Allied Health Professions - At the forefront of improving care - a year in review 2017/2018
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Allied Health Professions
At the forefront of improving care -
a year in review 2017/2018
1
Allied Health Professions
At the forefront of improving care - a year in review 2017/2018
Page
Contents
Forewords 3
Context and introduction 4
The contribution of AHPs to the HEE mandate priority areas – primary care, urgent & emergency care, mental health, cancer 7
and maternity
Supporting the small and vulnerable professions – podiatry, prosthetics & orthotics, orthoptists and therapeutic radiography 16
Workforce, career and professional development – Apprenticeships, Return to Practice, AHP careers and professional 22
Development and Advanced Clinical Practice
AHP National Programme 30
2
Forewords
In the last two decades, healthcare has been moving from being There has never been a more important time to maximise the contribution
predominantly profession-centric care delivered in acute settings to of AHPs in transforming the health and wellbeing of the population.
patient centric, team-based care increasingly delivered in community
settings. The Allied Health Professions (AHPs), with their long history of AHPs are the third largest workforce in health and care in England. Our
team working, patient-centredness, kindness, compassion and reflection national implementation programme, AHPs into Action, highlights the
on practice have been well placed to be role models for these changes, transformative potential of AHPs within the health, social and wider care
all of which better serve patients and their families and acknowledge system. Ensuring we have an AHP workforce in sufficient numbers, with
them as equal partners in decision making. There is still some way to the right skills and experience, is critical to realising this potential and I am
travel before the goal of an integrated, team based system is reached, delighted to be providing the overarching leadership for the significant
where cooperation not competition drive progress and improvement. AHP work programme being driven by Health Education England (HEE).
This is the first update on HEE’s work with the AHPs towards this goal, May I take this opportunity to thank AHP colleagues, HEE and everyone
providing a snapshot of the achievements to date and work in progress. who has worked with them for all your hard work and commitment to the
Next year, we will publish a second report with input from key Allied Health Professions. We have some real challenges to overcome
stakeholders, which will give a steer on where the focus for developing and many opportunities to exploit. The development of our AHP workforce
and strengthening the AHP workforce will be and how it will is critical to the development of a sustainable health and care system and
contribute to HEE’s mandate. improving population health. It is reassuring to see that so much has been
done and the proactive and important work being planned.
Anna van der Gaag
Non Executive Director and Suzanne Rastrick
Chair of the AHP Strategic Oversight Board Chief Allied Health Professions Officer (England)
Health Education England
Allied Health Professions are: art therapists, drama therapists, music therapists, dietitians, occupational
therapists, operating department practitioners, orthoptists, osteopaths, podiatrists, prosthetists and orthotists,
paramedics, physiotherapists, diagnostic radiographers, therapeutic radiographers, speech and language therapists. 3
Allied Health Professions
Exploring the potential
At the forefront of improving care contribution to the four
AHPs into Action impact areas
A year in review 2017/18
Impact 1 – AHPs will improve the health
Welcome to our review of Health Education England’s (HEE) work during 2017/18 to develop and and wellbeing of individuals and
strengthen Allied Health Professions (AHPs) in England. We recognise the many vital ways in which AHP populations.
colleagues improve the health and wellbeing of the people they care for and support
Impact 2 – AHPs will support and
AHPs into Action (2017) articulated the AHP vision and many HEE-led workforce development activities have provide solutions to general practice and
taken shape over the last year, one of which was to increase the AHP leadership capacity within HEE. This report urgent and emergency services to
highlights some of the national work over the last year and sets the scene for next year’s activity.
address demand.
HEE will enter the Autumn of 2018 with a new national AHP team working collaboratively across the arms length
bodies and a new programme of work, guided by a national AHP strategic oversight group. Impact 3 – AHPs will support integration,
addressing historical service boundaries
The national work to date has involved differing levels of attention being paid across the HEE priority areas and to reduce duplication and fragmentation.
professions as we prioritised activity. Our work has focused on profession-specific activity to stabilise, modernise
and advance many of the professions; develop areas of progressive workforce transformation; and lay the Impact 4 – AHPs will deliver evidence-
foundations for future work. This work is supported by a large volume of work to develop the professions across based/informed practice to address
the HEE regions that will be included in future reports. unexplained variances in service quality
and efficiency.
May I take this opportunity to thank everyone who has contributed to this report’s development; those who have
been involved in achieving so much; and to all the AHPs who are at the forefront of improving care and developing
the workforce. #AHPsintoAction
Beverley Harden, National AHP Lead, Health Education England
Allied Health Professionals
• work across every sector of the health and social care system – from social care to
tertiary services. Collectively, AHPs
are the third largest
• contribute to the diagnosis and care of people at every life stage – from before workforce in health
birth to end of life. and care in England
and comprise of 14
• work across all clinical specialities – from involvement in autism to x-ray imaging. individual
professional
• provide clinical leadership at all levels of the health and social care system – from disciplines.
direct patient care to chief executive.
5
Health Education England’s mandate - to support the delivery of excellent healthcare and health by
ensuring that the workforce of today and tomorrow has the right numbers, skills, values and behaviours, at the
right time and in the right place.
