently have any sample interview questions for care coordinators. Please stand by for an update.
Are there any requirements to receive ARRS funding?
As noted under ‘Is funding available for them?‘, care coordinators can be reimbursed via the Additional Roles Reimbursement Scheme (ARRS). However, to be eligible for this funding, there are requirements that must be adhered to.
For instance, as stated in Annex B of the Network Contract Directed Enhanced Service contract specification 2021 / 22:
“B5.2. Where a PCN employs or engages one or more Care Coordinators under the Additional Roles Reimbursement Scheme, the PCN must ensure that each Care Coordinator has the following key responsibilities, in delivering health services:
utilise population health intelligence to proactively identify and work with a cohort of patients to deliver personalised care;
support patients to utilise decision aids in preparation for a shared decision-making conversation;
holistically bring together all of a person’s identified care and support
needs, and explore options to meet these within a single personalised
care and support plan (PCSP), in line with PCSP best practice, based on
what matters to the person;
help people to manage their needs through answering queries, making and managing appointments, and ensuring that people have good quality written or verbal information to help them make choices about their care, using tools to understand peoples level of knowledge, confidence in skills in managing their own health;
support people to take up training and employment, and to access appropriate benefits where eligible for example, through referral to social prescribing link workers;
assist people to access self-management education courses, peer support or interventions that support them to take more control of their health and wellbeing;
explore and assist people to access personal health budgets where appropriate;
provide coordination and navigation for people and their carers across health and care services, working closely with social prescribing link workers, health and wellbeing coaches, and other primary care professionals;
and support the coordination and delivery of MDTs within the PCN.
For more information:
Network Contract DES specification 2021 / 22
Provided by NHS England & Improvement (NHSE / I), this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.
Neither Health Education England (HEE), NHS England & Improvement (NHSE / I), nor the Personalised Care Institute have provided formal guidelines regarding what clinical supervisioncare coordinators require in primary care.
Please stand by for an update.
What should practice induction include?
Neither Health Education England (HEE), NHS England & Improvement (NHSE / I), nor the Personalised Care Institute have provided formal guidelines regarding what practice induction should look like for care coordinators.
Please stand by for an update.
What ongoing support is available for care coordinators?
NHS England & Improvement (NHSE / I) have, in their care coordinator welcome pack, compiled a list of available support structures and mechanisms — including an online learning community, accessible by contacting: england.supportedselfmanagement@nhs.net
NHSE / I Services
Included in their welcome pack for care coordinators, NHS England & Improvement (NHSE / I) have compiled a list of ongoing support and resources, including:
The Personalised Care Institute has a range of FREE training, resources, and podcasts available for care coordinators.
This includes training covering:
Core Personalised Care Skills — providing a holistic view of health and care, highlighting the benefits of personalised care, and demonstrating how it improves both health outcomes and patient / clinician satisfaction
Shared Decision Making
Personalised Care and Support Planning
The Personalised Care Institute also offers a two-day health coaching course, which allows attendees to discover and develop health coaching mindsets and skills tailored to activation. Feedback suggests that this training is experiential, authentic and immediately impactful.
OurCare Coordinator Profession Lead, Vicky Wood, and Personalised Care Project Manager, Jeannie Morrice, can answer any queries you may have around this personalised care role and provide signposts to additional resources and specific individuals working in this area.
Provided by Health Education England (HEE), this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of care coordinators.
Provided by NHS England & NHS Improvement (NHSE / I), this document serves as a welcome pack for care coordinators starting employment in a primary care network.
"Clinical pharmacists work in primary care as part of a multidisciplinary team in a patient facing role to clinically assess and treat patients using expert knowledge of medicines for specific disease areas."
Clinical pharmacists are primary care health professionals, who work in a patient-facing role as part of a multidisciplinary team (MDT) to clinically assess and treat patients using their specialised knowledge of medicines. They are responsible for medicines optimisation within their respective primary care network (PCN) and conduct clinical medication reviews for patients with complex polypharmacy, especially the elderly, care home residents, or individuals with multiple co-morbidities.
