Category: Reimbursable Role Summaries

Concise summaries of the new, reimbursable roles, accompanied by links to additional reading and resources.

Occupational Therapist

Physician associates

Use their generalist medical education to work with GPs, physicians, and surgeons

Have been in the UK for over ten years, with the knowledge, skills, and attitude to deliver supervised holistic care in general practice

The Department of Health predicts there will be 1,000 qualified PAs across the country by the end of 2020

previous arrowprevious arrow
next arrownext arrow
Slider

Why an Occupational Therapist?

What can an Occupational Therapist do?

What is the scope of their practice?

What academic qualifications does an OT have?

Any example Job Description?

Any Case Studies?

Any Sample Interview questions?

What should practice induction include?

HEE Roadmap for Occupational Therapy

What clinical supervision do I need to provide?

What ongoing support can I provide?

Network Contract DES

Finance and DES-supported roles

Further Guidance

Resources

Why an Occupational Therapist?

Occupational Therapists (OTs)

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:

What is their scope of practice?

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.

What academic qualifications does an OT have?

To practice as an Occupational Therapist you will need to have attained the following:

  • BSc or pre reg MSc in Occupational Therapy under an approved training programme
  • Registered member of Health and Care Professions Council (HCPC)

Further information can be found on the below link to careers website:

What Skills & Characteristics?

Occupational Therapists need to have:

    • well-developed oral and verbal communication skills in order to develop a therapeutic relationship with your patients
    • interpersonal skills to connect with others and develop rapport with your patients
    • compassion and empathy
    • the ability to explain, encourage and build confidence
    • observation skills
    • the ability to think outside the box and work under pressure
    • decision-making skills and the ability to organise and plan your workload
    • a flexible approach to work
    • assessment and report writing skills
    • problem-solving skills
    • good creative and practical skills
    • teamworking skills, as you’ll often liaise with other professionals such as doctors and social workers
    • enthusiasm, sensitivity and patience to deal with a range of needs
    • computer literacy.

This profile is provided from the following source:

Skills Occupational therapist Link

Any example Job Description?

Please find an example job description for Occupational Therapist below

Any Case Studies?

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.

OT Case Study Link

Any Sample Interview Questions?

Some sample job interview questions you will want to ask an Occupational Therapist could include the following:

 

  1. What motivates you as an Occupational Therapist?
  2. Tell me about a time when you felt most proud as an Occupational Therapist…
  3. Describe two key skills required by an Occupational Therapist?
  4. What’s the worst thing about being an occupational therapist?
  5. How would you deal with a patient who is being confrontational or aggressive?
  6. How do you stay informed about new techniques and technology?
  7. What’s the role of an occupational therapist in a multi-disciplinary team?

For the weblink source please see below:

What should Practice Induction include?

TBC

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:

What ongoing support can I provide?

More information on how Training Hubs can provide support your PCN can be found on the HEE website (see below):

HEE Roadmap for Occupational Therapy

HEE Roadmap for Occupational Therapy:

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.

Network Contract DES

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:

B0431-network-contract-des-specification-pcn-requirements-and-entitlements-21-22

Finance & DES-supported roles

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.

Network DES

https://www.bnssgtraininghub.com/wp-content/uploads/B0431-network-contract-des-specification-pcn-requirements-and-entitlements-21-22-2.pdf

Guidance

You can contact our ACP Lead, Kerri Magnus at the BNSSG Training Hub for further information/support on this role see below link:

Kerri Magnus Contact

Email: [email protected]

Mob: 07841618247

Protected: Dietitian

This content is password protected. To view it please enter your password below:

Protected: Podiatrists

This content is password protected. To view it please enter your password below:

Health & Wellbeing Coach

Questions?

If you have any questions relating to health and wellbeing coaches, please send your queries to [email protected]

Health and Wellbeing Coaches

"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

previous arrowprevious arrow
next arrownext arrow
Slider

What are they?

What benefits can they bring?

What is the scope of their practice?

Is funding available for them?

Any case studies?

What characteristics, training / qualifications, and competencies should they have?

Are there any requirements to receive ARRS funding?

Any example job descriptions?

Any sample interview questions?

What clinical supervision do they need?

What should practice induction include?

What ongoing support is available for HWBCs?

What is a Health & Wellbeing Coach (HWBC)?

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).

To read it, please click here.

What benefits can they bring?

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).

To read it, please click here.

What clinical supervision do they need?

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.

To read it, please click here.

What should practice induction include?

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.

To read it, please click here.

What ongoing support is available for HWBCs?

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:

[email protected]

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:

  • Online health and wellbeing coach learning
  • National ‘share and learn’ lessons
  • Learning, developmental, and peer support
  • Online collaboration

To read it, please click here.

Personalised Care Institute

The Personalised Care Institute has a range of FREE training, resources, and podcasts available for health and wellbeing coaches (HWBC).

To find out more, please click here.

What is the scope of their practice?

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).

To read it, please click here.

Is funding available for them?

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).

To read it, please click here.

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).

To read it, please click here.

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.

To read it, please click here.

Any example job descriptions?

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.

To read it, please click here.

Any example sample interview questions?

NHS England & Improvement (NHSE / I) have produced a recruitment pack featuring sample interview questions.

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.

To read it, please click here.

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).

To read it, please click here.

Literature
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).

To read it, please click here.

Network Contract DES contract specification 2021 / 22

Provided by NHSE / I, this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.

To read it, please click here.

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).

To read it, please click here.

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).

To read it, please click here.

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.

To read it, please click here.

A / V resources
Health and Wellbeing Coaches - A Typical Day

A short video provided by Cumbria City Council, which offers an insight into the day-to-day work of health and wellbeing coaches (HWBCs).

To watch it, please click here.

[This video was uploaded on 11.07.18.]

Social Prescribing Link Worker

Questions?

If you have any questions relating to mental health support workers, please send your queries to [email protected]

Social Prescribing Link Workers

"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

previous arrowprevious arrow
next arrownext arrow
Slider

What are they?

What benefits can they bring?

What is their scope of practice?

Is funding available for them?

Are there any case studies?

What characteristics, training / qualifications, and competencies should they have?

Are there any requirements to receive ARRS funding?

What employment routes are there?