AHPs’ skills are central to the delivery of sustainable services – prevention; early
1. diagnosis; the skills to maintain, restore and develop independence; return to
Why Allied
work/practice; and self management.
Health
Professions are AHPs work across all life stages, within all sectors – so are ideally placed to take an
so strategically 2. active role in integrated, person-centred care.
important:
3. AHPs have a long history of intelligent skill mix and multi-professional team working
– key to service transformation.
6
AHPs’ support to HEE’s mandate priority areas
AHPs’ support to HEE’s priority areas
Primary Care The development of a population health approach across primary care offers new opportunities to
redefine how to best use the workforce’s skills and attributes. AHPs’ focus on prevention and
supported self management, restoration and development of independence, plus their autonomy
of practice, makes their contribution within the team vital to improving clinical outcomes through
early diagnosis and management, increasing capacity and providing care closer to home.
Urgent & AHPs have significant potential to support the development of sustainable, integrated urgent care
systems to help manage rising demand and improve care and access.
Emergency
Providing the right response first time by the most appropriate health professional (often an AHP)
Care to those in need of urgent care is key to reducing demand on urgent and emergency services.
AHPs have key roles across the cancer clinical pathway, contributing to the lives of people affected
Cancer by and living with, and beyond, cancer; promoting wellbeing, prevention, screening, diagnosis and
treatment, alongside rehabilitation, survivorship and end-of-life care.
The skills of AHPs are invaluable within mental health and learning disability services, yet are
Mental Health often less understood. Development of the AHP workforce in mental health, learning disability and
autism is a key area of focus for HEE in 2018/9.
Maternity The AHP workforce offers vital support to maternity services and yet their vital contribution is so
rarely seen; work to illustrate the roles and impact is ongoing.
Primary Care
New ways of working
Workforce challenges within primary care are well recognised. We have been
exploring opportunities to utilise the skills and experience of AHPs in new ways to
build capacity, alleviate workforce pressures, improve access to early diagnosis
and treatment, as well as develop the AHP professions.
During 2017/8, HEE built upon the learning of the New Models of Care
programme and the opportunities presented by the GP Forward View (2016) and
Roland Report (2015) to scale up musculoskeletal practitioners and paramedics in
primary care. This involved working intelligently with the system to integrate AHP
clinicians within primary care and maximise their contribution.
The development of frameworks to identify and document core capabilities has
been key to setting the standards for safety and efficacy. The potential system Pie chart here -
quality improvements and savings from getting care models right for citizens at how the
the first point of contact are significant.
professions are
In 2018/19, work to develop frailty and dietetic related First Point of Contact AHP split. Waiting for
roles will continue its early stage development.
this information.
Work with NHS England has been essential to ensure that proactive workforce
development, and creation of the evidence base, is supported by commissioning
modernisation across health and social care systems.
9
Musculoskeletal practitioners in primary care
Delivering the GP Forward view - increasing capacity and improving access to primary care - by the
national implementation of musculoskeletal (MSK) first contact practitioners.
Making the case for change Core capabilities Person centred skills Educational
Collaboration with NHSE Multi-professional clinical Person-centred approaches support Next steps:
including NHS RightCare, core capabilities framework developed to Development of
the Elective Care Board and framework developed for underpin a new way of working, MSK First Contact • Mapping to Advanced Clinical
Getting it Right First Time First Point of Contact MSK centrally placing the skills of Practitioner e- Practice training routes including
(GIRFT) to develop evidence practitioners. The building prevention, coaching, shared learning package to the apprenticeship
based High Impact Guidance block for the workforce to decision making and care support primary care • Link to primary care Post
for commissioning MSK build towards Advanced planning. E-learning and face to working e.g. social Graduate Medical Education
services. Clinical Practitioners. face learning. prescribing, frailty. schools, work based learning and
clinical assessment
• National evaluation of impact
National programme to support successful implementation of pilots in 2018/19 • ‘How to’ toolkit for employers
– one in every STP • Work with partners to develop
health economic case
Skills modernisation • Person-centred approaches
Leadership Collaboration with the Economic impact Data for impact training
Clinical fellowships Department of Work Development of an Work with NHS Digital to • Links with Occupational Health
offering professional and Pensions to embed economic tool to model establish the primary and Emergency Medicine
support and leadership training to support the the impact - both care data set to integrate • Working across podiatry,
and advice, supporting extension to the Fit financial and patient care and record activity physiotherapy, osteopathy and
local development of Note for Advanced Care flow radiology and to evidence and monitor occupational therapy
educational pilots. Practitioners. surgical services. impact . • Prescribing support
Working in
partnership with
10Paramedics in primary care
HEE is working to develop the profession and ensure paramedics work safely and effectively in
primary care.
