Additional Roles Reimbursement Scheme (ARRS)

• New roles in the PCNs – how to make the most of the new services webinar –   What does the next phase of the PCN evolution look like? In this webinar, recorded on 8 September 2020, the Practice Managers Association explores the scope and breath of the new roles in PCNs with a discussion around the challenges and opportunities.

• Future NHS– this site has lots of resources, information and case studies that can help you regarding specific roles- it is free to sign up to with your NHS email address. NHS Futures NEW ROLES

• Allied Health Professions (AHPs) provide system-wide care to assess, diagnose and treat patients. They focus on improving health and wellbeing to allow individuals to maximise the potential to live full and active lives – for more information on AHPs in Primary Care Networks, and example job descriptions, click here.

• The Roadmap Supervision – Top Up Session for GP Educational Supervisors (GP ESs) video provides a supportive additional training session to the existing GP Educator Supervisors training. It helps support understanding of the roadmap training for first contact practitioners and advanced practitioners.

Clinical pharmacists 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.

The Clinical Pharmacist role has already been introduced in some practices in Cornwall. The Training Hub is supporting the system to create portfolio opportunities for Pharmacists to develop the skills and experience to work in multiple settings across within healthcare.

Below are some helpful links about employing a pharmacist and career pathways for the role:

Pharmacy technicians are an emerging profession in general practice and play a valuable role supporting their fellow healthcare professionals in focusing on clinical care.

The role complements clinical pharmacists, with pharmacy technicians typically working under the direction of clinical pharmacists in a practice pharmacy team.

Pharmacy technicians can complete a variety of tasks through use of their acquired pharmaceutical knowledge, help with a range of tasks that vary in complexity from preparing the repeat prescriptions to undertaking prescribing audits and helping patients get the best outcomes from taking their medicines providing consultations to ensure patients use their medicines appropriately, and conducting audits.

Training for pharmacy technicians | Health Education England (hee.nhs.uk)

Criteria for registration as a pharmacy technician in Great Britain (pharmacyregulation.org)

The role of a First Contact Physiotherapist is to work within GP surgeries and offer physiotherapy appointments for patients with musculoskeletal (MSK) conditions.

This gives the patients immediate access to physiotherapy and has become an important addition to primary care, helping to reduce onward referrals and support patients with MSK conditions.

The links and documents here may help you in understanding the value this role can add to your practice.

In Cornwall, a professional network of primary care FCPs runs, offering networking, peer support and relevant CPD opportunities. Please contact us to join this group. In addition, for those FCPs working through the “Roadmap to Practice” we can support you with advice and guidance as you navigate this with your supervisor in the PCN.

Increased pressure and demand on primary care services have been a catalyst for more opportunities for Paramedics to work in this environment.

First contact paramedics are autonomous, diagnostic clinicians with experience in handling undifferentiated and unpredictable cases; conducting an array of clinical assessment, diagnostic, and treatment activities; and directing and signposting care and have been transitioning into enhanced and advanced practice roles within General Practice for a number of years.

Within Cornwall, Paramedics are an already established workforce in General Practice and are increasingly supporting PCN’s to change their care models to best treat their patients.

In February 2021, the Paramedic Roadmap to practice was published. You can find information about the roadmap here. 
In Cornwall there is an established professional community of practice for primary care FCP Paramedics. Please contact us to join this group.

Paramedics workforce | Health Education England (hee.nhs.uk)

Paramedic Specialist in Primary and Urgent Care Core Capabilities Framework.pdf (hee.nhs.uk)

Advanced Practice (hee.nhs.uk)

Dietitians are qualified and regulated healthcare professionals that assess, diagnose and treat dietary and nutritional problems at an individual and wider public health level.

Working in primary care, dieticians can support patients with a wide range of conditions including obesity, diabetes, IBS and allergies and have the expertise and behaviour change skills to support these patients more quickly and effectively, helping people manage their conditions and make important lifestyle changes.

You can find out more about the role and how this could support your practice, along with example job description, via the below links

First Contact Dietician in Primary Care

Podiatrists are experts in lower limb health and disease, and have the requisite knowledge, skills and training to work as First Contact Practitioners (FCPs) in primary and community care.  Podiatrists work in a variety of places and can work with a team of people including doctors, nurses and physiotherapists.

Podiatrists working in primary care can support patients with a wide range of conditions including Diabetes and Rheumatology as well as wound care.

A Roadmap to Practice and further information can be found here.

Occupational Therapists (OTs) support people of all ages with problems resulting from physical, mental, social, or development difficulties.

They 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.

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).

A Roadmap to Practice and further information can be found here.

Physician Associates (PA) are medically trained, generalist healthcare professionals, who work alongside doctors and provide medical care as an integral part of the multidisciplinary team. PAs are dependent practitioners working with a dedicated medical supervisor, but are able to work autonomously with appropriate support.

For more information, example job descriptions and helpful advice about the role, the following links provide some helpful advice:

The Nursing Associate role bridges the gap between a healthcare support worker and a 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

This role is a good training and career pathway for PCNs and practices wishing to develop current healthcare support staff or create further team opportunities.

