The two projects are the Additional Roles Reimbursement Scheme (ARRS) Optimisation Project and the Legacy Practitioner (LP) Expansion Programme: Social Work and Speech and Language Therapy. They reflect a local workforce planning focus on population health needs, previous experience and evidence concerning ARRS roles and LPs, and engagement with local system leaders
Together, MSE ICB, ARU and provider partners have used mutual commitment to build on previous success by:
- Adopting a partnership approach.
- Facilitating Patient and Public Involvement activities and practitioner ‘critical friends’.
- Adapting to the changing context.
- Using a blended approach (mostly online working, with some face-to-face).
- Jointly designing and implementing the evaluation.
- Information/data sharing.
Project 1: ARRS Optimisation Project
Project features
- First Contact Physiotherapy (FCP) and Personalised Care roles
- Four Primary Care Networks (PCNs) across four MSE Alliances
- Multi-method stakeholder evaluation: primary and secondary data sources
Aims
- Explore recruitment and retention challenges.
- Ensure ARRS roles continue to become embedded in PCNs, and are used effectively.
- Maximise recruitment and retention as Integrated Neighbourhood Teams are implemented.
- Identify examples of good practice in ARRS implementation.
- Inform future workforce planning.
The project is designed to enable the optimisation of additional roles in primary care to support future workforce planning, enhance service delivery to improve population health outcomes. This includes identifying and sharing best practice and success stories, including the opportunities for personal development, quality improvement, collaborative working and increased morale.
The ARRS was introduced in 2019 in primary care in England to support service provision. The scheme supports the recruitment of Allied Health Professionals to provide an enhanced range of healthcare services to support general practices (Baird et al, 2022).
The original range of ARRS roles was extended to include other disciplines. The specific focus for this project is FCP and Personalised Care (Health and Wellbeing Coach, Care Co-ordinator, Social Prescriber) ARRS roles, as determined in consultation with system leaders.
The multi-method, project evaluation builds on previous local (EQUIP 2021, 2022) and wider evidence (Baird et al, 2022) and involves a stratified sample of PCNs (based on deprivation indices, population density, employment model etc) from across the region. It will be completed in 2025.
Early findings indicate a range of beneficial outcomes for stakeholders, including improved service delivery and staff wellbeing, and the development of local community agency. In addition, the leveraging of cross-sector and cross-organisation relationships developed during the programme (organisational and individual levels) for future collaborative development is apparent. Finally, there are early indications of how any remaining barriers potentially preventing full use of these roles can be addressed.
Project 2: Legacy Practitioner Extension Programme: Social Work and Speech and Language Therapy
Project features
- Three Partner provider organisations
- New legacy mental health, social worker (SW) and Speech and Language Therapist (SALT) roles
- Action Learning Sets with established LPs
- Multi-method stakeholder evaluation: primary and secondary data sources
Aims
- Build on the success of the MSE Legacy Nurse programme.
- Support service delivery by addressing recruitment and retention challenges by:
- Retaining highly experienced clinicians.
- Providing additional support for colleagues in the early stages of their career, students on placement and staff returning to practice after a break.
This project builds on the success of the Legacy Nurse programme, a national initiative to help improve NHS staff retention (NHSE 2020, NHS England/NHS Employers 2022), which was successfully implemented in Mid and South Essex.
This project enables Legacy staff to use their wide experience of working in a clinical setting to bridge the gap between academic and clinical settings, share good practice, and provide clinical and pastoral support for the next generation of clinicians (Clauson, 2011, Hardy, 2023). Funding was provided for two WTE Band 7 LPs for 12 months and flexible recruitment employed. Additional programme support was provided via, for example, Action Learning Sets.
SALTs and SWs were selected as the focus due to specific recruitment and retention challenges facing these professions and to support ‘levelling up’ of key areas defined as ‘left behind’ (neighbourhoods/communities with a combination of social and economic deprivation, poor connectivity (physical and digital), low levels of community engagement and a lack of community spaces and places), and help to address poor health outcomes and unfulfilled life chances. The programme evaluation will be completed in 2025.
Early findings indicate a range of beneficial outcomes regarding staff retention and service delivery and strategies for addressing the challenges faced when introducing such new roles. In addition, the leveraging of cross-sector and cross-organisation relationships developed as a result of the programme (organisational and individual levels) for future collaborative development is apparent.
Project team
- Prof Gillian Janes, Professor of Nursing and Quality Improvement, ARU
- Kathryn Perry, Head of Primary Care Workforce, MSE ICB
- Jenni Speller, Deputy Director for Primary Care Development, MSE ICB
- Debalina Gupta, Programme Lead, MSE Partners
- Georgia Fenn, Project Support Manager, MSE ICB
- Louise Pinder, Director of Practice, ARU
- Dr Valerie Brueton, Postdoctoral Research Fellow, ARU
- Fiona Bodle, Assistant Director Strategic Innovation, ARU