Introduction

We supported the embedding of the personalised care workforce across London. We developed networks of frontline workers, their managers and those involved in embedding the roles. In response we co-created resources, webinars and a programme of work to tackle the most pressing workforce challenges. 

Funding sources, partnerships and groups 

NHS England funded a Regional Learning Coordinator to provide learning and peer support opportunities to the social prescribing workforce, and a Regional Facilitator role, tasked with supporting local system leaders to develop and embed social prescribing and community-based approaches across their boroughs and ICBs. 

This led to the creation of a PCN Advisor role, to support the work to embed the three personalised care roles within primary care, helping PCN colleagues better understand, connect with and develop the personalised care roles in their teams.  

This was alongside funding mentor roles for both Health and Wellbeing Coaches and Care Coordinators, operating a similar role to the Regional Learning Coordinators but for the other personalised care roles.  

Through these roles we ran the following networks and sessions: 

• Regular peer support sessions for Social Prescribing Link Workers  
• Peer learning webinars for Social Prescribing Link Workers 
• Training needs assessments and feedback questionnaires – feeding back to ICBs and NHSE  
• Training for specific things such as suicide prevention, MHFA, social welfare advice and so on 
• Monthly peer support and learning for Health and Wellbeing Coaches 
• Monthly peer support and learning for Care Coordinators 
• System support sessions for people involved in managing or embedding the personalised care roles  

These networks enabled: 

• Roles to come together to the first time to problem solve and share best practice 
• People to ask questions, find out about guidance and resources 
• Myths to be busted and greater understanding about the value of personalised care roles  
• Skills to be built in how to move towards a new biopsychosocial model of care that emphasised prevention 
• Improved management of the roles, including better recruitment, retention, training and support 

History including how it came about, what was the need, biggest challenges 

The personalised care roles came into primary care as part of the PCN DES (Network Contract Direct Enhanced Service) and the Additional Roles Reimbursement Scheme (ARRs). 

Social Prescribing Link Workers, Health and Wellbeing Coaches a three of the roles in the ARRs scheme, who are non-clinical and support people with things that impact health outside of medical care, the social determinants of health. This includes lifestyle factors, our social environment, employment and housing to name a few. 

These roles represent a huge culture shift within the NHS and therefore require new ways of working within the system and between health, the community, voluntary and other statutory organisations. 

Because of this, there were many organisational challenges to these roles having their intended impact on patients. This included: 

• Being misused as administrative roles 
• Lack of clinical support, supervision or line management support 
• Lack of proper induction, training and ongoing development  
• Not being embedded into MDTs and existing clinical structures  
• Not having time to carry out community engagement and build relationships to services that support patients 
• Being given overambitious case load targets and short appointment slots 
• High turnover and difficulty recruiting the roles 
• Lack of capacity in VCSE to take referrals (lack of funding for VCSE and complexity of issues individuals faced) 

In response to this NHS England funded regions to deliver projects to support the system to tackle these challenges and embed the roles.    

The evolution of this work  

• Still many challenges 

There has been great progress and development in social prescribing services and non-clinical teams within the NHS. Particularly the growth of social prescribing managers who are leaders in their area, working at the interface between health, community and voluntary sector. 

However, several challenges remain to maintain a strong and successful personalised care workforce. We continued working with social prescribing managers, running a network to allow them to discuss challenges, problem solve and inform regional and national work. 

This work evolved into larger once-for-London pieces of work to develop system leaders, ICBs and the infrastructure around support for the personalised care roles. You can read more about this on our Workforce and System Support workstream pages.  

A critical challenge coming up frequently was a lack of funding linked to being able to demonstrate the impact of the roles. This led us to work with a range of stakeholders across London and develop our Impact and Evaluation workstream and Community Chest Programme. 

We also developed work to support specialisms of social prescribing and co-created networks for Children and Young People Social Prescribing, Secondary care and Social Welfare Legal Advice. 

Resources