If not already able to prescribe, clinical pharmacists can achieve an independent prescribing qualification following completion of the Centre for Pharmacy Postgraduate Education’s (CPPE) 18-month pathway (completing this or an equivalent, approved course is necessary for clinical pharmacists receiving funding through the Additional Roles Reimbursement Scheme (ARRS)).
For more information:
HEE's Clinical Pharmacist Role Overview
Provided by HEE, this page offers a succinct look at the education and training requirements, skills and competencies, and work activities of clinical pharmacists.
This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.
Clinical pharmacists can help to ease the workload of and release time for GPs — as a case study provided by NSHEI suggests, the inclusion of a clinical pharmacist in an MDT can reduce the patient need for GP appointments to a significant degree (by 30% in the case of Wallingbrook Health Group, Devon). By extension, clinical pharmacists can help to decrease prescription error rates and medication-related, non-elective hospital admissions.
In short, clinical pharmacists can help to improve not only the quality of care provided to practice’s service-users, but also the efficiency and well-being of other members of staff.
Please read NHSEI Devon Case Study and Clinical pharmacists in general practice: a necessity not a luxury?below, for more information.
NHSEI Devon Case Study
Hosted by NHSEI, this case study examines the highly positive impact a clinical pharmacist had on practices in Devon.
The PCN DES clarifies the annual maximum reimbursable amount per role.
Pharmacists must be employed for at least 0.5WTE under the terms of the DES.
Pharmacists receiving funding through the Additional Roles Reimbursement Scheme (ARRS) must complete the 18-month Centre for Pharmacy Postgraduate Education (CPPE) Primary Care Pharmacy Education Pathway (PCPEP) unless they are exempt. For further details of the pathway including exemptions please see below and also Primary care pharmacy education pathway : CPPE. Pharmacists employed through the ARRS will need to complete their Independent Prescribing certificate at the end of the PCPEP.
Pharmacists must deliver the key responsibilities that are outlined in the DES.
There is currently no funding for pharmacists who are not employed under the terms of the PCN DES (ARRS)
NHSEI is able to provide a couple of case studies, focused on clinical pharmacists located in Devon and Norwich, and the valuable contributions they made to their respective practices.
For more:
NHSEI Devon Case Study
Hosted by NHSEI, this case study examines the highly positive impact a clinical pharmacist had on practices in Devon.
What characteristics, training / qualifications, and competencies should they have?
Please find information on what you should look out for when employing a clinical pharmacist below:
Personal Characteristics
Clinical pharmacists should have personal characteristics that are in keeping with the Standards for pharmacy professionals provided by the General Pharmaceutical Council, with the most recent standards being published in May 2017. They outline what is expected from pharmacy professionals, and serve as a reflection of how pharmacy professionals view themselves and their colleagues.
In short, clinical pharmacists should adhere to these nine standards:
Provide person-centred care
Work in partnership with others
Communicate effectively
Maintain, develop and use their professional knowledge and skills
Use professional judgement
Behave in a professional manner
Respect and maintain patient confidentiality and privacy
Speak up when they have concerns or when things go wrong
All pharmacists must be registered with the General Pharmaceutical Council (GPhC) and will need to revalidate with them each year. To be registered with the GPhC, pharmacists must have completed a GPhC-accredited or approved degree (in the UK this is now a 4-year Masters degree [MPharm] but previously was a 3-year Bachelors degree [BPharm]). Pharmacists will then undertake a Foundation Year training programme (formerly pre-registration year) which will be signed off by a tutor and undertake a registration exam. It is to be noted that some pharmacists will have completed their degree outside of the UK but all will have undertaken registration by the GPhC).
To be employed in primary care and for the PCN to receive funding from the Additional Roles Reimbursement Scheme (ARRS), there are additional criteria that pharmacists must meet – See appendix B of the PCN DES.
Are there any requirements to receive ARRS funding?
