Employers in the NHS are facing challenges with recruiting and retaining podiatrists. Developing the podiatry workforce is vital if the NHS is to provide patients with the necessary podiatric care they require at the right time with the right skills at the right level. Central to this development is the need for services to fully utilise the skill mix that is available to them. Podiatry services are provided by a range of clinical staff from the support workforce to advanced (also known as ACP) and consultant level practitioners. In developing services, patient safety is paramount.
The purpose of this guide
This guide was developed in partnership with NHS England and will provide the necessary guidance to enable NHS organisations to develop your podiatry services effectively to provide safe and effective care to the patients and communities you serve. It will enable organisations to increase routes into podiatry and better use the skills and capabilities of existing staff. We showcase experiences of individuals and organisations that have embarked on journeys to future-proof podiatry in the NHS.
What is podiatry?
Podiatrists prevent, diagnose, and treat problems affecting the foot, ankle and leg. They see patients with a range of conditions that require medical, surgical, or palliative intervention, or rehabilitation and preventative care. Podiatrists play an essential role in managing general health conditions, including a range of systemic conditions that can affect the lower limb. Learn more about the remit of podiatry in a video by Royal College of Podiatry (RCPod).
The Saks report published by RCPod in 2021, outlines the vital role that podiatrists play in meeting the increasing need for foot and lower limb healthcare services, and makes recommendations on what the profession needs to do to develop and sustain itself for the future. Employers can benefit from implementing the recommendations made in the report, to help achieve and sustain an effective podiatry workforce. This guide cites and explains how some of the report’s recommendations can be achieved, including:
using flexible educational approaches like apprenticeships, to attract individuals into podiatry
focusing on professional development to aid retention, including facilitating opportunities to develop foot health support workers into registered professionals, and advanced practitioners
further delegation of routine work to support workers to help grow and expand the podiatry workforce.
Podiatry in the NHS
In the NHS, podiatry is one of the 14 allied health professions. Podiatrists play a vital role in supporting services in the NHS, with a range of roles in primary, secondary, and community care. They can work as part of a larger multidisciplinary team, or independently in community clinics.
Currently, their contribution to community services is particularly critical, given the ambitions outlined in NHS England’s Priorities and Operational Planning Guidance (2023/24). The guidance highlights this as a key area of focus and encourages more self-referral routes to podiatrists. The aim is to diagnose and treat patients early, decreasing hospital admissions and enabling early discharge. Redesigning the workforce with new roles and ways of working can help reduce waiting lists, improve the patient experience and support the services NHS organisations offer.
NHS podiatric practice covers specialist services in clinical areas such as diabetes, rheumatology, foot ulcer clinics and wound care services, as well as foot and ankle surgery and musculoskeletal care. NHS podiatrists offer podiatric care to patients with complex medical pathologies such as vascular, neurological, and autoimmune diseases plus nail surgery under local anaesthesia.
Some podiatrists work as first contact practitioners in primary care and help minimise the pressure on general practitioners and other healthcare professionals. By undertaking additional training, podiatrists can become advanced practitioners specialising in a specific area of practice.
What the statistics show
Research suggests an ongoing decline in the number of entrants into the profession and increasing attrition rates. The latter is due to the ageing workforce, although other factors such as working in a highly pressured environment also play a part. This is causing challenges meeting the increasing demand for podiatry services in the UK. NHS England has highlighted that employers must put measures in place to protect their podiatry workforce and future-proof the profession to aid supply. The Health and Care Professions Council (HCPC) regulates podiatrists and other allied health professions in the UK. There are currently 11,977 podiatrists/chiropodists registered with the council (HCPC, 2023); 800 less than in 2019. With less than half of this regulated workforce working in the NHS.
The HCPC’s Diversity Data report (2021) shows the following demographics.
Diversifying the workforce
Raising the profile of podiatry and widening the remit and reach of career campaigns is a potential way to increase the gender and ethnic diversity of the workforce. Organisations could also improve this by working as a system to share resources, and to communicate the opportunities available with their local communities.
Ensuring inclusive practices in the workplace for groups such as LGBTQ+ is also essential towards a more inclusive and compassionate workforce in podiatry and other healthcare professions.
