Are We Moving Forwards or Backwards in Primary Care?

As a Health and Wellbeing Coach working in the NHS, I’ve seen first-hand the positive impact personalised care can have on people’s lives. Our role is about proactive support – empowering individuals to take control of their health and wellbeing, rather than waiting for illness to strike. It’s about health care, not sick care.

Yet despite years of progress, it now feels like we’re taking a step backwards.

With ARRS (Additional Roles Reimbursement Scheme) funding now open to medical clinician roles, some PCNs are choosing to prioritise these at the expense of the personalised care workforce – Health and Wellbeing Coaches, Care Coordinators, and Social Prescribing Link Workers. I’m watching skilled colleagues in nearby PCNs lose their jobs. These are people delivering vital, preventative, person-centred care – the kind of care NHS policy says we need more of, not less.

It took years for the Workforce Development Frameworks for Personalised Care roles to be created – long after these roles were introduced. Existing clinical outcome measures don’t reflect what we do and there’s still no standard appropriate way to measure the true impact of personalised care – so the burden to justify our existence falls to individual coaches, link workers, and coordinators.

It’s disheartening. We’re using old models to solve new challenges. We’re falling back into reactive, illness-focused approaches just as we should be doubling down on prevention, empowerment, and community-based support.

If we truly believe in a sustainable NHS, personalised care must be protected and embedded – not sidelined.

This isn’t just about jobs. It’s about the future of healthcare.