System impact – feasibility Capabilities framework Primary Care Employment
A feasibility study has shown the HEE working with system partners and Toolkit Paramedic Prescribing
potential system benefits of rotating the professions have co-produced a Guidance on the employment of Changes in legislation in 2018
Specialist and Advanced Paramedics Primary and Urgent Care Core paramedics to support system means Advanced Paramedics are
between ambulance services, Capabilities Framework scheduled to working is being developed, in now able to prescribe.
community and primary care to be published in Autumn 2018. For the association with the Royal HEE is working with the College of
increase capacity, reduce silos by first time, this will provide employers College of General Practitioners’ Paramedics and the Association of
building a more resilient system and paramedics with a detailed picture (RCGP) Council to be Ambulance Chief Executives
response, and sharing new skills and of primary care competencies and published later in 2018. (AACE) to commission and develop
knowledge across the system. inform the scope of practice. the additional support needed to
introduce non-medical prescribing
Increasing and ensuring primary care competencies in order to maximise the and utilise the rotation, with
contribution of paramedics in primary care as part of safe and effective systems additional support, as a mechanism
to support skills development.
Educational support Leadership development Primary Care Paramedic
Pathway Arms Length Body Collaboration
HEE has supported the Drawing on support from Education
A postgraduate part time pathway The team is working with NHSI and
development of a post-graduate Training Hubs and Deanery
into primary care for new NHSE as part of system planning for
diploma in primary and urgent care colleagues, three Paramedic Clinical
paramedic graduates has been winter, system capacity and
with the College of Paramedics. Fellows have been recruited. The
developed and is being considered resilience building and as part of the
The qualification will demonstrate Fellows are making a positive
as a pilot. The pathway allows Ambulance Improvement
defined capabilities and support contribution as professional clinical
students to continue to work within Programme.
aimed at Specialist Paramedic leads, assisting in curriculum
level. This is designed to assess development; networking and ambulance services or other
the development of critical supporting paramedics in primary employers (e.g. urgent care
reasoning in a primary and urgent care, as well as working with regional centres) on a part-time basis to
care setting, underpinned by the HEE leads to inform the development maintain connections and breadth
core capabilities framework. of the paramedic workforce. of learning.
11Urgent and Emergency Care
Making the best use of paramedics’ unique skill set to increase capacity in both primary and
urgent & emergency care services, as well as provide more care closer to home.
Increasing system capacity - Rotating Paramedic Programme
Recognising that paramedics are ideally placed to help manage increasing demand
for primary and urgent care services and building on the Paramedics Evidence- A rotational
based Education Project (PEEP), HEE has worked to develop the profession; model example
designed and piloted a new rotational working model that offers a ‘win-‘win’ solution
for primary care and the ambulance service.
A new model of working is being piloted with HEE funding and support. It involves
specialist and advanced paramedics working in rotations across a variety of
settings, including primary and community-based care, as well as within the
ambulance service.
Many emergency calls that result in conveyance to accident and emergency
department could be avoided if paramedics/community teams were able to deliver
more patient care at the scene. The pilot aims to send the most appropriate
healthcare professional, with the appropriate skill set, to offer definitive care to
patients - the right response, first time.
The four pilots, running in collaboration with East Midlands,
North East, South Central and Yorkshire ambulance
services, show real potential to improve patient care and Winner - Primary Care Innovation 2018
experience; reduce pressure on the NHS; improve
retention of paramedics across systems and improve
career opportunities for paramedics.
Phase 2 is now starting to further develop and spread the
rotational model, buddying with new rotational schemes, Finalist
and it will be subject to detailed evaluation. 12Cancer
Maximising the essential role of AHPs in diagnosis, treatment, rehabilitation and transforming the
experience of living with and beyond cancer.
Sonography
Workforce planning
HEE is working with stakeholders
Development of the HEE
Cancer Workforce Plan
to develop pre-registration level 6 Next steps:
routes to training; seek regulation
published in 2017 - sets out a
for the profession of sonography; • Developing the career
course of expanding both
build training capacity; and framework and educational
diagnostic and therapeutic
develop Advanced Clinical support to build the profession
radiography by 2021.
Practice standards. of sonography.
HEE aims to increase supply of
Pre-registration clinical standards
both diagnostic and therapeutic
were published in June 2018 to • Application for sonography to be
radiography by 800.
support both traditional and considered for regulation.
HEE is investing in upskilling
apprenticeship pre-registration
300 radiographers into
pathways. • National occupational standards
reporting roles.
to be published 2019.
Ensuring that cancer care services have access to sufficient AHPs with right skills
and experience. • Further ACP work to build skills
to support people living with and
beyond cancer .
Advanced Clinical Practice (ACP) Mammography Supply Cross system
The ACP framework will lead to Return to Practice Preparing level 6 HEE is working with • Significant programme of work
more AHPs working across work across HEE apprenticeship NHS England, the with the Office for Students, The
traditional boundaries to support and PHE screening standards in diagnostic Cancer Alliances and Society and College of
care of people affected by cancer. teams. Level 4 radiography and Macmillan Cancer Radiographers and wider
Early work is developing standards Mammography therapeutic radiography Support, building partners to support Therapeutic
with partners for ACP diagnostic Associate to improve accessibility upon their AHP Radiography.
radiography and therapeutic Apprenticeship was and growth. workforce survey.
radiography and image approved in August A number of short
interpretation and reporting 2018. publications are being
credentials for the wider workforce. developed. 13Mental Health and Learning Disability (LD) & Autism
The transforming care agenda has highlighted the vital contribution of AHPs in mental health,
learning disability and autism services.