Pharmacists receiving funding through the Additional Roles Reimbursement Scheme (ARRS) must complete the 18-month Centre for Pharmacy Postgraduate Education (CPPE) Primary Care Pharmacy Education Pathway (PCPEP) unless they are exempt. For further details of the pathway including exemptions please see below link also Primary care pharmacy education pathway : CPPE. Pharmacists employed through the ARRS will need to complete their Independent Prescribing certificate at the end of the PCPEP.
A clinical pharmacist employed under the ARRS scheme must be employed for at least 0.5 WTE.
Pharmacists must deliver the key responsibilities that are outlined in the DES:
Where a PCN employs or engages one or more Clinical Pharmacists under the Additional Roles Reimbursement Scheme, the PCN must ensure that each Clinical Pharmacist has the following key responsibilities in relation to delivering health services:
work as part of a multi-disciplinary team in a patient facing role to clinically assess and treat patients using their expert knowledge of medicines for specific disease areas;
be a prescriber, or completing training to become prescribers, and work with and alongside the general practice team;
be responsible for the care management of patients with chronic diseases and undertake clinical medication reviews to proactively manage people with complex polypharmacy, especially the elderly, people in care homes, those with multiple co-morbidities (in particular frailty, COPD and asthma) and people with learning disabilities or autism (through STOMP – Stop Over Medication Programme);
provide specialist expertise in the use of medicines whilst helping to address both the public health and social care needs of patients at the PCN’s practice(s) and to help in tackling inequalities;
provide leadership on person-centred medicines optimisation (including ensuring prescribers in the practice conserve antibiotics in line with local antimicrobial stewardship guidance) and quality improvement, whilst contributing to the quality and outcomes framework and enhanced services;
through structured medication reviews, support patients to take their medications to get the best from them, reduce waste and promote self[1]care;
have a leadership role in supporting further integration of general practice with the wider healthcare teams (including community and hospital pharmacy) to help improve patient outcomes, ensure better access to healthcare and help manage general practice workload;
develop relationships and work closely with other pharmacy professionals across PCNs and the wider health and social care system;
take a central role in the clinical aspects of shared care protocols, clinical research with medicines, liaison with specialist pharmacists (including mental health and reduction of inappropriate antipsychotic use in people with learning difficulties), liaison with community pharmacists and anticoagulation; and
be part of a professional clinical network and have access to appropriate clinical supervision. Appropriate clinical supervision means:
each clinical pharmacist must receive a minimum of one supervision session per month by a senior clinical pharmacist
the senior clinical pharmacist must receive a minimum of one supervision session every three months by a GP clinical supervisor
each clinical pharmacist will have access to an assigned GP clinical supervisor for support and development; and
a ratio of one senior clinical pharmacist to no more than five junior clinical pharmacists, with appropriate peer support and supervision in place.
To read the full annex, please consult ARRS Minimum Role Requirementsbelow.
ARRS Minimum Role Requirements
This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.
Clinical Pharmacists can be employed under the ARRS scheme – see ‘Requirements to receive ARRS funding’ and ‘Is funding available for them?’ sections for further details of the requirements under the DES.
Clinical Pharmacists can be employed directly by the GP practice but would not qualify for any ARRS funding. They won’t have access to the Primary Care Pharmacy Education Pathway (PCPEP) but there is other training available.
Any example job descriptions?
NSHEI have developed a job description, in addition to a recruitment pack — these are both available on the FutureNHS site. Accessing the site requires you to create an account; once done, you can visit the role selection page to find the resources in question (click here to jump to the role selection page — remember, you will need to be logged in to access it).
Alternatively, you can download HealthWest’s job description by clicking here.
The Primary Care Pharmacy Association (PCPA) have also kindly provided several example job descriptions, for various bands of working, on their site, accessible via the buttonbelow.
The Primary Care Pharmacy Association (PCPA) kindly provides sample interview questions for clinical pharmacists on their website, accessible via the button below. The sample interview questions themselves are at the bottom of the page.
