David Wylie, NMAHP Associate Director at NHS Education Scotland (NES) considers the challenges facing Allied Health Professions in the UK @wylieedpod @NESnmahp @NHS_Education

I qualified as a Podiatrist in 1982. That places me at the tail end of the ‘baby-boomer’ generation of practitioners who were the first AHPs to qualify with local anaesthesia as part of their pre-registration training. Although we thought the world was our oyster back then, little did we grasp the Copernican revolution that we were to experience during the 40 years of our professional lives.

Education led the way as it always does. That is why the privilege of working in NHS Education for Scotland weighs heavily on the shoulders, and why connectivity with the wider health and care system remains crucial to its strategic and operational planning.

We were the first generation of Allied Health Professionals to benefit from the introduction of more formalised postgraduate learning. Those from this generation who elected to engage with these learning opportunities have, for the last 35 years, led AHP professions forward educationally, clinically and professionally. It is a journey every bit as radical as the social revolution that took place within the wider culture across the UK over this generation.

There is no doubt that the drive toward higher academic rigour has revolutionised undergraduate AHP training and placed the emphasis far more firmly on programmes marked by robust educational governance, accompanied by the ability to critically evaluate evidence.

The future impact of postgraduate AHP educational opportunities at Masters and Doctoral levels cannot be underestimated. Continuing education challenges individuals to question and critically evaluate clinical, professional and organisational practices at all levels.

Role development has followed. The desire within an aspirational workforce for extended skills to support medical and surgical redesign in key clinical areas has delivered senior clinical and academic posts across the AHP community. However, the full impact of AHPs at all levels within the career framework functioning as fully as their regulatory body allows remains unrealised across the entire health and care system. Nonetheless, AHP-MAX remains a vision worth pursuing.

As ‘baby-boomer’ minds begin to wander towards retirement, the AHP profession face a new challenge. A challenge that will be most acutely felt by Gen Y-ers; those born between the early 1980s through to the early 2000s.

Put simply, the challenge is this: what will Gen Y make of the legacy handed down by the ‘baby boomers’? The answer to this question will determine the nature of Allied Health over the next 35 years.

Managerially and organisationally, radical changes are needed in the way AHP services are delivered across the traditional divide between primary care, community services, and acute hospitals. This dichotomy, largely unaltered since the birth of the NHS, is a barrier to the personalised and integrated care individuals need. Those working in the NHS will increasingly need to dissolve these traditional boundaries. Long-term conditions are now the central focus of the NHS; caring for these needs requires a partnership with individuals over the long term rather than providing single, disconnected ‘episodes’ of care. Gen Y AHPs will need to manage networks of care integrated around individuals – not just organise AHP services.

Gen Y AHPs will also need to learn much faster from the best examples. Increasingly, these will emerge not just from within the UK but internationally. They will also, as they introduce them, need to evaluate new care models to establish which produce the best experience for patients and the best value for money.

One of the biggest challenges faced by Gen Y AHPs Is to engage fully with national and local policy makers in order to reduce secondary care interventions by maximising the AHP contribution for individuals with multiple co-morbidities and poly-pharmaceutical management.

Gen Y AHPs also require to contribute to public health by developing the knowledge and skills necessary to fully participate in the delivery of general health interventions relating to mental health, physical activity, smoking, obesity, dementia and other public health initiatives at local and national levels.

Finally, Gen Y AHPs face the challenge of advising local and national policy makers with reference to workforce planning activities, not only with reference to developing extended roles across the career framework, but also in influencing the scope of practice, competency framework and governance for associate and assistant practitioners.

Gen Y AHPs have been handed a legacy that their ‘baby-boomer’ predecessors gave their professional lives to secure. Much has been achieved.

However, strong and transparent transformational, adaptive and compassionate   systems leadership is required in order to improve succession planning for future leaders within the AHP professions. Leaders who will define the future of these professions, in the words of Michael West, by ‘doing what is difficult, rather than simply manage the inevitable.’ As Alan Borthwick and Susan Nancarrow pointedly conclude in their excellent book, The Allied Health Professions: A Sociological Perspective, ‘The Allied Health Professions must adapt; survival may hinge on becoming what is asked of them, not what they desire.’1

The challenge facing Generation Y AHPs is therefore already upon us. For the sake of the next generation, and beyond, failure now is not an option.


1 Nancarrow, S & Borthwick, A (2021) The Allied Health Professions: A Sociological Perspective. The Policy Press. Bristol.


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