New and extended practice roles in NHS primary and community health and social care: a scoping review and meta-review of realist reviews and evaluations with integrated knowledge mobilisation
Start date
September 2025End date
February 2028Overview
To tackle the workforce crisis, NHS England's Additional Roles Reimbursement Scheme (ARRS) has introduced a number of new and extended roles – including paramedics, physician associates and social prescribers – into GP surgeries. The initiative has been successful in meeting its recruitment targets in the past. However, questions remain about how these roles are best integrated into healthcare teams and the impacts they have on patients and existing staff.
Our study, which is funded by the National Institute for Health Research (NIHR) will look to provide evidence that enhances the successful integration of these new roles into existing healthcare teams, working closely with a range of stakeholders, including the public, to ensure the findings are relevant, actionable and sustainable.
Funding amount
£511,872.83
Funder
NIHR HSDR
Team
Principal investigators
Professor Kamal Mahtani
GP and Professor of Evidence Based Healthcare
See profile
Dr Ruth Abrams
Associate Professor
Biography
Dr Ruth Abrams is an Associate Professor in the School of Health Sciences at the University of Surrey and an organisational psychologist with an internationally recognised programme of research focused on creating healthy, sustainable and equitable healthcare workplaces.
Her research examines how workforce, organisational and system factors shape staff wellbeing, retention and service delivery across health and care settings. She has particular expertise in primary care workforce development, women in healthcare, and workplace interventions that support women's reproductive health across pregnancy, postnatal return to work and menopause. She is also recognised for methodological expertise in realist review and realist evaluation, which she applies to understanding what works, for whom, in what circumstances and why.
Ruth leads and collaborates on major NIHR-funded research exploring workforce sustainability, multidisciplinary models of primary care, women's experiences of work and healthcare careers. Her work aims to generate actionable evidence that informs policy, service redesign and workforce practice.
Beyond her research, Ruth provides leadership internationally in the development and application of realist methods. She founded (in 2022) and co-leads the Realist Health and Social Care Workforce Special Interest Group, supporting researchers and practitioners interested in workforce-focused realist inquiry. She also founded the Primary Care Organisational Culture Exchange (in 2026). Nationally, she sits on the Editorial Board of the British Journal of General Practice and serves as a member of the NIHR Public Health Research Funding Committee.
At the University of Surrey, Ruth serves as Academic Co-Lead for Research Culture: People and Environment. She previously served as Interim Director of Research and Impact Champion for the School of Health Sciences.
Recent outputs
Read our recent BMJ opinion piece on why General Practice must be the foundation of primary care reform.