Any example job descriptions?

What clinical supervision do they need?

What should practice induction include?

What ongoing support is available for SPLWs?

What are social prescribing link workers (SPLWs)?

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.

To read it, please click here.

Diagram sourced from NHSE / I’s Induction 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?

[2] Dayson, C. and Bashir, N. (2014), The social and economic impact of the Rotherham Social Prescribing Pilot. Sheffield: Sheffield Hallam University: https://www4.shu.ac.uk/research/cresr/sites/shu.ac.uk/files/socialeconomicimpactrotherham.pdf

[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

[5] RCGP (2018), Spotlight on the 10 High Impact Actions: http://www.rcgp.org.uk/aboutus/news/2018/may/rcgpcallsongovernmenttofacilitatesocialprescribingforallpractices.aspx (accessed 2 June 2018)

What benefits can SPLWs bring?

Principally, social prescribing link workers (SPLWs) can help to ease the workload and 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’s Social 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.

To read it, please click here.

Is funding available for them?

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.

For more information:

Network Contract Directed Enhanced Service: Additional Roles Reimbursement Scheme Guidance

Provided by NHS England & NHS Improvement (NHSE / I), this guidance document provides information on the Additional Roles Reimbursement Scheme (ARRS).

To read it, please click here.

This is custom heading element

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.

To read it, please click here.

Are there any case studies?

As it turns out, NHSE / I have helpfully put together a page full of case studies for the social prescribing link worker (SPLW) role.

To access it, please use the button below.

What employment routes are there?

As it turns out, NHSE / I have helpfully put together a page full of case studies for the social prescribing link worker (SPLW) role.

To access it, please use the button below.

What can a Social Prescribing Link Worker do?

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.

NHS England Link

The above information can be found at NHS England » Expanding our workforce

Previous relevant experience

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.

Any Sample Case Studies?

 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.

 

A day in the life of a SPLW?

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 studinksi

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).

To read it, please click here.

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.

To read it, please click here.

What clinical supervision do they need?

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.

To read it, please click here.

What should practice induction include?

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.

To read it, please click here.

What ongoing support is available for SPLWs?

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 [email protected].

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 [email protected] 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:

  • Learning, developmental and peer support
  • Regional learning co-ordinators
  • Online link worker learning
  • Online collaboration

To read it, please click here.

Example Job Description?

Health Education England (HEE) have not yet produced a template job description. Please check back for future updates.

What supervision do I need to provide?

See technical annexe

What Training & Development is available for SPLW?

Training and support from NHSE/I & HEE:

 

 

 

 

 

 

 

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 [email protected] 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, [email protected]

 

Personalised care training:

The recommended training for SPLWs is as follows:

(Modules include: Core skills, Shared Decision Making, Personalised Care & Support Planning, Person Centred Approaches)

 

 

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.

Health Careers Webpage

Pleased full details of requirements etc on the health careers site: Social prescribing link worker | Health Careers

The DES Role Descriptors

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

Network Contract DES

Finance & Network DES

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

This can be found in the Network DES contract document, in chapter 8: Document template (england.nhs.uk)

Here is a reference guide, provided by NHS England which is aimed at primary care for the social prescribing link worker role:

NHS England report template – data icon

Finance and DES-supported roles

This can be found in the Network DES contract document, in chapter 8: Document template (england.nhs.uk)

Here is a reference guide, provided by NHS England which is aimed at primary care for the social prescribing link worker role:

NHS England report template – data iconB0431-network-contract-des-specification-pcn-requirements-and-entitlements-21-22

Network Contract Links

This can be found in the Network DES contract document, in chapter 8: Document template (england.nhs.uk)

Here is a reference guide, provided by NHS England which is aimed at primary care for the social prescribing link worker role:

NHS England report template – data iconB0431-network-contract-des-specification-pcn-requirements-and-entitlements-21-22

Finance and DES-supported roles

This can be found in the Network DES contract document, in chapter 8: Document template (england.nhs.uk)

Here is a reference guide, provided by NHS England which is aimed at primary care for the social prescribing link worker role:

NHS England report template – data iconB0431-network-contract-des-specification-pcn-requirements-and-entitlements-21-22

Personalised Institute training links

Health Careers Webpage

Pleased full details of requirements etc on the health careers site: Social prescribing link worker | Health Careers

Literature
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.

To read it, please click here.

Network Contract DES contract specification 2021 / 22

Provided by NHSE / I, this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.

To read it, please click here.

NHSE / I Case Studies

Provided by NHS England & NHS Improvement (NHSE / I), this webpage features a wealth of case studies on social prescribing link workers.

To read it, please click here.

Network Contract Directed Enhanced Service: Additional Roles Reimbursement Scheme Guidance

Provided by NHS England & NHS Improvement (NHSE / I), this guidance document provides information on the Additional Roles Reimbursement Scheme (ARRS).

To read it, please click here.

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.

To read it, please click here.

NHS Health Careers: Social Prescribing Link Worker

The NHS Health Careers page on social prescribing link workers (SPLWs).

To read it, please click here.

A / V resources
Social prescribing in practice: supporting social prescribing link workers

A series of short films produced by NSHE / I, exploring the impact that social prescribing can make on people, communities, and systems.

To watch it, please click here.

[This video was uploaded on 25.01.22.]

Care Coordinator

Questions?

If you have any questions relating to health and wellbeing coaches, please send your queries to [email protected]

Care Coordinators

"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. "

Source: HEE's Care Coordinator Role Overview

previous arrowprevious arrow
next arrownext arrow
Slider

What are they?

What benefits can they bring?

What is their scope of practice?

Is funding available for them?

Any case studies?

What characteristics, training / qualifications, and competencies should they have?

Are there any requirements to receive ARRS funding?

Any example job descriptions?

Any sample interview questions?

What clinical supervision do they need?

What should practice induction include?

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.

To read it, please click here.

What benefits can they bring?

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, and to 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.

To read it, please click here.

What is their scope of practice?

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.

To read it, please click here.

Is funding available for them?

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 over 12 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.

To read it, please click here.

Any case studies?

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

To read HEE’s role overview, please click here.

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.

To read it, please click here.

What clinical supervision do they need?