AHP Work Plan
The report ‘Stepping forward to 2020/21: Understanding AHPs in LD Promoting careers
The mental health workforce plan for The film ‘I am here with you.’ The WOW Careers
England’ (2017) highlighted the vital role was produced, show to support school
of AHPs, the complexity of the agenda, with the British Association of children’s career
and specific workforce challenges that Drama Therapists, to start to choices Next steps:
require a considered approach. HEE is develop the narrative of https://www.youtube.co
working with the Royal College of AHPs working with clients m/watch?v=wWZ5FNL
Occupational Therapists and the British with a learning disability, • Conference 2019 to develop
PP1s
Association of Arts Therapists to engage autism or both – due for further the narrative for LD AHP
AHPs in mental health across services to release in late 2018. role.
inform key areas of work. • Coproduction work to focus on
placements, work experience for
Raising the profile, understanding the contribution of AHPs and new and existing staff.
• ACP pathway development.
developing the workforce • Development of the career
framework and educational
National TCP workforce Advanced Clinical Practice support for new entrants into LD.
HEE’s national AHP LD workforce summit in March (ACP) • Work with music therapy to
2018 informed recommendations for the ACP pathways for both LD/Autism showcase the workforce and their
Transforming Care Partnership (TCP) workforce and Mental Health are in early impact.
subgroup report which looks at the care of people development to support AHP ACP
with learning disabilities. roles and to enable transferable
In June 2018, an AHP workforce paper was qualifications to be available and
submitted and presented to the national TCP linked (where possible) to the
workforce subgroup, outlining the contribution of Level 7 ACP Apprenticeship.
AHPs to the modernisation of the LD workforce. 14Maternity
Understanding the contribution of AHPs in maternity and gynaecology services to maximise their
impact.
Exploring the potential
Scoping exercise
Maternity care scoping exercise commissioned by HEE to be carried out in 2018. Working contribution into the four
with the professional bodies that represent the AHP professions, sonographer AHP into Action impact areas
professionals, as well as the Royal College of Obstetricians and Gynaecologists and the
Royal College of Midwives to gain a greater understanding of: Impact 1 – AHPs will improve the
• the sectors and settings AHPs work in to deliver support to gynaecology and maternity health and wellbeing of individuals and
services. populations
• access to AHPs by gynaecology and maternity services.
• activities and interventions undertaken by each profession in gynaecology and Impact 2 – AHPs will support and
maternity services. provide solutions to general practice
and urgent and emergency services to
address demand
Maximising the impact of AHPs in maternity and gynaecology services
Impact 3 – AHPs will support
E-Learning Programme Apprenticeships integration, addressing historical
HEE Maternity Programme E-learning for Level 6/7 sonography apprenticeship in service boundaries to reduce
Health Care Courses Guide published – June development and currently awaiting level duplication and fragmentation.
2018 (expected to be available in 2019).
Provides an overview of all of the e-learning Other relevant apprenticeships under development Impact 4 – AHPs will deliver evidence
packages that are related to Maternity and include Dietitians, Occupational Therapist, based/informed practice to address
Pregnancy - collating them in one place for Operating Department Practitioners. unexplained variances in service
easy reference to improve accessibility and
quality and efficiency.
encourage their use.Small and vulnerable professions
Small and vulnerable professions
Working with professions and their professional bodies to raise awareness, ease access and
develop the professions.
The Universities and Colleges Admissions Service (UCAS) has reported a 27% drop in Using the HEE STAR tool to support the professions
applicants to healthcare programmes in the period 2014-18 placing some AHP The HEE STAR is a tool to support workforce transformation,
programmes at risk. Many courses in the UK are uncertain they will be able to recruit helping providers understand their workforce requirements and
to their cohort numbers and, in some cases, even to recruit a viable cohort. also providing a range of potential solutions.
This comes at a time when the need for the skills of AHPs and the understanding of The programme has applied the organisational development
their added value and potential is increasing. methodology of the HEE STAR Tool, considering all aspects of
workforce transformation (supply, up-skilling, new roles, new ways
The Office for Students (OfS) recognises Therapeutic Radiography, Prosthetics and of working and leadership) to address workforce shortfalls.
Orthotics, Orthoptists and Podiatry as the AHP small & vulnerable professions. HEE
is working closely with the OfS to monitor and support the market and to develop a
long term strategic plan to stabilise and develop these professions. The following
pages outline the action taken in relation to those professions in the last year.
Monitoring all the AHPs to ensure their continued success and viability, taking
appropriate action as required, is a key focus for HEE.