- The Diversity Dividend article by The Podiatrist highlights issues with inclusivity and negative experiences of LGBTQ+ staff working in podiatry.
- NHS Employers’ guidance on widening participation as a strategic approach.
- Read how Great Ormond Street Hospital diversified their apprenticeships programme.
- Read our working with the Prince’s Trust Page on supporting more young people into employment.
Integrating podiatry into your service
You may not have a podiatry service in your organisation, or you may wish to recruit more podiatrists to add to your existing workforce. Either way, building a strong business case for your plans will help ensure board-level commitment from the outset.
Building an effective business case
- NHS England expects demand for podiatrists to increase by nine per cent between 2023 and 2025 to meet core service and provider demands, and by 19 per cent across all services. Outline the consequences to patient care if this demand is not met, with reference to the NHS Long Term Plan.
- Use your own workforce data, latest statistics, as well as external information on the benefits of employing podiatrists in your trust or service. RCPod released Saks report (2021) to help you, which outlines the benefits of podiatry in the NHS.
- Network with podiatrists in other services to hear success stories you can share with your leaders, highlighting the benefits of improving patient care. A cost-benefit analysis is recommended. There are free templates available online.
- NHS podiatry managers who are members of the RCPod, can request to join their NHS managers group by emailing email@example.com This steering group includes NHS managers, with representatives from each English region as well as Scotland, Wales and Northern Ireland, and shares advice on growing the service.
- Develop a strong partnership with your local education providers and regional NHS England teams.
“We worked in partnership with our local college and university to develop a course that trained staff to level 5 foundation degree with an accreditation of prior experiential learning (APEL) opportunity onto podiatry degree programme. This course is available nationally via distance learning or an apprenticeship route.” Angie Abbott, head of podiatry and orthotics services (acute and community) at South Devon NHS Foundation Trust
Transforming your existing podiatry service
Identify areas for improvement and create an action plan
Transforming your workforce can be challenging but can ensure a better service for your patients and the podiatry workforce in the long term. The first step is understanding how your current service is performing, what works well and areas for improvement. It can mean reviewing your service in full. This involves looking at your data, resources, processes, and performance in detail.
Employers should connect with relevant stakeholders to gather the information to build a business case for change and create a carefully considered action plan. Since transformations often involve major organisational change, they should be carefully planned and executed to minimise any negative impact on staff and patient care.
Engage your leaders and staff
Having strong leadership and decision makers on board is essential in driving the change. These people can help secure the required funding, resources and address any setbacks along the way. Leaders also play an important role in regularly communicating and reassuring employees while being honest and transparent about any challenges. When employees are consulted and feel involved in the process, leaders are likely to get a better response.
Read how Sherwood Forest Hospitals NHS Foundation Trust made significant improvements to its performance through effective staff engagement initiatives.
Transforming your service the Bedfordshire way
Bedfordshire Community Health Service (BCHS) podiatry service needed a full transformation following a serious incident and increasing attrition rates.
BCHS underwent a full service review to help inform its workforce transformation journey. Emma Stoneman, professional lead for podiatry at the centre, has the following advice for other services on this journey.
Transforming podiatry in the South East region
NHS podiatry services across the south east of England engaged in a workforce transformation project, which is currently in its first phase. This was in response to outputs from the national advanced healthcare practitioners (AHP) data task force, who identified the podiatry workforce was facing significantly challenges to meet patient demand. The COVID-19 pandemic further complicated this situation and created an additional demand for recovery and growth.
As a result, the South East AHP undertook a profession-specific workforce reform programme, targeting podiatry. In scoping the work, podiatry was seen to be facing significant recruitment challenges, particularly into band 5 posts. Overall, joiners to the workforce had decreased while leavers increased. Some of the programme’s interventions included exploring a range of apprenticeships at levels 2, 5 and 6, and expanding practice-based learning environments to embed a more holistic approach to learning.. Plus, expanding the support workforce and looking into international recruitment initiatives.
Read more about the ongoing work in the report on the South East podiatry workforce sustainability and transformation project.