Neither Health Education England (HEE)NHS England & Improvement (NHSE / I), nor the Personalised Care Institute have provided formal guidelines regarding what clinical supervision care 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:

[email protected]

NHSE / I Services

Included in their welcome pack for care coordinatorsNHS England & Improvement (NHSE / I) have compiled a list of ongoing support and resources, including:

  • Online care coordinator learning
  • Online collaboration
  • Learning, developmental, and peer support
  • Supported self-management mentors

To read it, please click here.

Personalised Care Institute

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.

To find out more, please visit their site here.

Training Hub Personalised Care Lead

The Training Hub’s Personalised Care Lead, Dr. Sarah Ballisat, 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.

To contact Dr. Ballisat, please click here.

Literature
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.

To read it, please click here.

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.

To read it, please click here.

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.

To read it, please click here.

Surrey Training Hub Role Overivew

This is Surrey Training Hub’s overview for the care coordinator role.

To read it, please click here.

A / V resources

Mental Health Support Workers

Questions?

If you have any questions relating to mental health support workers, please send your queries to [email protected]

Mental Health Support Workers

"Working with other PCN-based roles, MHPs can address the potential range of biopsychosocial needs of patients with mental health problems, as part of a multi-disciplinary team."

Source: NHS Confederation's recruiting mental health practitioners through ARRS guide

previous arrowprevious arrow
next arrownext arrow
Slider

What are they?

What benefits can they bring?

What is their scope of practice?

Is funding available for them?

Any case studies?

What characteristics, training / qualifications, and competencies should they have?

Are there any requirements to receive ARRS funding?

Any example job descriptions?

Any sample interview questions?

What employment models are there?

What clinical supervision do they need?

What are mental health support workers?

Mental health support workers (MHSWs) are healthcare practitioners trained to support patients (both adults and children) with their mental health, as fully-embedded members of the PCN multidisciplinary team (MDT).

MHSWs work in a ‘first contact’ role, typically seeing patients referred to them by their GP colleagues. Specifically, MHSWs work with patients to support shared decision making about self-management, enable access to treatment services, and – where appropriate – conduct brief psychological interventions. As part of their role, MHSWs work closely with other members of the MDT to address a range of biopsychosocial needs.

While MHSWs are deployed by the PCN, and operate as part of their workforce, they should be employed and provided by the local community mental health service provider. A local service agreement will confirm this arrangement.

This role can be undertaken by any registered clinician working at Band 5 or above, such as:

  • Community psychiatric nurses
  • Clinical psychologists
  • Mental health occupational therapists

This should be agreed between the PCN and community mental health service 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.

To read it, please click here.

NHS Confederation's MHSW guide

Provided by NHS Confederation, this document provides a brief outline of how MHSWs can be recruited via the additional roles reimbursement scheme (ARRS) and the benefits of doing so.

To read it, please click here.

What can a Mental Health Support Worker do?

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:

 

Band 6 Mental Health Practitioner (ARRS BNSSG) AGREED 04.08.21

What is their scope of practice?

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.

To read it, please click here.

What are the benefits of a mental health support worker?

Mental health support workers can bring a wide range of benefits to both their PCN and patients, as follows (sourced from NHS Confederation):

  • Benefits for PCNs:
    • No formal referral processes required
    • Practitioner works as part of the PCN MDT
    • Provides a bridge between primary care and specialist mental health providers
    • Can draw on a range of provider mental health services
    • Reduces employment burden
    • Improved integration between primary care and mental health
  • Benefits for patients:
    • Integrated pathway for patients
    • Access to specialist mental health support services
    • Reduced waiting times
    • Prevention of referral into secondary care
    • Positive patient experience

For more information:

NHS Confederation's MHSW guide

Provided by NHS Confederation, this document provides a brief outline of how MHSWs can be recruited via the additional roles reimbursement scheme (ARRS) and the benefits of doing so.

To read it, please click here.

Is funding available for them?

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.

To read it, please click here.

What characteristics, training / qualifications, and competencies should they have?

Please find information on what you should look out for when employing a mental health support worker below:

Personal Characteristics

The Avon and Wiltshire Mental Health Partnership (AWP) suggests that mental health practitioners 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: this 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.

Training and Qualifications

The Avon and Wiltshire Mental Health Partnership (AWP) suggests that mental health practitioners 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, and a commitment to CPD
Competencies

This is an emerging role — we hope to have more information here in due course.

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.

To read it, please click here.

Any example job descriptions?

Avon and Wiltshire Mental Health Partnership (AWP) have a job description appropriate to this role, featuring a role summary and description of its duties, in addition to an example person specification.

For more information:

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.

To read it, please click here.

Any case studies?

Pulse Intelligence can provide a case study on the impact of implementing a mental health support worker (MHSW), written by Dr. Sophie Kilmartin in 2019 and relating to a practice based in South Gloucestershire. Please consult the full case study below, but the summary reads as follows:

“Our mental health practitioner is a key member of our clinical team. She provides an important service to our patients and we plan to carry on the role in the future. It is easy to forget how much she has eased our workload, but we get a glimpse of that when she is on annual leave and the clinics go back to how they used to be.”

Source:

Pulse Intelligence MHSW case study

Published by Pulse Intelligence, this case study was written by Dr. Sophie Kilmartin in 2019 and relates to the implementation of a mental health support worker (MHSW) in a practice in South Gloucestershire.

To read it, please click here.

Any sample interview questions?

Below is a set of sample interview questions:

  • “What are you able to bring to this post?”
  • “Can you recall a stressful experience you’ve had in the workplace — how did you resolve it?”
  • “What are your strengths and weaknesses?”
  • “How would you assess a patient’s needs?”
  • “How would you monitor a patient’s well-being?”
  • “How would you develop a patient’s treatment plan?”
  • “How do you go about defining professional boundaries between yourself and patients, and how do you maintain them?”
  • “How do you minimise risks to your clients and to yourself?”
What employment models are there?

As of April 2021mental health support workers (MHSWs) are included in the additional roles reimbursement scheme (ARRS), owing to a wider transformation of community mental health services for adults and older adults that seeks to bridge the gap between primary and secondary mental health care / physical and mental health services. The full list of measures included in this transformation can be found in the source document below.