17Podiatry
Supporting the podiatry workforce to offer limb and life saving support to people with high risk
lower limbs as a result of diabetic and cardio-vascular disease; and make significant contribution to
musculoskeletal pathways Next Steps:
Career Framework Support workforce Engagement Supply routes
HEE development of a Development of support roles HEE have hosted two Apprenticeship level 6 • HEE/Office for Students to monitor
Podiatry Careers and extension of skills with co-production events podiatry is completed, course uptake and the continued
Framework including training to support the needs of with the College of and being updated to impact post Comprehensive
Support Worker; Assistant the service. Consideration of Podiatry and incorporate the level 7 Spending Review and the impact of
Practitioner; and the opportunities for an podiatrists in service option. National the apprenticeship over time.
Advanced Clinical associate podiatry role. and education. Work procurement and • Facilitate the implementation of
Practice pathways to Working with colleagues across with the other intelligent level 6 apprenticeships.
create new roles and the wider foot health landscape representative bodies implementation • Support leadership and learner
widen career opportunities to determine methods of and independent discussions have support.
- mapped to the upskilling. practice is ongoing. begun. • Develop and support current and
apprenticeship agenda. future educators.
• Consider curriculum in light of
Understanding the benefits of podiatry and supporting the profession to meet service acuity.
the needs of a population with increasingly complex needs • Ensure clear communication and
promotion of the return to practice
Careers Advanced Clinical Professional Image and Office for Students programme across the workforce.
New content on the Practice Identity Strategic Interventions in • Develop innovative work experience
Health Careers The musculoskeletal Work is ongoing to Health Education opportunities.
website, work through pathway is now in complement the Office of Disciplines (SIHED) project • Determine ACP routes.
clearing and into 2019 development Students’ work, building the to support small and • Placements capacity and work
with the Medic Portal The High Risk Foot professional narrative. vulnerable professions. experience work to start with
– showing AHP work is in Work to develop leadership, This funding aims to independent practice representative
careers as an development educators and researchers support demand for, and groups to develop responsibility
alternative to nationally and will be within the professions improve retention on, these across the profession for supply.
medicine Work with ready in early 2019. alongside the skills of courses. • Conference workshops are planned.
‘Inspiring Futures’ influence are essential.
18Prosthetics and Orthotics
Raising awareness of the Prosthetics and Orthotics (P and O) professions and supporting and
stabilising the workforce to boost this vulnerable profession.
Next Steps:
One Year On report Workforce data Learner support Office for Students • HEE/Office for Students to monitor
‘The Future of the Work with NHS Digital E-learning support Participation in the course uptake and the continued
Prosthetic and Orthotic to ensure occupation to clinical educators Strategic impact post Comprehensive
Workforce in England: codes for P and O are to support students Interventions in Spending Review and the impact of
One year on’ report included in NHS and preceptorship Health Education the apprenticeship over time.
published August 2018: - workforce data. A data will be published in Disciplines (SIHED) • Facilitate the implementation of level
driving actions towards sharing agreement is autumn 2018. project to support 6 apprenticeships.
improving the P and O being developed Further work will be small and vulnerable • Scope new routes for P and O
workforce. between all providers undertaken to professions. education which provide wide
of NHS commissioned support geographical, cultural and social
services. apprenticeships. access across the population.
• Development of a core curriculum for
Raising awareness, easing access and developing the profession. all pre-registration P and O courses.
• Support leadership and educators.
Stabilising the workforce and improving the service • Ensure clear communication and
Careers Apprenticeships Careers promotion of the Return to Practice
Further materials, Apprenticeships at level New content on. the Health programme across the P and O
such as career 3 and 6 are in active Careers website, work workforce.
presentations using development with through clearing and into • Further scoping work to see how
stories, which can be implementation and 2019 with the Medic Portal – other AHP professions can support
delivered by P and O national procurement showing AHP careers as an delivery.
professionals within commencing. Significant alternative to medicine • Develop innovative work experience
schools, colleges and employer engagement opportunities
community groups are and support to enable
Innovative careers work with the WOW Careers • Determine ACP routes and work with
show live streamed to schools military providers to support
being developed by nationwide provision and
www.youtube.com/watch?v=4s3FF1H9K2o advancement of the profession.
HEE and the British increase training
Work with ‘Inspiring Futures’ 19
Association of APO. capacity.Orthoptists
Proactively managing the orthoptic workforce challenge to protect and nurture the profession.
Deep Dive Engagement Image and Supply routes Office for Students
HEE has worked with HEE and Identity The Strategic Interventions in
the British and Irish BIOS plan a HEE is supporting apprenticeship Health Education Next Steps:
Orthoptists Society further BIOS to level 6 orthoptists Disciplines (SIHED)
(BIOS), orthoptists in discussion investigate this trailblazer is project to support small • HEE/OfficeNext steps to monitor
for Students
service, Higher forum in the and develop their developing and and vulnerable course uptake and the continued
Education Institutes Autumn to orthoptic HEE will work to professions. This funding • impact post Comprehensive
Preceptorship
and student orthoptists develop a plan campaign to build support aims to support demand Spending Review and the impact of
to start to understand of action to the professional implementation in for, and improve retention • the apprenticeship
Scope over time.
related training
the workforce issues support. narrative. parallel to fast on these courses. • Facilitate the implementation of
across the regions. track opportunity • level 6 apprenticeships.