There is a funded apprenticeship option for those looking to train as a Nursing Associate. The individual undertaking the training programme needs to be employed on a contract minimum of 30 hours per week to develop via this route. There is often an option for practices to access levy transfer from larger organisations and the Training Hub can support employing practices to access this.

The training course is available via Plymouth University or Truro & Penwith College for potential Nursing Associate trainees in Cornwall. Applicants need minimum of GCSE Maths and English at grade 9 to 4 (A to C) or Functional Skills Level 2 in Maths and English (local support available to achieve this if required).

RCN Nursing Associate information

NHS Futures support 

Mental health practitioners support patients (both adults and children) with their mental health, typically seeing patients referred to them by their GP colleagues.

They work with patients to support shared decision making about self-management, enable access to treatment services, and where appropriate conduct brief psychological interventions.

The role will involve liaison with practice clinicians, as well as liaison with secondary care, social workers and voluntary sector staff, where appropriate, and making best use of third sector and other community opportunities for promotion of patient wellbeing and maintenance of mental health.

Mental-health-practitioners-ARRS.pdf (nhsconfed.org)

The Social Prescribing Link Worker role works in partnership with GP practices and other referral agencies, often in the voluntary and social enterprise sectors.

They are employed in non-clinical roles to help reduce health inequalities by supporting people to unpick complex issues affecting their well-being and to enable them to have more control over their lives, develop skills and give their time to others, through involvement in community groups.

The social prescribing role is well established in primary care, and across Cornwall, practices already have good networks of support. This varies, with some social prescribers now employed directly within a practice or across a PCN. Social prescribing provides a holistic approach to care, and this role is now hugely valued by practice teams.

We can signpost you to development opportunities within Cornwall that would enable you to be eligible for a role of this kind.

What is Health Coaching?

Health coaching is a partnership between health and care practitioners and people. It guides and prompts people to change their behaviour, so they can make healthcare choices based on what matters to them. It also supports them to become more active in their health and care. Health coaching is defined in Universal Personalised Care as:

Helping people gain and use the knowledge, skills and confidence to become active participants in their care so that they can reach their self-identified health and wellbeing goals.

There are two distinct approaches to using Health Coaching:

Health Coaching Services – Health Coaches as a new stand-alone service targeting a specific group e.g., supporting healthy behaviour changes in diabetes. Health coaches need to have completed a minimum of 4 days training (accredited training through the Personalised Care Institute) to become an EMCC Accredited Health Coach

Health Coaching Skills – training health and social care staff and voluntary sector representatives or carers to use health coaching skills as part of their consultations or conversations, as an approach to practice or mind-set. Health coaching skills can be used to enhance an existing service, as part of wider workforce development. This is usually a 2-day training in Health coaching skills and is particularly recommended for Social Prescribing Link Workers and Care Coordinators

The Personalised Care Institute

The Personalised Care Institute provide information on training providers and courses that meet the standards required with recommendations of training levels for different staff groups.

NHS England

A Guide to the Requirements and Implementation Checklists for Employing a Health and Well-being Coach – please see Annex C

Health Coaching Implementation and Quality Summary Guide

NHS England » Tools to implement supported self-management

Additional Information

Sample job descriptions and recruitment support documentation –

• NHSE & I Sample
• Addition Sample

Health Coaching Conversations training – details of local training is available here

Care Coordinators work closely with and in partnership with other members of the primary health care team, in particular the Social Prescribing Link Workers and Health and Wellbeing Coaches. In conjunction with these other roles, Care Coordinator’s play an important role in supporting patients to use health services appropriately and effectively.

PCN/General Practices must ensure that the Care Coordinator is enrolled in or qualified from appropriate health coaching training with the training delivered by a training organisation listed by the Personalised Care Institute.

The following links may be helpful if you are employing or supporting staff in these roles:

NHS England Health coaching summary guide

Supporting health and care staff to deliver personalised care

Future NHS Recruitment Support for Care Coordinator role

Future NHS Recruitment Support for Health & Wellbeing Coach

Health Coaching Conversations training – (local training available via the link)

As part of the wider team in general practice, General Practice Assistants provide a support role, carrying out administrative tasks, combined in some areas with basic clinical duties. They focus on supporting General Practitioners in their day-to-day management of patients, specifically aimed at reducing the administrative burden, making the best use of consultation time and supporting those particularly vulnerable to isolation who are regular attenders at the practice.

Development of the role depends on a range of factors – patient needs, existing skills mix, culture and having the staff, time and financial resource to invest in work-based learning, mentorship and supervision.

The Digital and Transformation Lead role was introduced as a reimbursable role via the ARRS in October 2022 to support transformation activities in PCNs, including the adoption and effective use of technology.

The key objective of the role is to support PCNs and their practices to deliver ongoing improvement to services. Improvement projects are not restricted to those that focus on the utilisation of digital tools and could include any transformation work that utilises data or quality improvement tools to improve quality, drive efficiency or improve patient experience.

Advanced clinical practice is delivered by experienced, registered health and care practitioners. It is a level of practice characterised by a high degree of autonomy and complex decision making. This is underpinned by a master’s level award or equivalent that encompasses the four pillars of clinical practice, leadership and management, education and research, with demonstration of core capabilities and area specific clinical competence.

More information can be found here.