But against this backdrop, all PCNs are now entitled to a fully-embedded mental health support worker, employed and provided by the local community mental health service provider. The PCN will be responsible for 50% of the MHSW’s salary and of other costs associated with the role, while the remaining costs are paid for by the community mental health provider. The PCN contribution will be reimbursable via the ARRS, however, up to the maximum reimbursable amount associated with the banding of this role.

This model provides the following benefits for PCNs:

  • PCNs need only fund 50% of the role, while getting the full capacity benefit
  • PCNs do not need to manage the recruitment process, the community mental health service provider does; as such, the MHSW can be deployed more swiftly
  • The role itself if flexible and can be developed based on local needs and circumstances
  • The role will be embedded within the PCN as a shared resource, working across both the PCN core team and their local mental health provider so as to support access to a wider range of community mental health services. This is intended to eliminate current barriers to accessing services and support a genuinely integrated approach across the system.

For more information:

Innovative Employment Models for PCNs

Provided by NHSE / I, this document outlines the different employment models open to primary care networks (PCNs), including for mental health support workers (MHSWs).

To read it, please click here.

What clinical supervision do they need?

There is not yet any detailed guidance on or requirements for clinical supervision for mental health support workers (MHSWs).

But as stated in Annex B of the Network Contract Directed Enhanced Service contract specification 2021 / 22:

  • 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.”

Please stand by until more information becomes available.

Source:

Network Contract DES contract specification 2021 / 22

Provided by NHSE / I, this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.

To read it, please click here.

What ongoing support is available for MHSWs?

Currently, mental health support workers (MHSWs) can receive ongoing support from: ???

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:

https://www.e-lfh.org.uk/programmes/new-roles-in-primary-care/

The DES Role Descriptors

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:

B0431-network-contract-des-specification-pcn-requirements-and-entitlements-21-22

Literature
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.

To read it, please click here.

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.

To read it, please click here.

Innovative Employment Models for PCNs

Provided by NHSE / I, this document outlines the different employment models open to primary care networks (PCNs), including for mental health support workers (MHSWs).

To read it, please click here.

Network Contract DES contract specification 2021 / 22

Provided by NHSE / I, this document outlines the Network Contract Directed Enhanced Service (DES) for 2021 / 22.

To read it, please click here.

NHS Confederation's MHSW guide

Provided by NHS Confederation, this document provides a brief outline of how MHSWs can be recruited via the additional roles reimbursement scheme (ARRS) and the benefits of doing so.

To read it, please click here.

Pulse Intelligence MHSW case study

Published by Pulse Intelligence, this case study was written by Dr. Sophie Kilmartin in 2019 and relates to the implementation of a mental health support worker (MHSW) in a practice in South Gloucestershire.

To read it, please click here.

A / V resources

There is nothing here yet. Please check back later.

Clinical Pharmacist

Questions?

If you have any questions relating to clinical pharmacists, please send your queries to us at [email protected]

Clinical Pharmacists

"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."

Source: HEE's Role Overview

previous arrowprevious arrow
next arrownext arrow
Slider

What are they?

What benefits can they bring?

What is their scope of practice?

Is funding available for them?

Are there any case studies?

What characteristics, training / qualifications, and competencies should they have?

Are there any requirements to receive ARRS funding?

What employment routes are there?

Any example job descriptions?

Any sample interview questions?

What clinical supervision do they need?

What should practice induction include?

What ongoing support is available?

What are clinical pharmacists?

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.

To read it, please click here.

ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

What benefits can clinical pharmacists bring?

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.

To read it, please click here.

Clinical pharmacists in general practice: a necessity not a luxury?

From the British Journal of General Practice (February 2018), this article is linked to from Dorset Training Hub’s website.

To read it, please click here.

What is their scope of practice?

Clinical pharmacists are qualified to carry out the following activities, as part of their scope of practice:

  • Collaborate with care homes to provide support on medicines-related issues
  • Conduct clinical switching protocols and alternative prescribing policies
  • Conduct evidence-based Medicines and Best Practice reviews
  • Conduct structured medication reviews
  • Domiciliary reviews
  • Educate other members of their MDT and patients on the use of specific medicines
  • Manage polypharmacy and co-morbidity complexities
  • Provide high-risk medicines monitoring
  • Provide medicines information and advice to other members of their MDT, patients, and the general public
  • Provide medicines reconciliation, supporting safe transfers of care
  • Provide prescribing and clinic management (e.g., Minor Ailments Clinics)
  • Treat patients with complex long-term conditions, like “difficult” hypertension

Please note that this is not an exhaustive list, however.

For more information on the scope of practice of this profession, please consult HEE’s Clinical Pharmacist Role Overview and the Dorset Training Hub’s page on clinical pharmacists.

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.

To read it, please click here.

Dorset Training Hub's Clinical Pharmacist Page

Kindly provided by Dorset Training Hub, this page signposts to several useful documents exploring the role of clinical pharmacists.

To read it, please click here.

Is funding available for them?

HEE stipulates that from April 2020, clinical pharmacists will be reimbursed via the Additional Roles Reimbursement Scheme (ARRS) at 100% of actual salary plus defined on costs. This is up the maximum reimbursable amount of £55,670 over 12 months.

Source:

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.

To read it, please click here.

Are there any case studies?

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.

To read it, please click here.

NHSEI Norwich Case Study

Hosted by NHSEI, this case study examines the beneficial impact a clinical pharmacist had on practices in Norwich.

To read it, please click here.

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
  • Demonstrate leadership

To read the Standards themselves, which include a breakdown, please click here.

Training and Qualifications

Clinical pharmacists must have completed a General Pharmaceutical Council-accredited (GPhC) Master of Pharmacy (MPharm) degree. This is typically a full-time, four-year course, provided by a number of universities from across the country.

A clinical pharmacist should also be registered with the General Pharmaceutical Council (GPhC). To see what is required to register with the GPhC, please consult the guide linked below, published in January 2021.

To access it the guide, please click here.
For a list of all accredited courses and qualifications, please click here.

To be employed in primary care and receive funding from the Additional Roles Reimbursement Scheme (ARRS), there are additional criteria that pharmacy technicians must meet.

For a breakdown of these, please click here.

