Enhanced practice

Enhanced practice is a level of practice within the healthcare workforce. It covers the graduate professional workforce delivering the majority of clinical activity, those who have moved beyond novice/competent and who are not working at the level of advanced practice. This is a highly valued, broad and essential level of practice within the workforce for whom training and development to maximise their professional skills and capability is a vital aspect of building safe and effective services, workforce productivity and retaining our staff.

People working at enhanced level practice will use a wide variety of job titles and are experienced registered professionals (first level statutory registration or a managed voluntary registration) who undertake complex work and manage day to day risk, including risks on behalf of, or with people. Enhanced practice occurs in multiple settings including secondary, community, primary and social care.

The enhanced practice workforce have many job titles and roles across many different professions. They tend to have undertaken post registration education relevant to their profession, area of practice and role. They usually work in their professional role as part of a multidisciplinary team and apply their skills, knowledge, and experience to substantially contribute to patient care. Although they work across different settings, they will often have a skillset and depth of knowledge related to their professional background.

Those working at enhanced practice level, occupy a space before advanced practice in terms of the management of complexity and uncertainty with enhanced practice can be a precursor to advanced practice, or it can be a valued workplace destination in itself, offering services and patients a consistent level of expertise.

To support our work and growth in this area, we have developed two documents which are available to view. 

-  A workforce modelling project for Health Education England

- The Principles of Enhanced Level Practice

Speaking on this work, Alison Leary for the Enhanced Practice Steering Group said:

‘Sustainable health and care requires a confident, capable, registered workforce able to fully realise their scope of practice at each level of practice from novice to expert. Developing as professionals means that clinical staff can effectively work with increasing levels of complexity and unpredictability.’

And Beverley Harden, AHP Lead Health Education England and Deputy Chief Allied Health Professions Officer noted:

‘Each profession develops approaches and expertise to meet the needs of patients and populations and to develop a body of knowledge that they hold and apply. Enhanced level practice is very much rooted in that development of knowledge and expertise, therefore different professional different groups express what it looks like to work at this level of practice. This means there is no generic “enhanced clinical practitioner” role or training.’

Programme update

We’re delighted to share some significant progress in our work to develop nationally recognised profession-specific training schema and model curricula for the enhanced level practice apprenticeship applicable to the individual Allied Health Professions (AHPs).

Following a positive procurement exercise, we have successfully awarded four contracts to the following organisations:

• University of Salford
• Coventry University
• Sheffield Hallam University
• and the Institute of Osteopathy.

This is an important step in the development of AHP profession specific clinical academic qualifications enhancing the options available across the breadth of the career framework.  Working collaboratively within innovation partnerships alongside education providers, professional bodies, clinical experts and employers, we are pleased that 10 of the AHP professions will be covered* by this piece of work.

Working to a timeline of delivery by the end of June 2023 this work will bring a blueprint for the delivery of profession specific content within the enhanced practice apprenticeship framework, alongside examples of key model curricular for each of the awarded professions critical to the delivery of 21st century care. This work will then be made available by HEE to other education providers to enable their delivery of the enhanced practice apprenticeship to cohorts of AHP learners. These apprenticeships will provide an alternative education route to co-exist alongside traditional education for the enhanced workforce such as post qualification certificates, professional development courses, degree, or master’s level qualifications.

The partnerships delivering this commission will incorporate a strong element of blended learning and technology enhanced learning (TEL), aiming to utilise the most up to date methods of education delivery.

Claire Arditto, Programme Lead and Regional Head of AHPs in the North East Yorkshire said:

‘I am delighted that 10 of our AHP professions will have access to profession specific enhanced practice apprenticeships for those delivering patient care in environments that are complex and require highly specialist levels of clinical expertise and leadership. We will be working closely with our innovation partners to develop training and upskilling fit for the future.’

We intend to explore opportunities in the future for enhanced practice schema for those professions not covered in this current phase of work.  We will maximise the learning opportunities from the current work to develop robust approaches with these professional groups.

More on our enhanced practice work