Training capabilities
• Support leadership and learner
Ensuring that there sufficient orthoptists to meet the future demand • support.
Regulation
. • Develop and support current and
future educators.
Advanced Clinical Practice (ACP) •• Consider curriculum in light of
Leadership
Careers
Eye Health • technological
Educators advances.
New content on the Health
Working across the professions to build • Ensure clear communication and
Careers website, work
upon the Core Common Competency • promotion
Placementsof the RTP programme
leadership
through clearing and into
Framework to develop the ACP level of across workforce.
2019 with the Medic Portal
practice across four key pathways. • Develop innovative work experience
– showing AHP careers as
Developing the training for the ACP opportunities.
an alternative to medicine
modules and working with the Post • Determine ACP routes.
Work with ‘Inspiring Futures’
Graduate Schools of Medicine to • Event in the Autumn to outline key
develop work based learning alongside areas of activity.
Innovative careers work with the WOW Careers show multi-professional colleagues.
live streamed to schools
www.youtube.com/watch?v=4s3FF1H9K2o
Work with ‘Inspiring Futures’ 20Therapeutic Radiography
The Cancer Workforce plan (2017) has called for more radiographers (both diagnostic and
therapeutic) to be trained. Therapeutic Radiography, as a vulnerable profession, needs to be
supported and nurtured.
Supply RePAIR Engagement Supply routes
HEE aims to increase the (Reducing Pre- HEE and the Society Discussions are Next Steps:
supply of both diagnostic registration and and College of beginning to determine
and therapeutic Improving Retention) Radiographers are co- the opportunity of an • HEE/Office for Students to monitor
radiographers by 800 by legacy project for the hosting a discussion Associate Therapeutic course uptake and the continued
2021 through local vulnerable professions. forum in November radiographer role. impact post Comprehensive
actions to improve The learning from this 2018 to develop a Apprenticeship level 6 Spending Review and the impact of
retention, delay programme is being plan of action to therapeutic radiography is the apprenticeship over time.
retirement, return to developed for roll out support the Cancer nearing completion – • Facilitate the implementation of
practice and national and and support to Workforce Plan. national procurement and level 6 apprenticeships.
international recruitment departmental leads is intelligent implementation • Support leadership and learner
campaigns. being discussed. will be key.. support
• Develop and support current and
Ensuring that there are sufficient Therapeutic Radiographers to meet the future future educators
demand, in line with the Cancer Workforce Plan • Consider curriculum in light of
technological advances
Careers New content on the Advanced Clinical Office for Students • Ensure clear communication and
Health Careers website, work Practice Strategic Interventions promotion of the Return to Practice
through clearing and into Work with oncology in Health Education programme across workforce
2019 with the Medic Portal – and dosimetry to Disciplines (SIHED) project • Develop innovative work experience
showing AHP careers as an develop ACP roles to support small and opportunities
alternative to medicine. to support workforce vulnerable professions. • Determine ACP routes
and retention with This funding aims to • Event in November 2018 to outline
Innovative careers work with the WOW Careers key areas of activity and test the
clear nationally support demand for, and
show live streamed to schools Associate Therapeutic Radiographer
recognised training improve retention on, these
www.youtube.com/watch?v=4s3FF1H9K2o
pathways is courses. model.
Work with ‘Inspiring Futures’
commencing.
21Workforce, career and professional development
Workforce development
Proactively managing workforce challenges to ensure the skills of AHPs are available for
generations into the future
Monitoring supply Workforce data Supply routes Deep dives
Office for Students Current workforce data Apprenticeship HEE has
and HEE will monitor is unable to offer the implementation and commissioned work to
trends and view of the whole AHP support for employers undertake a deep dive
Next steps
take proactive workforce. Data sharing to understand their into the Operating
proportionate agreements are in smaller volume Department
• Develop AHP supply data.
and appropriate action development and workforce and the vital Practitioners’ (ODP)
at key points of the conversations with the nature of workforce challenges
• Support the implementation of
academic year to HCPC is ongoing apprenticeships in and ensure that all
apprenticeships.
ensure sufficient supply working with maintaining the supply intended action to date
of AHPs. professional bodies. pipeline. has been completed.
• Develop work experience
opportunities.
Ensuring that there are sufficient AHPs to meet the future demand and realise
the benefits to the system of AHP contribution • To continue to support proactive
careers activity.
Careers Educators • Preceptorships.
Skill mix & team working
New content on the Health Careers HEE will continue work with
HEE will continue to
website, work through clearing and the Council of Deans for • Support the future educator and
support the development
into 2019 with the Medic Portal – Health to support existing and academic workforce.
of support roles and safe
showing AHP careers as an future educators.
and effective delegation of
alternative to medicine Work with Current work to determine
activity through effective
‘Inspiring Futures’ has been Educator leadership
education and training.
undertaken for all professions. A opportunities and barriers will
further campaign is in discussion for report in 2019.
the Autumn.