Competencies

Clinical pharmacists should have experience with the following competencies:

  • Working with GPs and patients to address medicine adherence
  • Reviewing patients on complex medicine regimens
  • Triaging and managing common ailments
  • Responding to acute medicine requests
  • Managing and prescribing for long-term conditions (often with the practice nurse)
  • Holding minor ailment clinics
  • Prescription management
  • Dealing with medication for patients recently discharged from hospital
  • Helping the practice deliver on the patients recently discharged from hospital
  • Helping the practice deliver on the Quality, Innovation, Productivity and Prevention (QIPP) and Quality Outcomes Framework (QOF) agenda and enhanced services
  • Delivering repeat prescription reviews
  • Being the point of contact for all medicine-related queries
  • Overseeing the practice’s repeat prescription policy
  • Taking over clinical medicines reviews from GPs
  • Audit and education
  • Medicines management
  • In dispensing practices, pharmacists can take responsibility for the business management of the dispensary

This list has been sourced from HEE’s Clinical Pharmacist Role Overview. To see the original, please click here.

Are there any requirements to receive ARRS funding?

As noted under ‘Is funding available for them?‘, clinical pharmacists can be reimbursed via the Additional Roles Reimbursement Scheme (ARRS). However, to be eligible for this funding, there are requirements that clinical pharmacists must adhere to.

For instance, as stated in Annex B of the Clinical Pharmacist Direct Enhanced Service (DES) contract:

  • “B1.1. Where a PCN employs or engages a Clinical Pharmacist under the Additional Roles Reimbursement Scheme, the PCN ensure that the Clinical Pharmacist is enrolled in, or has qualified from, an approved 18-month training pathway or equivalent that equips the Clinical Pharmacist to:
    • a. be able to practice and prescribe safely and effectively in a primary care setting (for example, the CPPE Clinical Pharmacist training pathways);
    • b. and deliver the key responsibilities outlined in section B1.2.”

Section B1.2. relates to the key responsibilities that clinical pharmacists must undertake.

To read the full annex, please consult ARRS Minimum Role Requirements below.

ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

What employment routes are there?

According to the General Pharmaceutical Council (GPhC), there are two routes to registration for clinical pharmacists intending to work in Great Britain. As laid out in their Criteria for registration document, the routes are:

  • Initial registration by UK- and internationally-qualified pharmacy technicians
  • Initial registration by an applicant not in possession of a relevant European qualification
  • Returning to registration after a period of absence

All three routes are detailed in the Criteria document, linked below. In addition to education and training checks, the registration routes also look at candidates’ health, character, identity, and grasp of the English language.

For more information:

GPhC Criteria for registration

Produced by the General Pharmaceutical Council (GPhC), this twelve-page document covers the requirements for clinical pharmacists wishing to practise in Great Britain (which requires registering with them). Last published in January 2021.

To access it, please click here.

Please note: to be employed in primary care and receive funding from the Additional Roles Reimbursement Scheme (ARRS), there are additional criteria that clinical pharmacists must meet.

For a breakdown of these additional requirements:

ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

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 button below.

Any sample interview questions?

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.

What clinical supervision do they need?

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.

To read it, please click here.

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, here. 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.

To read it, please click here.

What should practice induction include?

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
  • Set them up on the CPPE site and with access to Canvas, so they that can undertake the Centre’s e-Courses | Please click here for more information

Clinical pharmacists should be sure to meet and shadow your PCN’s current pharmacists and prescription team. They should meet practice manager(s), deputy practice manager(s), reception manager(s), reception lead(s), clinical staff, and their supervisor(s), in addition to the CCG’s Medicines Optimisation Pharmacist.

What ongoing support is available for clinical pharmacists?

There are various ways in which clinical pharmacists can receive support, including:

The ACP Forum

Organised and led by our ACP Lead, Kerri Magnus, The ACP Forum can assist clinical pharmacists on the journey to becoming an advanced clinical practitioner. The Forum can signpost to relevant education and training, provide 1-to-1 guidance, and facilitate networking with like-minded colleagues from across BNSSG.

To visit The ACP Forum’s site, please click here.

The Hub's Physiotherapy Lead

Our Profession Lead for Physiotherapy is Jo Clarke, here to provide a point of contact for clinical pharmacists, help set objectives and career goals, and to keep you n the loop with our pharmacy-related work.

Jo can be contacted at [email protected] using the button below.

Training Opportunities & Funding for General Practice Pharmacists

Compiled by Jo Clarke (Profession Lead for Pharmacy), this guide outlines the assortment of training opportunities and funding on offer for clinical pharmacists working in Bristol, North Somerset, and South Gloucestershire — whether they’re funded through the additional roles reimbursement scheme (ARRS), or by the CCG.

Version 1.2 is currently available, which was last updated on Wednesday 1 December.

To read it, please click here.

Centre for Pharmacy Postgraduate Education (CPPE)

The CPPE is part of the Division of Pharmacy and Optometry in the University of Manchester’s Faculty of Biology, Medicine, and Health. It is dedicated to providing professional development opportunities and support to pharmacy staff, including through coaching and networking.

To find out more, please click here.

Literature
ARRS Minimum Role Requirements

This appendix, from the Clinical Pharmacist DES Contract, clarifies the minimum requirements for clinical pharmacists receiving funding through the ARRS.

To read it, please click here.

Clinical pharmacists in general practice: a necessity not a luxury?

From the British Journal of General Practice (February 2018), this article is linked to from Dorset Training Hub’s website.

To read it, please click here.

Dorset Training Hub's Clinical Pharmacist Page

Kindly provided by Dorset Training Hub, this page signposts to several useful documents exploring the role of clinical pharmacists.

To read it, please click here.

GPhC Criteria for registration

Produced by the General Pharmaceutical Council (GPhC), this twelve-page document covers the requirements for clinical pharmacists wishing to practise in Great Britain (which requires registering with them). Last published in January 2021.

To access it, please click here.

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.

To read it, please click here.

NHSEI Devon Case Study

Hosted by NHSEI, this case study examines the highly positive impact a clinical pharmacist had on practices in Devon.

To read it, please click here.

NHSEI Norwich Case Study

Hosted by NHSEI, this case study examines the beneficial impact a clinical pharmacist had on practices in Norwich.

