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Introducing new roles

Read how others have introduced new roles on the ground.

Christopher Morton, Service Manager, Oxford Health NHS Foundation Trust, shares his experience of introducing Peer Support Workers to Mental Health services

I am a qualified social worker and have worked at Oxford Health NHS FT for 13 years as an Approved Mental Health Professional and a service manager. I have a service line responsibility for a number of areas, including adult and older adult community mental health and early intervention in psychosis.

In 2016 we started introducing peer support workers in a pilot within the community adult mental health team in Oxford City. This soon expanded and we now have over 30 peer support workers across the organisation covering two counties, Oxfordshire and Buckinghamshire. They work in community adult mental health, inpatient adult mental health specialist urgent care, early intervention in psychosis and perinatal services. We are on our fourth training cohort and are now entering a new phase where we are going to expand the leadership and operational infrastructure, this will include a new career pathway for peer support workers, allowing them to develop into more senior roles, and introducing the role into forensic and older adult services. We are also doing research to evaluate and better understand how the roles work in different settings.  

To introduce a new role I recommend engagement, engagement, engagement. You need to work proactively with all your stakeholders. Spend time working across professional silos and bridging them, understand what is already in place for the service you are trying to introduce, work with your demographic for the population and the workforce, that will help you build a solid foundation for pragmatic change. Early engagement and a consistent communication strategy will help you navigate any potential resistance, you must be prepared to tackle the difficult conversations head on. Never assume that things are broken or not working, as the opportunity to evolve the good in your teams through service change may pass you by. You can then build an agile infrastructure; the change is not a straight line; you will need allow your change project to have flexible boundaries so it can become embedded and work with and for the services that are already there. Don’t set it up with the view that there can’t be some failures, just make sure that it is safe to navigate bumps in the road and learn them when they happen, because they will happen. This will increase your chances of success and result in your change becoming embedded and business as usual.


Alexander Reynolds, Lead Physician Associate, Neurosurgery, UCLH, Lead Physician Associate Ambassador, North London, Health Education England, shares his experience of being a Physician Associate and introducing the role

I qualified as a physician associate (PA) in 2014 at a time when the role was still developing in the UK.  I worked in Neurosciences and vascular surgery at St. Georges Hospital in London and in 2016 was appointed as a lecturer at the University of Reading. In 2018 I started as Lead PA at University College London Hospitals and was tasked to introduce the role and develop a career approach across neurosciences.

I did this by spending time with each department, showcasing the role and its ability, building new relationships and sharing trust wide communications on our work. Ensuring that the right clinical governance policy was in place was a top priority as it helped in defining the areas that a PA could work in within the trust This included transcriptions, prescriptions, performing procedures, appraisals and training requirements. Once this is in place employers and clinicians have the confidence to delegate complex tasks and it provides the ability for the PA to develop their role and career. To future proof the policy it was made applicable to all specialties and departments.  To ensure its efficacy, I collected data on the impact the role had on patients, looking at the quality of procedures and how the improved performance of the service effects patient outcomes and supported the training of Junior Doctors.

The key thing to recommend to employers is to be creative. The more creative you are the more interesting a job will be to a PA. If you set a narrow job description this will likely result in unhappy PA’s who are not retained resulting in a high turnover of staff. It’s it also likely any initial introduction of the role will not gain traction and PA workforce expansion will stall. A creative job description will aim to compliment a service and its staff.

By offering the PA the chance to expand their skills, this can free up clinical time for doctors to focus on more complex cases, adding value to patient care. A PA should be seen as a boost or advantage rather than competition, because a PA allows traditional roles to expand and do much more. The benefits typically take a year or two and should be seen as a medium to long term plan, rather than a short term solution.

The more investment an employer puts into their PA, the greater the rewards will be.