King's College London

Background

In health and social care there is increasing interest in new work roles that can change how existing tasks and responsibilities are distributed. The NHSE Long-Term Workforce Plan (LTWP) distinguishes two sets of new roles in healthcare. One is designed to support other healthcare professionals, including nursing and physician associates and advanced practitioners. The other is designed to further the development of more personalised care. This includes care co-ordinator roles, health and wellbeing coaches, social prescribing link workers, and peer support workers.

Aims and objectives

This project will build on the Policy Research Unit’s (PRU) evaluation of the new Nursing Associate (NA) role in both health and social care.

• We will examine the nature of the new roles and the scale of their adoption.
• We will assess whether some are taken up with greater ease and why.
• We will consider why and how such roles have been introduced and managed.
• We will examine potential consequences for stakeholders including the postholder themselves, their managers, co-workers and people who use services.

Methodology

There are new, widely trialled national roles which can take many forms. However, there is also scope to examine whether health and social care commissioners and providers seek to re-design and develop new roles locally.

• We will map new roles to compile the new roles directory.
• We will purposefully select various new roles (likely to be about six). Some will cut across both health and social care and others will be found exclusively in their respective contexts. With each role, case studies will be conducted, involving interviews and focus groups with organisational managers; postholders and their co-workers; and people who use services.
• We will hold co-production design events with people who use services.
• We will interview expert policymakers and practitioners to look at current patterns in take up and the nature of roles in health and social care.

Timeframe

January 2024 – June 2026

Funding

NIHR Policy Research Programme: NIHR206121(04)

Policy relevance

New and enhanced work roles figure prominently in both the social care reform White Paper, Putting People at the Heart of Care (PPHC) and the NHSE Long Term Workplan (LTWP). New roles can be a way of addressing staffing shortages, providing development and upskilling opportunities, reducing pressures on registered staff and improving care quality. In spanning health and social care, there might well be important differences in whether and how new roles are adopted in the respective sectors, but also some shared learning about the related processes.

The proposed project will provide national policy makers with an evidence-base on the take -up and impact of new roles. It will provide fuller information about the form these roles take, and how challenges to their introduction might be addressed. The study will be of use to providers, commissioners and people who use services.

Involvement

24 April 2024: Caroline Norrie spoke about this study at the Unit PCIE Advisory Group. Questions for discussion at the meeting included:

1. Have you experience of being seen by staff working in new roles?
2. What new roles do you think are most useful?
3. We are proposing to explore i) care co-ordinator roles and ii) new roles in new contexts (e.g. Nursing Associates in a new clinical speciality). Is that a good idea and what is important to explore in relation to these roles? e.g. training needs?
4. What factors improve embedding of new roles in different areas?
5. Do you think the public understand contributions/role of practitioners in these new roles? How could this be improved?
6. How will we identify the more organically, locally evolving roles?
7. How can we design co-production events and best involve service users in this study?

Dissemination

The main outputs from this study will be a report of findings and a directory of new roles. All participants will receive a copy of the summary and recommendations. The full report will be published online on the Unit’s website. We will also prepare further outputs throughout the project, working with PPIE representatives, local partners (Applied Research Collaboration South London and Making Research Count) and national stakeholders. We will present findings at academic conferences and publish at least one article in a peer reviewed journal.