To read it, please click here.

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.

To read it, please click here.

Standards for pharmacy professionals

Regulated by the General Pharmaceutical Council, these standards outline what is expected of pharmacy professionals, including clinical pharmacists.

To read them, please click here.

A/V resources
I'd like to see the clinical pharmacist

Produced by NSHEI for the NHS’ 70th anniversary in 2018, this video explores the role of a clinical pharmacist in their primary care MDT.

To watch it, please click here.

[This video was uploaded on 07.05.19.]

Nursing Associates

Nursing ASSOCIATES

A new role in England, bridging the gap between care assistants and registered nurses

NURSING ASSOCIATES

Deliver hands-on, person-centred care for people of all ages, and in a variety of settings in health & social care

Nursing Associates

The NMC became the regulator for this role, in England, in July 2018

previous arrowprevious arrow
next arrownext arrow
Slider

What can nursing associates do?

What benefits can nursing associates bring?

What should I look for from a nursing associate?

What is their scope of practice?

What benefits can nursing associates bring?

How much training do they have?

Can I receive funding to employ them?

Can I see some case studies?

Am I eligible for the apprenticeship levy?

What academic qualifications should an NA have?

Any example job descriptions?

Any sample interview questions?

What clinical supervision do I need to provide?

Who can supervise a trainee nursing associate?

What ongoing support can I provide?

What can nursing associates do?

The nursing associate role is a new role in the NHS, bridging the gap between a healthcare support worker and a graduate registered nurse. Nursing associates are qualified at foundation-degree level and work with individuals of all ages / backgrounds, across a range of health and social care settings.

Nursing associates work alongside registered nurses, carrying out much of the same clinical duties and care, but they do not share the same status and therefore cannot perform certain tasks

What benefits can nursing associates bring?

The nursing associate role was introduced in 2015, in response to the Shape of Caring Review from Health Education England. This document stipulated that healthcare assistants and nurses require high-quality education and training, if they are to provide the highest standard of patient care, and identified three key problems within primary care:

  • A lack of training / development opportunities for HCAs, despite their supporting the bulk of over 60% of care work
  • An aging population with increasingly complex needs which demanded nurses delegate tasks more, so that they are able to focus on these complex issues
  • A shortage of nurses in the NHS and social care

Including nursing associates in your MDT will help address these issues and convey the following benefits:

  • Improved service delivery and patient care
  • Improved staff retention
  • A ‘grow your own’ nurse workforce
  • A tried-and-tested nursing programme, accredited by the NMC
  • Nursing associates, once qualified, can go on to registered nurse status
  • Providing supervision and preceptorships can improve recruitment and retention rates
Sources

HEE’s Why hire a nursing associate?
Click here

HEE’s Nursing Associates page
Click here

What should I look for from a nursing associate?

The Standards for Proficiency for nursing associates, as set out by the NMC, outlines six standards:

  • Be an accountable professional
  • Promote health and prevent ill health
  • Provide and monitor care
  • Work in a team
  • Improve safety and quality of care
  • Contribute to integrated care

Two annexes emphasise that nursing associates should be able to communicate effectively and sensitively, and to manage relationships with people, too.

For more information, please read the Standards themselves, by clicking the button below.

What is the scope of their practice?

Nursing associates work with people of all ages, in a variety of settings in health and social care; contribute to the core work of nursing; and free up registered nurses to focus on more complex clinical care.

Duties / areas nursing associates cannot perform:

  • Act autonomously to change the prescribed plan of care
  • Act autonomously in situations where there may be limits to confidentiality – for example, in safeguarding situations
  • Decide to make specialist referrals
  • Decide to share information across multiagency boundaries
  • Interpret and resolve risk issues (they must be able to identify risk and halt practice if necessary)
  • Decide to discharge an individual from a service
  • Manage situations of conflict or risk beyond immediate actions to maintain safety
  • Administer medicines under a patient group directive
  • Prescribe medicines
How much training do they have?

In addition to complying with the NMC’s Standards for Proficiency, registered nursing associates must have completed a foundation-level qualification approved by the NMC over the course of two years. This usually involves 2,300 hours of training and studying, split between academic and vocation-based learning.

A condition of the programme is that nursing associates must gain experience of all nursing areas: mental health, learning disability, adult, and children, to ensure they have the breadth and depth of knowledge and experience needed to support and enhance the quality of care. This is achieved by trainees taking on placements outside of their usual employment setting.

Can I receive funding to employ them?

As an employer, you can fund your nursing associate programme through the apprenticeship levy scheme. This is paid by all employers who have an annual bill of £3 million or more, which they can claim as funding for a max of 15,000 per employee.

Nursing associates are commonly taken on by employers via the apprenticeship route, but there are a number of self-funded university-level courses.

You can find out more about how you can employ nursing associates through the apprenticeship route below.

NAs and the apprenticeship levy: A quick guide for employers

To read this document from HEE, please click here.

Apprenticeships Procurement Toolkit: Guidance for Employers

To read this document from HEE, please click here.

Using the apprenticeship levy

To read this article from NHS Employers, please click here.

Your Future Nursing Associates infographic

To view this infographic from NHS Employers, please click here.

Can I see some case studies?

There are a number of case studies available from HEE, with many NHS Trusts across England – including Devon, Birmingham, Pennine, and Mersey – having employed nursing associates.

You can access these studies below. Please do note, though, that many of them pertain to settings other than primary and social care.

Am I eligible for the apprenticeship levy?

Employers with a payroll of more than £3 million can use their apprenticeship levy contributions to pay for places on apprenticeship programmes. Any business with a payroll below £3 million is eligible for government funding that will cover at least 95% of the cost of an apprenticeship course.

As an employer, you must be able to meet any costs exceeding the 15,000 per employee allowance, and this includes clinical supervision. For more information, please click the button below.

What academic qualifications should an NA have?

