New Roles, New Challenges: Understanding boundary work to support the implementation of new roles in mental health Trusts

The NHS is currently dealing with a workforce crisis,  as it faces huge challenges recruiting and retaining workforce capable of responding to increasing demand for care. 

This workforce crisis is most acute in mental health services, which suffers from a higher turnover of staff and more vacant positions than the rest of the NHS. At the same time, demand for mental health services has risen significantly in recent years, exacerbated by the mental health impact of the Covid-19 pandemic and ongoing social and economic pressures.

One response to this challenge is to recruit staff to various new roles, such as:

Introducing these new roles also means changing the 'skill-mix' in mental health services, and this often means changing how care is organised and delivered.

This project

Previous research about these new roles has typically looked at each role individually to decide if they improve care. This is important but it does not tell us how the wider mental health team and the healthcare system is affected by the changes. 

Introducing new roles inevitably means existing roles also must change; for example, current staff may do fewer tasks as others take on work but then have to spend time supervising these new colleagues, or may need support to develop new skills in systems working or leadership. 

Research shows new roles can improve care for service users and lead to better job satisfaction and career opportunities for staff if managed well. However, as service users may receive care from larger teams, this may lead to a lack of continuity in their care, and it may not be clear what staff in these new roles do, causing confusion for both staff and service users.

Our aim is to discover how new roles should be introduced to make sure they work well and improve care. 

To do this, we first need to know which new roles have been introduced, where, how and why. 

Across the project, we will develop an understanding of:

Our research findings will provide guidance for those managing and planning new roles in NHS mental health services in the future. We will share our findings as reports, podcasts, videos, and infographics via this website and on social media, and make these available to the public as well as professionals and NHS leadership. Our findings will also be shared through research papers in academic journals and presentations at international conferences.

This project will help us understand how mental health services can best implement new roles, to maximise benefits for staff, service users and organisations.

In this short video Tim Kendall highlights why it is important to understand how implementing new roles in mental health services impacts on others working in the system.

Funded by National Institute for Health and Care Research logo alongside decorative image

The project (grant ref NIHR152665) is funded by the Health Services & Delivery Research (HS&DR) programme of the National Institute of Health Research (NIHR). The views expressed on this website are those of the author(s) and not necessarily those of the NIHR or the UK government.

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Contact us

For further information, please contact the project’s principal investigators:


Participant information sheets for New Roles case studies