When employed in primary care under the Additional Roles Reimbursement Scheme (ARRS), clinical pharmacists must be part of a professional clinical network and receive clinical supervision. Specifically, they must have:
A minimum of one supervision session per month, delivered by a senior clinical pharmacist
Senior pharmacists should receive a minimum of one supervision session every three months, delivered by a GP clinical supervisor
All pharmacy professionals must have access to an assigned GP clinical supervisor, whom can provide support and development
There should be a ratio of one senior clinical pharmacist to five clinical pharmacists — and in all cases, appropriate peer support and supervision must be in place for each pharmacist
Sourced from:
ARRS Minimum Role Requirements
This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.
The Centre for Pharmacy Postgraduate Education (CPPE) offers training to become a clinical supervisor for individuals supervising pharmacy professionals on the CPPE Primary Care Pharmacy Education Pathway. This is a half-day workshop generally, but it can be completed by attending two webinars.
Interested individuals can apply for a space via the CPPE website, Primary care pharmacy education pathway : CPPE. If you are not a pharmacy professional, you will need to create an account on the site before you are able to book a place.
For more:
Primary Care Pharmacy Education Pathway
This page, produced by the Centre for Pharmacy Postgraduate Education (CPPE), elaborates on the clinical supervision requirements for clinical pharmacists working in primary care.
Practice induction for clinical pharmacists should include:
Signing them up on e-Learning for Health (e-LFH) to complete mandatory training | Please click here to access e-LFH
Signing them up on TeamNet, so that they can access relevant policies | Please click here to access TeamNet
Provide them with EMIS training, via the CCG
Familiarise them with the BNSSG Joint Formulary | Please click here to access it
Link with the CCG Medicines Optimisation Team, particularly if they should need Eclipse / Radar training
Provide them with Docman training
Those employed under the ARRS scheme need to apply to the CPPE Primary Care Pharmacy Education Pathway (PCPEP). This usually requires being added to a waiting list and you will need to enrol when enrolment is open. CPPE residential course booking. There is an exemption process which can be worked through if the pharmacist has specific relevant prior learning. The exemption process is available at Primary care pharmacy education pathway : CPPE. Whilst waiting for the cohort to start pharmacists are advised to complete the Primary Care essentials e-course which is part of module 1 of the pathway – Primary care essentials e-course : CPPE
It is advised that all pharmacists working in general practice should meet and shadow any current pharmacists, pharmacy technicians and prescription teams. They should also meet with all other members of the clinical and non-clinical teams and link in with the Training Hub Pharmacy Lead as well as their PCN / practice-assigned CCG Medicines Optimisation Pharmacist.
Those not employed under the ARRS scheme and are going to be completing Structured Medication Reviews (SMRs) under the DES, must have the skills and knowledge required to complete these. The DES states ‘ensure that only appropriately trained clinicians working within their sphere of competence undertake SMRs. The PCN must also ensure that these professionals undertaking SMRs have a prescribing qualification and advanced assessment and history taking skills, or be enrolled in a current training pathway to develop this qualification and skills.’ NHS England has produced guidance on SMRs – NHS England » Structured medication reviews and medicines optimisation 2021/22 and CPPE have published an exemption process – any pharmacist who is not enrolled on the PCPEP or who has not completed the PCPEP has to go through this equivalence recognition process in order to complete SMRs.
What ongoing support is available for clinical pharmacists?
The Training Hub is keen to support and develop pharmacists in general practice and the Pharmacy Lead can advise on any further support. Work is being undertaken to look at Training Needs Analyses of individual pharmacists to support professional development plans.
Please contact TH email inbox for further support@ bnssg.training.hub@nhs.net and see links below for further guidance
Literature
List of CPPE resources available to non-ARRS funded Pharmacists
This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.
This page, produced by the Centre for Pharmacy Postgraduate Education (CPPE), elaborates on the clinical supervision requirements for clinical pharmacists working in primary care.