A nursing associate should have:

  • A foundation-level qualification accredited by the Nursing and Midwifery Council, completed over two years
  • This must include 2,300 hours of on-the-job training and academic study, with varied clinical placements
  • This is principally achieved through an apprenticeship or self-funded university route

Additionally, trainee nursing associates must:

  • Be employed within healthcare, for 30 hours+ per week
  • Have the support of their employers
  • Confirm eligibility for apprenticeship funding *
  • Have evidence of study at level 3 (e.g., A Levels, BTEC Health & Social Care, or evidence of ability to study at or above this level)
  • Level 2 / GCSEs in Maths and English, at C+
  • Have an Enhanced DBS Adult and Child Workforce, dated within the last 12 months
  • Have occupational health clearance from their employer

* Please note: entry requirements will vary between universities

Any example job descriptions?

At present, HEE have not issued any job description for the nursing associate role. However, it is clear that this will likely cover and include experience, skills, and attributes described in previous sections as core to the nursing associate role.

Once qualified, a nursing associate will be able to undertake skills including, but not limited to, compression bandaging, drug administration, cervical cytology and childhood immunisations.

Any sample interview questions?

At present, there are no guidelines on job interview questions. But HEE shall be releasing some guidance on the job description details for nursing associates in the near future.

What clinical supervision do I need to provide?

Trainee nursing associates are assigned a practice supervisor, a practice assessor, and an academic assessor. Practice supervisors can be any registered health and social care professional, though it is typically a registered nurse, in the case of nursing associates. Practice assessors cannot simultaneously be the supervisor for a student.

Supervision is outlined by the NMC’s employer guidance as follows:

  • Sharing, demonstrating, and providing support
  • Confidence building
  • Encouraging and developing reflective practice
  • Developing appropriate skills and competence
  • Supporting learning
  • Providing any required guidance, signposting, and information
  • Helping the trainee nursing associate to make progress

Additionally, whilst in your employ, trainee nursing associates should have:

  • A thorough induction into work
  • Preceptorship * and mentoring (especially if newly-qualified)
  • Ongoing access to professional development

For more information on supervision standards, supervision codes of conduct, and the * principles of preceptorship, please look below.

Standards for student supervision and assessment

To view this document from the NMC, please click here.

Practice supervisor preparation

To read this article from the NMC, please click here.

Principles of preceptorship

To read this article from the NMC, please click here.

Who can supervise a trainee nursing associate?

The curriculum framework states that supervision can be provided by an appropriate manager or any registered health professional (e.g., a registered nurse (across any of the professions)) working in practice that has been prepared to take up the role and is up-to-date on the knowledge and experience relevant to the student.

Supervision can be provided directly / face-to-face or indirectly / virtually.

What ongoing support can I provide?

You can:

  • Assign supervisors for each trainee nursing associate on placement
  • Manage both poor performance and recognise good performance — and, legally, you are responsible if a nursing associate carries out duties beyond their defined capacities and this results in errors or harm
  • Conduct annual appraisals, to review the progress and performance of nursing associates in your practice
  • Take all steps to improve management of the employee’s fitness to practice

You can read more about the support you should provide and your responsibilities by clicking the button below.

Additional literature
HEE's easy-read

To download HEE’s easy-read guide on nursing associates, click here.

Additional A/V resources
New Roles: Nursing Associate

To watch HEE’s video on the work of nursing associates and their invaluable opportunity the role provides, in the words of an nursing associate ambassador, please click here.

[This video was published on 25/10/19]

Becoming a nursing associate

To watch HEE’s video on becoming a nursing associate and joining the wider nursing team, please click here.

[This video was published on 08/01/20]

Physician Associates (PAs)

Physician associates

Use their generalist medical education to work with GPs, physicians, and surgeons

Have been in the UK for over ten years, with the knowledge, skills, and attitude to deliver supervised holistic care in general practice

The Department of Health predicts there will be 1,000 qualified PAs across the country by the end of 2020

previous arrowprevious arrow
next arrownext arrow
Slider

Questions?

If you have any questions relating to physician associates (PAs), please consider contacting the South West Physician Associate Network (SWPAN) by clicking here.

Join the SWPAN

If you’re a physician associate looking to network with other PAs in the South West, consider joining the South West Physician Associate Network (SWPAN); it was formed as a central hub to keep PAs across the region connected and up-to-date.

Find out more by clicking here.

NEW: What are they?

What can a physician associate do?

What should you look for from a PA?

What is their scope of practice?

How much training do they have?

NEW: Can I receive funding for a PA?

Can I see some case studies?

How should I go about recruiting a PA?

What academic qualifications should a primary care PA have?

Any example job descriptions?

Any sample interview questions?

What clinical supervision do I need to provide?

What ongoing support can I provide?

What should practice induction include?

NEW: What are they?

Physician associates (PAs) are clinical graduates, trained in the medical model and intended to seamlessly integrate with the modern healthcare workforce. They have received 5 years of training, having completed an intensive 2-year university course at diploma or Masters’ level and a 3-year biomedical or healthcare-related degree. With 37 Higher Education Institutes providing PA training programmes, there is an increasing number of qualified PAs in the UK.

PAs are intended not as a substitute for GPs, but as a complementary role, to work alongside the wider practice team in providing continuity of care for patients, especially those with long-term conditions. PAs can diagnose illnesses, develop management plans, and perform physical examinations (see What is their scope of practice? for more). With support, PAs can conduct themselves autonomously; they require a named consultant for supervision purposes, but as they gain experience, the necessary level of supervision will decrease.

What is a Physician Associate? [SWPAN]

Produced by SWPAN, this page outlines what PAs are and what their qualification process is like.

To visit this page, please click here.

Physician Associates in General Practice [Health Careers]

Available on the NHS Health Careers site, this page elaborates on the role of PAs in primary care specifically and serves as a landing page from which to learn more.

To visit this page, please click here.

Physician Associates in Primary Care [HEE]

Likewise, produced by HEE, this page also explores the role of PAs in primary care and offers links to further information.

To visit this page, please click here.

What can a physician associate do?

All PAs can:

  • Access, manage, and treat patients with a variety of acute conditions
  • Conduct telephone consultations
  • Develop and deliver appropriate treatment and management plans
  • Formulate differential diagnoses and management plans
  • Perform diagnostic and therapeutic procedures
  • Perform peak flow examinations
  • Perform physical examinations
  • Perform urine dip sticks
  • Provide health promotion and disease prevention advice
  • Request and interpret diagnostics studies
  • Review laboratory test results
  • See patients with undifferentiated diagnoses
  • Send out referrals
  • Take medical histories from patients
  • Triage patients

Some PAs can:

  • Carry out home visits (including to care homes)
  • Offer specialised clinics, including family planning
  • Run checks for COPD, asthma, diabetes, and anticoagulation

With more experience, PAs can:

  • Provide service development and design, serve as clinical placement leads for students, and undertake minor operations
What should you look for from a PA?

