Consultation analysis - draft standards for the foot health workforce - executive summary

HEE is committed to making an effective contribution to tackling these challenges. A range of partner organisations have come to together with HEE to form the Foot Health Consortium. This collaboration will help to ensure that there is a sustained supply of registered podiatrists and support workers to support the care of patients in the NHS in England who need their services. The wider work programme includes careers and retention work, widening participation in podiatry through apprenticeships and now a government-funded NHS international recruitment programme.

A key part of the work undertaken has been to review the podiatry workforce including the non-regulated support workforce and the regulated podiatry workforce (this aligns with the wider NHS AHP workforce review being undertaken). The creation of the standards for the non–regulated foot health work force (The Standards) is an opportunity to expand and harmonise the role of the podiatry support workforce and earn and learn routes to become a podiatrist within the NHS. This will enable, for the first time, recognition of the translation of skills across sectors and the potential contribution of foot health practitioners (FHPs) to the NHS support workforce. Additionally, the Standards will provide opportunities to further consolidate and enhance work already underway around the development of career pathways for support workers to become a podiatrist, thus improving the expansion of routes into podiatry.

Education routes such as apprenticeships, which provide career progression opportunities for the support workforce are being explored as well as supporting routes into podiatry pre-registration degree programmes. The level 5 foundation degree provides opportunities for upskilling the existing support workforce and providing step on points to the degree routes to train as podiatrists, thus expanding joiners to the profession.

The Standards themselves were commissioned by HEE and developed by the Standards Writing Group. The development of the Standards was overseen by the Foot Health Education and Training Standards Group. Members of these groups included professional body representatives, educators, academics, clinical managers, clinical practitioners, foot health practitioners and assistant practitioners in podiatry.

The draft Standards underwent an open consultation that ran from Monday 23 November 2020 until midday Monday 15 February 2021. Most of the data collected were qualitative free-text responses. The responses were centred around 5 key questions. The Standards cover academic levels 3,4, &5.

There was a total of 433 responses. Two methods have been executed in the analysis of the responses. First, a pragmatic deductive, analysis of the responses that specifically addressed the questions posed was undertaken. Secondly, thematic analysis was conducted on the remaining responses. The responses that did not directly address the questions posed formed a large qualitative data set best suited to an inductive thematic analysis. The analysis has been used to finalise the Foot Health Standards, as well as making recommendations for further work.

The two largest groups who responded to the consultation were podiatrists (59%) and foot health practitioners (25%). The largest sector responses came from private practice (68%), followed by the NHS (17%). Responses were received from all devolved nations, although the majority (90.5%) were from England.

In addition to specific amendments to the Standards the following recommendations have been made:

1. Recommendation for HEE to work with colleagues to provide clear alignment of the Standards to existing apprenticeship programmes at level 3/5/6. Using the Standards to identify gaps in provision could help develop an apprenticeship route that would deliver profession-specific content offering bespoke routes into the podiatry workforce.
2. Recommendation that NHS implementation is undertaken with service leaders as part of wider NHS work across HEE and NHSEI to support services facing a 17% vacancy rate, as part of the wide suite of support activities.
3. Recommendation for discussions to continue across the sector to explore how the Standards, once finalised, may be used and implemented within the independent/private sector.
4. Recommendation that consideration is given to explore how support and governance arrangements for independent and NHS practice, could be more closely aligned.
5. Recommendation for foot health leaders to consider how the standards could be utilised to aid standardisation of education and training of the non-regulated sector provided by the independent sector.