Increasing pipelines into your podiatry service
Employers need to engage with their future podiatry workforce to encourage people to join the profession. By offering good placement opportunities for students, engaging with local higher education institution (HEIs) and university students, offering preceptorship and supervision opportunities, and talking about the development opportunities available.
Recruiting degree graduates
The most traditional route for people wanting to pursue a career in podiatry is through an approved degree (BSc), which takes around three years to complete full time. Alternatively, individuals who already have a BSc (Hons) in a health-related subject can complete a two/three pre-registration Master’s programme (MSc) in podiatry or podiatric medicine. Recruiting graduates who have taken this education route gives employers access to a cohort of people who have studied extensive theoretical and practical modules.
Making the most of your support workforce
Education level 2-5 support workers
Support workers in NHS podiatry services comprise a growing and vital part of the workforce. In the NHS podiatry sector, support workers typically work between education level 2-5, and are often called podiatry assistants, foot care assistants, podiatry technicians or podiatry assistant practitioners. Depending on the level of training and competence, they can support with procedures and support registered podiatrists, releasing them to undertake complex work, embark on new learning opportunities or try new technologies and helping clear waiting lists. They are key in helping you create the right skill mix in your team, and enabling your podiatrists to provide specialised, high-quality patient.
The support workforce may be your future podiatry workforce, it makes sense to nurture them and promote their development. Historically, these workers received in-house training, with some going on to complete foundation degrees, or other training routes such as the assistant practitioner training course provided by the RCPod.
How South Devon NHS Foundation Trust uses support staff
Angie Abbott, head of podiatry and orthotics services at South Devon NHS Foundation Trust, says “Recruitment challenges and an increase in treatment demand and complexity led me to review the tasks that podiatrists undertook. I knew I needed additional support for my podiatrists, and to create a better skill mix within the team to meet our patients’ needs. I recruited a range of support workers with an educational level between 2-5 to ease the pressure on by supporting them with some routine procedures. For example, level 5 foundation degree trained assistant practitioners provide a home visiting service to redress foot wounds, doppler and vascular testing and scalpel debridement of corns and calluses on high-risk feet. This support is invaluable and gives everyone additional opportunities to develop and learn new skills or develop enhanced services. It also means we can provide more specialised, high quality patient care.
Skill mixing within the team has cleared the trust’s waiting list; enabled delivery of a NICE-compliant diabetic foot service; enhanced podiatry roles enabling non-medical prescribing, research, ultrasound imaging, steroid injection therapy, shockwave and other innovative practices.”
NHS England’s AHP Support Worker Competency, Education and Career Development Framework provides guidance on recruitment, training, education and competencies for AHP support workers.
NHS England’s guide on developing the role of AHP support workers.
Thinking beyond traditional recruitment routes
Recruiting foot health practitioners into the NHS podiatry support workforce
We would encourage employers to explore and facilitate routes for foot health practitioners (FHPs) into the NHS, to boost the support available to the NHS podiatry workforce.
The training provided across the sector is variable with a lack of clarity around which treatments can be carried out by FHPs. However, the introduction of the standards for the foot health workforce is intended to support the NHS in utilising the full skills mix of the foot health workforce to meet demand, by providing a clear understanding of the footcare treatments that FHPs and the podiatry support workforce can safely perform. The needs and safety of patients have been central to this work. Employers can use the standards to support the development and progression of the podiatry support workforce, by mapping their existing support workforce to identify training needs for individuals. It can be used as an appraisal or self-assessment tool for existing NHS support workers.
The RCPod is developing an accreditation route for individuals and education providers. This NHS England-funded initiative will aid the development of the NHS podiatry support workforce. Read more about the initiative on the RCPod website.
Together with the level 3 and 5 apprenticeship pathways now available within the NHS, the accreditation route will enable both FHPs to join the NHS, and existing NHS support workers to develop their careers. By providing recognised development pathways and standardised education and training pathways, the workforce can develop and grow to meet demand, ultimately leading to better care for patients.
Lois talks about her passion for a career in podiatry, the benefits it brings her and her family and how she will achieve her dream of becoming a podiatrist.
After having my son, I knew I couldn’t return to a full-time job in an office, but I still needed to provide an income for my family. In 2012, for my first course to enable me to practice as an FHP.