When identifying PAs to join their PCN, GPs should look for candidates whom:

  • Are recognised and qualified by the Faculty of Physician Associates (FPA) register
  • Are on the Managed Voluntary Register (click here to learn more)
  • Have completed their postgraduate medical training in PA studies
  • Have trained in the UK
What is their scope of practice?

A PA’s scope of practice covers:

  • Taking medical histories from patients
  • Carrying out physical examinations
  • Seeing patients with long-term chronic conditions
  • Formulating differential diagnoses and management plans
  • Performing diagnostic and therapeutic procedures
  • Developing and deliver appropriate treatment and management plans
  • Requesting and interpreting diagnostic studies
  • Providing health promotion and disease prevention advice for patients
Can I see some case studies?

Click here to read Physician Associates and how they could help your practice.

This document, produced by NHS Castle Point and Rochford, pertinently features a piece on the day-in-the-life of a physician associate, as well as some discussion of how they are educated and trained, and how to supervise a graduate PA in practice.

Click here to read about several examples of PA graduates working in general practice.

This document was produced by the University of the West of England.

Click here to find five more case studies from and about five PAs, ranging from students to senior PAs, at the RCP’s Faculty of Physician Associates site.

How should I go about recruiting a PA?
Recommended guidelines:
  • Ensure that your GP practice is clear on what role they need to fill, and the duties involved in primary care
  • Write a clear job description* detailing the duties of the role / what is expected of the PA. Bear in mind that the PCN will need to grant the PA some variation in working hours when offering the job position
  • Produce a clearly-defined and thorough job plan for the PA, taking into account CPD / career progression and a means by which to monitor their progress in primary care
  • Remember that newly-qualified PAs will require regular supervision
  • Allow for one dedicated GP / supervisor whom can get to know the PA, and vice versa

* Example job descriptions can be found in the ‘Any example job descriptions?’ section.

Click here to read HEE’s guide on recruiting PAs in general practice.

Click here to read An employers guide to physician associates.

This document was produced by the Royal College of Physicians’ Faculty of Physician Associates.

What academic qualifications should a primary care PA have?

A PA should have:

  • A post-graduate qualification consisting of 2 years of study, with 1,600 clinical hours and 1,600 hours of theory
  • An undergraduate degree in biomedical science / life sciences
Any example job descriptions?

To download a generic job description for a PA position, please click here.

For another example of a generic job description for a PA position, please click here.

To download a generic PA person specification, please click here.

Any sample interview questions?
  • What made you want to be a PA, not a doctor?
  • Why do you want to be a PA in primary care?
  • How do you see the role?
  • How do you deal with stress / teamwork / decision making?
  • What would you want to specialise or work towards in primary care?

  • Questions based around safeguardingScenarios might include:
    • You have a patient with a high NEWS score whom you think needs admitting, and your supervisor says they are able to go home. What do you do?
    • You have concerns regarding domestic violence and the person has a child with them. What do you do?
    • You are asked to stay late and hold a clinic beyond your level of competencies. What do you do?
What clinical supervision do I need to provide?

Each PA employed will require regular and ongoing supervision to develop in their role and within the PCN, with newly-qualified PAs requiring more than more experienced PAs.

Click here to download GP Supervisor and Physician Associate Guide: A step by step handbook for the first year in general practice as a PDF.

And click here to download it as a Word document.

What ongoing support can I provide?
  • You should provide one dedicated supervisor (a GP or otherwise) per PCN, whom the PA can get to know and form a bond with, and vice versa
  • There should be a six-month probation period with a review
  • The PA should be appraised on an annual basis
What ongoing support can I provide?
  • Employers should meet with PAs in their first week of work
  • Assess their skills and knowledge in and around general practice
  • Create a structured programme of specific educational goals
  • Establish a review process, with yearly appraisals and reviews every 3 – 6 months
NEW: Can I receive funding for a PA?

From April 2020, the PA role will be reimbursed at 100% of its actual salary plus defined on-costs, up to the maximum reimbursable amount of £53,724 over 12 months, via primary care networks.

As of 1 March, 2021, physician associates are on the list of healthcare professionals eligible to apply to the New to Partnership Payment Scheme (N2PP). This scheme offers participants up to £20,000, plus a contribution towards on-costs of up to £4,000 (for a full-time participant) and up to £3,000 as a training fund, all for PAs transferring into a partnership role.

PAs on N2PP

For more information on and a breakdown of N2PP, please click here.

How much training do PAs have?

PA students already have an undergraduate degree in life science, and / or a significant background in health care. To become a PA, students must complete a two-year, full-time, intensive postgraduate course at diploma or masters’ level in Physician Associate studies, which includes over 1,400 hours of clinical placement experience in both acute and community settings.

A new route to becoming a PA, via a four-year undergraduate Masters’ programme, is being considered.

Once qualified, PAs must maintain 50 hours of CPD per year and sit a re-certification exam every 6 years.

Additional literature
UWE's quick-reference placement guide

To download UWE’s easy-read guide on hosting PA students, click here.

HEE's easy-read

To download HEE’s easy-read guide on physician associates, click here.

South West Physician Associate Network

The South West Physician Associate Network (SWPAN) was formed as a central hub for PAs across the South West, enabling them to network, stay up-to-date, and contribute to the betterment of the profession as a whole.

To visit their site, please click here.

Additional A/V resources
A day in the life of a PA

To watch HEE’s video on the day in the life of a physician associate, click here.

Karen's storey #1

To watch part 1 of HEE’s video on physician associates working in general practice, click here.

Karen's storey #2

To watch part 2 of HEE’s video on physician associates working in general practice, click here.

South West ARRS Workforce Summit case study

To download HEE’s easy-read guide on physician associates, click here.

This website uses cookies to improve your experience; please consult our privacy policy for more information

Read more
X myStickymenu
Skip to content