23Apprenticeships
Developing new ways for people to enter the AHP workforce to improve accessibility and growth of the
professions at a time when vital AHP skills are needed for NHS sustainability. HEE has supported all
apprenticeships to come to fruition.
Approved: Under development: - Pre-registration Next Steps:
Level 4 - Mammography Level 6 - Sonographer Level 6 - Diagnostic Radiographer
Associate Level 6 – Dietitian Level 6 - Prosthetists and Orthotist • Support implementation of pre-
Level 6 – Podiatrist Level 6 - Operating Department Practitioner Level 6 - Therapeutic Radiographer registration apprenticeship across
Level 7 - Advanced Level 6 – Physiotherapist Level 6 - Speech and Language Therapist the professions sharing opportunities
Clinical Practice Level 6 - Paramedic Level 6 - Occupational Therapist and challenges.
Support Worker AHP Level 7 – Arts Therapist • Monitor the market to ensure there
These have now been agreed to be level 6 or 7 is no further destabilisation.
• Work with professions and
Ongoing development of apprenticeship standards for Allied Health Professions employers to develop national
procurement opportunities to drive
safe and effective delivery at scale
across the nation, especially for the
Under development: Support staff Pre expression of Implementation:
smaller professions.
Level 3 - Ambulance Healthcare Support Worker interest: Prosthetics & Orthotics,
• The Office for Students will ensure
Level 3 - Prosthetic/Orthotic Technician Level 8 OPD and Podiatry have
that all activities support both
- Clinical Fellow started to determine
delivery models.
- Consultant implementation plans
- Specialist in
discussion
24Return to Practice
Expanding the AHP workforce by encouraging and enabling Health and Care Professions Council
(HCPC) eligible professionals to return to practice.
Return to Practice Returnee support Workforce strategies
HEE is leading on an Returnees and Providers are being
innovative Return to providers have access encouraged to use
Practice programme, to to financial support Return to Practice in all
support 300 Allied Health with additional support AHP workforce
Professionals and for past returnees and strategies. New ways of
Healthcare Clinical a social media supporting returnees are
Scientists (HCS) to re-join platform. The being encouraged and
the Health and Care programme has a shared across the health
Professions Council (HCPC) national lead with a and social care
register by March 2019. AHP background. community to support.
workforce capacity.
Supporting workforce supply by maximising AHPs’ opportunities
to return to practice
Clinical placements Sharing good practice Return to practice benefits
Following HEE’s Supported organisational workforce Early benefits of supporting
successful pilot in the East plans for recruitment and retention. AHPs to Return to Practice are
Midlands, the programme Challenged current concepts and that they are highly motivated
has been expanded across views about AHP/HCS return to experienced practitioners that See return to practice case studies at
all of England, looking to practice to drive and share innovative can integrated into the work https://hee.nhs.uk/our-wok/return-practice-
signpost returnees with employment models and mechanisms place with minimal input and allied-health-professionals-healthcare-
placements with clinical to attract returnees. Shared the cost. Most returnees have a scientists
providers that could learning across the health and social variety of non-clinical
potentially lead to care community employing transferable skills they can
employment opportunities. AHP/HCS. bring to the work place and
patient care. 25Return to Practice
Current data from the National Programme for AHPs and HCS
Average age of returnee 44 years
Average number of clinical years’
experience before returning 8 years
Average number years away from 9 years
practice
Average cost per returnee £1,080
Average numbers of months to
HEE AHP Return to Practice completers
returning to employment
AHP percentage enquiries
breakdown by HEE region undertake Return to Practice training 4.5
London programme
20% 10%
North
20%
91% returnees gain employment after RTP
Midlands &
80%
East
33% South
Employed Not employed 37% 26Careers and Professional Development
Proactively raising awareness of AHP careers, particularly in response to the decreasing numbers
applying to undergraduate degrees. Securing the next generation of AHPs.
Next Steps:
Social media Engagement RePAIR programme
Social media review HEE is working with University The Office for Students’ • Establish innovative work
of where and how Technical Colleges to explore Strategic Interventions in Health Education experience opportunities and to
AHP careers innovative ways to engage people Disciplines (SIHED) and HEE RePAIR (Reducing encourage and support NHS and
messaging was in AHP careers e.g. career Pre-registration Attrition and Improving Retention) other providers to allow for
shared on social carousels, student engagement programme to help the smaller and specialist accessible and interesting work
media. projects, immersive weekends. disciplines, which are more vulnerable. experience for AHP careers.
Working with the Office for Students.