First, I gained a level 3 qualification that gave me the confidence and an appetite to learn and develop. My desire to continue learning led me to gain a level 4 qualification in 2018 plus a further assistant podiatry certificate, which I successfully completed in 2020.
Because I had an A Level in biology and had my Maths and English GCSEs, coupled with the foot care qualifications, I was able to apply to do the podiatry degree. I was accepted and started the course in September 2023.
I’m not going to lie, the journey has been tough. As soon as I qualified as an FHP, I was out seeing patients, juggling broken sleep and all the perils of motherhood. However, as soon as once I started, I knew it was for me. The role offers flexible working arrangements, and whatever work I put in, I would reap what came back to me.
From the beginning I’ve never stopped learning, I’ve continually enrolled in Continuing Professional Development (CPD) courses to boost my confidence and knowledge I’ve also been lucky the people I’ve met along the way have fuelled my inspiration. It’s always been about knowledge for me, to be better at what I do and offer the best outcomes for the people I treat.
I would love to work for the NHS as it’s the gold standard of healthcare and I personally feel it’s the best place to build experience and knowledge. I’ve come a long way, but I also know I have a long way to go. Becoming a podiatrist is the next natural step, and now I’ve been offered a place at university, feels like a dream come true.
I am nervous and apprehensive about starting the degree programme, after all, I have a family to take care of as well. My secret so far has always been little and often so if I stay up late or make an early start to finish an essay then that is what I will do. My previous experiences in life have meant that I’ve had to be planned and organised so I’m hoping
My advice to myself and others is if you love what you do, if you love the profession, then take the leap of faith. The world of podiatry is an amazing career, full of opportunities to diversify. With a bit of luck and hard work, the opportunities are endless.
After twelve years working in a performing art, music, and media college, I felt I was ready for a change of direction. I researched career options and mobility kept coming up. At the time, I did not know the role I now do even existed in the NHS, and so initially my search took me to the world of FHPs, Having completed the training, I really enjoyed working on a one-to-one basis with patients, helping people maintain their dignity and independence. This gave me a real sense of making a difference.
I had been working as an FHP for four years when I heard about an NHS band three podiatry assistant vacancy in my area. I liked the independence and slower pace of my FHP job, but I really wanted to find a way that would help me develop in my role. I was successful at the interview and was delighted to accept the post. Since joining the NHS two years ago I have benefitted from the advantages of working in a team setting. I have learnt so much about podiatry and have really appreciated the supervision and support as well as the varied and interesting work.
Working in the NHS has helped me develop in my role as a podiatry assistant, helping me build on my FHP training by completing an assistant practitioner course with RCPod. Working in a team has provided me with an appreciation of the complex caseload that podiatrists in the NHS have. Seeing a more complex caseload under the supervision of the podiatry team has helped me as a podiatry assistant spot the ‘red flags’ and early warning signs that patients may present with. I know when and how to refer or escalate concerns to the right professional to keep patients safe. The supervision and support have provided a psychological benefit for me too - not feeling like I am on my own.
Growing your own
Apprenticeships as the way forward
The podiatrist degree-level apprenticeship is available as a BSc (Hons) or a pre-registration MSc. It can appeal to people for who a full-time university course is not a viable option and can attract talented candidates into a professional role they may not have considered. This route can be used to help attract, retain and develop talent within an organisation and achieve goals around diversity, social mobility and widening participation. With the number and range of apprenticeships now available, many employers are using them to increase the workforce, support staff development and provide career pathways across the organisation and at all levels, for example from new recruits to advanced practitioners.
Degrees earned via the apprenticeship route are awarded by universities and are an equivalent standard to those gained using the full-time academic route and allow graduates to register with the HCPC as a registered podiatrist. A podiatrist degree programme delivered through an apprenticeship typically takes 48 months to deliver and includes an end-point assessment. Many courses will allow students or apprentices to accredit prior learning, which shortens their course.
The end-point assessment provides a valid, reliable and independent judgement that the apprentice has achieved the required standard to gain the integrated degree apprenticeship for podiatry and become registered with the HCPC.
