Dr Antonina Semkina is Research Associate at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. Antonina brought together contributions for this blog from the other presenters at this Health Services Research conference session in Newcastle. (773 words)
One of the core functions of conferences is to allow colleagues to present and discuss work in progress. Here we share the results of a fruitful session where colleagues researching the introduction of new roles in health and social care saw many important parallels that will help them in developing and sharpening their analysis.
On the 2 and 3 July 2025 Newcastle University hosted the 18th annual Health Services Research conference. It featured nine thematic streams including Person Centred Care, Workforce, Digital, Social Care and Health Inequalities. Delegates had an opportunity to attend research discussions and Pecha Kucha sessions (short form presentations), workshops (e.g., ‘How do we know if HSR impacts on Policy?’ led by Unit Director Professor Annette Boaz), plenary sessions (e.g., ‘The 2030 workforce: how will innovative research deliver impact’?), meet ups (e.g., for Early career researchers) and to view research posters.
One of the research discussion sessions in the Workforce stream featured four presentations related to various new roles being developed in UK health and care services. Unit researcher Dr Antonina Semkina presented on the ‘New Roles in Health and Social Care: What is the nature of new care coordinator roles?’ project that she is conducting as part of the Health and Social Care Workforce Policy Research Unit programme of work. The research project, developed in collaboration with the Unit Public Contributors Involvement and Engagement group, focuses on what kinds of new care co-ordinator roles are being created, what tasks are delegated to them and the implications for various stakeholders (e.g., colleagues’ workload).
During her presentation Antonina discussed the origins of the role, and the tensions and opportunities embedded in its design and implementation within primary care and beyond. She outlined the research progress to date, including data collection and thematic data analysis of 20 interviews with strategic HR managers, clinical directors, line managers and other experts with knowledge of the role. Then, she provided insights and shared indicative participant quotes related to the varied purposes of the care coordinator role in different contexts and the diverse non-clinical and clinical tasks that might be included in their remit. Finally, she identified consequences of the current lack of clarity around the role.
Another new role discussed during the session by Dr Yingxi Zhao from the University of Oxford was the physician assistant / associate role. He presented a realist review focusing on the role development and integration in high-income countries’ hospital settings, as part of a larger NIHR Health and Social Care Delivery Research project that examined physician assistant / associate roles in NHS hospitals. His review highlighted how these new roles have been shaped by institutional drivers, local workforce needs, and continuous professional boundary negotiations.
Also, during the session, Dr Imelda McDermott (University of Manchester) presented her work ‘New and Extended roles staff in general practice: A realist evaluation of supervision and support mechanisms’. Her presentation provided a detailed account of the variations and inconsistencies in supervision and support across different roles. This granular analysis contributes to a more nuanced understanding of the challenges in providing support for the increasingly diverse general practice workforce.
Professor Damian Hodgson and Dr Emily Wood (University of Sheffield) talked about their research ‘New roles in mental health services in England: a qualitative study of boundary work and organisational change’. They presented emergent findings from their NIHR HSDR funded project examining the implementation of new roles, drawing on case studies covering eight roles in mental health service providers in England. In this presentation, they compared the perceived rationale for the introduction of new roles to their perceived impacts, distinguishing between implementations that were “defensive” (aimed at protecting staff/services), proactive (aimed at enhancing and extending care), and career-focused rationales (aimed at retaining staff or providing career opportunities). They also reported on more “dysfunctional” understandings, where the rationale was perceived to be unclear or incoherent, with negative impacts on staff, service delivery and service users. They indicated that the analysis continues and will map this against a refined typology of new roles based on skill-mix models, paying attention to contextual conditions in each case, to be reported in future work.
The presentations were followed by a lively Q&A with the speakers. The discussion covered the introduction of new roles, supervision of role holders, their accountability and patient safety. Similarities and contrasts between the roles were also discussed. Of particular interest was the consideration of multiple positive and negative effects of extended flexibility of the new roles.
Overall, the topic of new health and social care roles generated a lot of interest in the audience, and the session was useful for exploring new research connections, collaborations and partnerships.
Dr Antonina Semkina is Research Associate at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London.
A focus on new roles is part of the Unit’s core work for DHSC: see a summary of our core work.