Seventy-eight role titles and inconsistent role scopes: Can we consolidate, streamline and create professional identities for care navigators?

Background:A growing workforce is being employed to assist patients and clients in navigating between health and social care providers. These professionals operate under various care models including care navigation, social prescribing, and care coordination. An evidence synthesis is needed to better understand role scopes, experiences, and enablers and barriers of embedding these roles in the health and social care systems.

 

Methods: An umbrella review of reviews of five databases (MEDLINE, Embase, CINAHL, Scopus, PsycINFO) were searched to May 2024. Reviews were included if they discussed the role or function of workers who were employed to coordinate services involving health and social care to support clients with complex needs. Reviews on volunteer coordinators or link workers were excluded. A qualitative thematic data synthesis approach was used to determine the key evidence themes. Although there was no public or patient involvement, we sought advice from link workers affiliated with a not-for profit organisation that provides link worker services.

 

Results: Twenty-six review articles were included, representing 824 unique primary peer-reviewed sources (1). Seventy-eight unique role titles were used to describe care navigators, which aggregated under seven role categories: Patient Navigator, Link Worker, Care Coordinator, Case Manager, Social Prescriber, Intermediary, Health Mediator, the most common being Patient Navigator and Link Worker. At least 20 task domains were identified, mostly related to care navigation, building service users’ capacity for self-management, and providing person-centred care, goal setting, motivational and emotional support, and education.

 

Patient Navigators more frequently provided motivational and emotional support, client education, care planning and clinical tasks, while Link Workers most frequently provided navigation and linking services with community supports, helped with practical tasks such as accompanying clients to appointments, appointment coordination, cultural or language interpretation.

 

Barriers of implementing navigator roles included unstable funding models; unclear role descriptions, role scope and role boundaries, often leading to burnout. There was also limited shared infrastructure e.g. medical records platforms, guidelines and training courses; limited professional networks or communities of practice, unclear referral pathways and limited understanding among other professionals about of the link worker role scope. Enablers included clear role descriptions, tailored training and support networks, lived experience or deep understanding of the population being served and local resources that could support clients. Personal attributes that enhanced experiences included high levels of health literacy, ability to explore client needs within context, communication and rapport-building skills.

 

Conclusion: s:Interchangeable role titles and overlapping role scopes and tasks create complexity for service users, providers, and researchers. Developing professional identities, training, and strategies to seamlessly embed such roles into existing health and social care structures are needed.

 

Reference: Wijekulasuriya S, Wahlstrom L, Lewis S, Triandafilidis Z, Rojas C, Goodwin N, Semkina A, Boaz A, Norrie C and Zurynski Y. (2025) Working between systems: an umbrella review of care navigator roles and responsibilities. Front. Health Serv. 5:1632307. doi: 10.3389/frhs.2025.1632307