Employers can use their apprenticeship levy to fund the cost of the apprenticeship training and end-point assessment up to the maximum of the assigned funding band, which is currently set at £24,000.
- Level 2 – Healthcare support worker (HCSW). Level: 2, Minimum duration 12 months, Maximum levy funding: £3,000
Healthcare support workers (HCSWs) work as part of a team and may carry out clinical and non-clinical duties depending on where they work. HCSWs work in a range of healthcare settings and with colleagues from both health and social care, they are supervised by a registered healthcare practitioner.
- Level 3 – Senior healthcare support worker (SHCSW). Typical length: 18-24 months.
Maximum levy funding = £5,000
Senior healthcare support workers help registered practitioners deliver healthcare services and often carry out a range of clinical and non-clinical healthcare or therapeutic tasks within the limits of their competence. They work under the direct or indirect supervision of the registered healthcare practitioner and can be based on a range of services such as hospital, community, GP surgeries, or in partnership with individuals, families and other service providers.
- Level 5 – Assistant practitioner (health). Typical length: 24 months.
Maximum levy funding = £14,000
An assistant practitioner can support organisations to deliver high-quality, patient-centred care in a variety of settings. Although they are not registered practitioners, they have a high level of skill and an in-depth understanding of the factors that influence health and ill health through their experience and training and work under the direction of registered healthcare professionals including registered podiatrists. Some level 5 assistant practitioner programmes allow for accreditation of prior learning (APEL) onto podiatry BSc programmes. RCPod also offers an assistant practitioner training programme.
- Level 6 - Podiatrist degree. Typical length: 48 months
Maximum levy funding = £24,000
The degree leads to an individual becoming a registered podiatrist who specialises in the lower limb, for example, feet, ankles, or legs. Podiatrists provide preventative advice, care, assessment, diagnosis and treatment. They also aim to reduce the impact of disability and dysfunction and have a role in rehabilitation. In addition, they play a pivotal part in reducing the risk of amputation, infection, pain, deformity and hospital admissions.
- Enhanced level of practice Typical length: 18 months
Maximum levy funding = £7,000
Enhanced practice is used to describe the practice of highly experienced, knowledgeable healthcare professionals who have obtained a level 6 qualification. They can work as part of a multidisciplinary team across a wide range of health and care settings and come from all multi-professional backgrounds, including podiatry. Visit the institute of apprenticeships and technical education webpage and NHS England’s guide for information on enhanced clinical practice roles.
- Level 7 – Advanced clinical practitioner - Typical length: 36 months
Maximum levy funding = £12,000
Advanced practitioners (also referred to as advanced clinical practitioners) are experienced clinicians who demonstrate expertise in their scope of practice. Advanced practitioners manage defined episodes of clinical care independently, from beginning to end, including admission, referral or discharge and carry out their full range of duties in relation to individuals’ physical and mental healthcare in acute, primary, urgent and emergency settings. Apprentices complete a Master’s degree in advanced clinical practice and combine expert clinical skills with research, education and clinical leadership within their scope of practice.
An interview with Marian Bennett, a specialist podiatrist from East London NHS Foundation Trust
1. Why do you think apprenticeships in podiatry are the way forward?
For the learners, it’s a fantastic opportunity to learn the profession from the inside out and get paid while they learn. Our apprentices are on the job and part of the team from day one. There’s no better way to learn.
For employers, supporting apprentices is a way of growing a strong, competent workforce for the future and giving people a different route into the profession. And while employers need to invest, both financially and in terms of time and support, apprentices quickly become valued, contributing team members.
2. What are some common myths around apprenticeships, and how would you challenge them?
I’ve heard it suggested that apprentices won’t have the same level of academic knowledge as their undergraduate peers - but they must complete the same academic exams and modules as traditional podiatry students. They also get a much greater opportunity to implement that knowledge in practice so it’s never just theoretical. They also get access to a team of qualified podiatrists to talk to about their learning.
I think people also believe that apprentices can’t do much clinically and are not going to be an asset until they have graduated, but that’s just not the case. If the apprentices are supported to develop their clinical and administrative skills. It’s important to remember that these are not students shadowing your service, they are employees with an active and important role to play. The more you put into them, the more your service will benefit throughout the apprenticeship, not just once they have graduated.