Ensuring that the Allied Health Profession careers are recognised and understood • Review the branding of the AHP
by those in education, potential mature students and the general public professions e.g. Orthoptics. HEE
and British and Irish Orthoptics
World of Medic Portal Engagement Professional Skills Society are working with a marketing
Work show Working with Engaging with AHP students, workforce Working with the company to rethink image and
New ‘Medic Portal’ and professional bodies at the Chief Royal College of Speech media profile.
collaboration which has 700K Allied Health Professions Officer and Language Therapists to
with the World visitors every year conference, #150leaders event and via upskill the work force with • Developing a careers resource for
of Work from those twitter to explore the issue - asking dysphagia knowledge and graduate AHPs to support ambition
(WoW) Show, interested in them: How did they find out about AHP skills . These skills are now and development and to show case
which medicine as a careers? How can we better encourage in the new curriculum and AHP career journeys.
career. people into AHP careers? national standards are
features on
YouTube. being refreshed.
www.youtube.c
om/watch?v=4
s3FF1H9K2o
27Advanced Clinical Practice
Driving new ways of working by developing Advanced Clinical Practice (ACP) to support individuals,
employers, commissioners, planners and educators in the transformation of services to improve
patient experience and outcomes.
Framework ACP Academy Equivalence
ACP definition Academic
Development of a System wide co- routes
A definition for ACP Career
multi-professional production to Links with NIHR,
agreed that will Pathway
framework for develop the the Leadership
support workforce Work to
advanced clinical Academy of Academy and
transformation in address and
practice in England’, Advancing Practice Education to
England across all clarify career
outlining the to support the map equivalence
professions to pathways for
capabilities that
support prescribing governance of routes to ACP AHPs pursuing
HEE, NHS
underpin ACP training pathways which use Improvement and
where appropriate a clinical
practice – leading to and a mechanism existing
the standardisation of
and use of the Fit
for equivalence.
academic NHS England
Note. evidence. career.
ACP across England. working together,
Developing national training pathways, qualifications and governance structures to along with a range
ensure consistent ACP practice and development of partners across
healthcare, to
Procurement Council of Deans Trailblazer group Pathways Consultant practice develop Advanced
Co-production of a Project with Council Support of the Development of key Developing principles
national procurement of Deans to support ACP Level 7 advanced practice for consultant practice and Consultant
framework to Higher Education apprenticeship pathways e.g. Eye in 2018/19.across the level practice.
underpin all Institutes trailblazer group to health ACP/ Surgical professions to
apprenticeship development of ACP ensure equity of ACP/ MSK ACP/ advance support to
training routes to routes and update of access to all Paramedics in this professional
become an ACP. apprenticeships. professional primary and urgent group.
groups. care ACP/Frailty ACP.Advanced Clinical Practice
Developing nationally recognisable Masters Level training pathways to underpin Advanced Clinical
Practice working with employers, ACPs, Professional Bodies, Royal Colleges and Higher Education
Institute partners. Pathway developments include:
Eye Health Musculoskeletal Radiography Frailty
Working across the professions A core capability The curricula guidance ACP clinical
to build upon the Core Common framework has been to underpin the components are in The four pillars that
Competency Framework to developed across development of ACP development with underpin ACP
develop the ACP level of practice stakeholders to guide the diagnostic radiography stakeholders to support
across four key pathways. central content which is in development with the development of the practice:
Developing the training for the forms part of a suite of system partners. clinical components of
ACP modules Masters level learning to Initially this will the ACP route for Clinical Practice
develop ACP develop the national frailty. This will support
Musculoskeletal – this can standards for image cross system, Leadership &
be tailored to primary care, interpretation and integration and primary Management
the emergency department reporting for all. care roles Education
or occupational health.
Research
Developing national training pathways, qualifications and governance structures to
ensure consistent ACP practice and development ACP training pathways
place the service user at
Surgery Learning Disability Mental Health Other ACP pathways the centre and are based
The development of the Core and specialist Core and specialist Other pathways starting in upon the knowledge,
surgical (non operating) capabilities are being capabilities will be development include Acute skills and behaviours
ACP curricula is ongoing developed to promote the developed to promote Medicine, General Practice, needed to fulfill the level
to develop both general range of advanced skills and the range of advanced Nursing, of practice required by
surgical and specialty knowledge in ACP roles. skills and knowledge in Paediatrics and the role.
specific skills to work Implementation with Higher ACP roles. Therapeutic Radiography.
within clinical teams. Education Institutes (HEI) Emergency Medicine is well
partners will be key. established
29AHP Programme
New national funded work programme for 2018/9 and regional leads appointed.
A new organisational structure within HEE will take a nationally funded AHP
programme of work forward from 2018.
This will provide a dedicated focus on the AHP professions to maximise
their significant contribution to people’s health and wellbeing and to the
sustainability of the NHS.
The national and supporting regional HEE AHP teams will work with system
partners and the Arms Length Bodies. This work reports into a strategic
oversight group within HEE, ensuring alignment with HEE’s other clinical
programmes and workstreams. It will also report into the HEE Board and
Executive and the NHS England’s Chief Allied Health Professions Officer
and NHS England’s AHPs into Action Programme Board.
30Acknowledgements
Thank you to the large number of people outside of, and within, HEE who
have worked hard to help co-produce and deliver these programmes, which
are starting to show real impact.
To name people would risk forgetting someone, so instead - thank you to
everyone who has participated in our work together and to those now joining
the team.
November 2018
www.healtheducationengland.nhs.uk
@NHS_HealthEdEng
Sharon.Kibble@hee.nhs.uk or Vanessa.Cullen@hee.nhs.uk
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