3. How have you seen apprenticeships help your service and what do you anticipate the long-term benefits will be?
We currently have three apprentices, they contribute a huge amount and are integral members of the team. As well as our more experienced apprentices running ulcer and high-risk clinics under podiatrist supervision, they run independent clinics including nail surgery assessments and redressing clinics. They provide support in nail surgery, hospital outpatients and musculoskeletal (MSK) clinics, and manage all the administration for our National Diabetes Footcare Audit reporting, our education service, peer audits, and so much more.
The apprenticeship is a win for them and the profession. They have a real understanding not only of how our service works, but also a broader understanding and working knowledge of podiatry services and the NHS in general. They will graduate with four years’ experience of full-time employment in a podiatry service, and clinical skills that will enable them to step immediately into more complex patient care.
4. How can podiatry services with no experience of recruiting and embedding apprentices get started?
There is support available through RCPod website including a set of resources and documents . Your trust will have an apprenticeship lead that can offer support and advice. It’s also worth looking at the healthcare apprenticeships website on Skills for Health for advice and resources. Your local universities can also support you.
Also, talk to people who have done it. There are apprentices all over the country now and while it’s still a new thing in podiatry, there are plenty of employers who do have experience that they can share with you.
5. What are the practical steps NHS organisations can take to best support their apprentices during their learning journey?
You’ll be given information on the academic modules that your apprentices will be doing through the course and you’ll be having conversations with the apprentices about this along the way. Where possible, it’s helpful to try and tie their clinical experience in with their academic learning. For example, enabling them to support in MSK clinics when they are studying anatomy or gait analysis. It’s also really important that as their academic learning progresses, they are able to develop more advanced clinical skills and be allowed to work more independently where possible.
Apprentices should have a clinical educator as well as a line manager – preferably not the same person – so that they have someone who is focused on supporting their learning journey separately from their management as an employee.
“The idea of growing your own staff and investing in their development is key to shaping your workforce effectively, keeping your staff happy and retaining them. I have encouraged and supported my staff to embark on apprenticeships, so they can get the invaluable hands-on experience during their learning journey and achieve their career goals.
Apprentices have exceeded my expectations and developed their knowledge and experience exponentially. One of my apprentices, achieved a level 5 foundation degree and is now currently on a level 6 apprenticeship and is on her way to becoming a podiatrist. She is already a part of the team and this will enable her to seamlessly embed herself into her new podiatry role when she graduates.
Don’t be afraid to try new things and explore they pipelines into podiatry. Through a paid work experience opportunity, we offered applicants the chance to explore the profession further. This was a successful endeavour, which led to the recruitment of an administrator into a level 3 support worker role.” Angie Abbott, head of podiatry and orthotics services (acute and community) at South Devon NHS Foundation Trust
How to pick and procure a podiatry degree apprenticeship training provider
Apprenticeships can only be delivered by a training provider listed on the Register of Apprenticeship Training Providers (RoATP) and the end-point assessment by an organisation on the Register of End-Point Assessment Organisations (RoEPAO). As an integrated degree apprenticeship, the end-point assessment organisation can also be the training provider, but they must be registered on both registers, The podiatry degree apprenticeship is often provided by an existing education provider of a BSc (Hons) podiatry programme. The RCPod website provides details of education providers.
- Information on how to find an approved apprenticeship training provider is available on Gov.uk.
- The Education and Skills Funding Agency (ESFA) manages the register of apprenticeship training providers.
- NHS England has produced an apprenticeship procurement toolkit for employers, which offers support with navigating the procurement process and provides an overview of the various options for support available nationally, as well as a series of case studies.
Lucy and Phoebe both work as podiatry apprentices at East London NHS Foundation Trust. They started their journeys at the same time and are benefitting from each other’s support.
Phoebe Edwards’ apprenticeship journey
I worked as an administrator in Cambridge Community Service NHS Trust in the community diabetes service in 2018. I learned how clinicians can make a huge difference in people’s lives, and how important mobility is for a good quality of life. It sparked an interest in me and I knew I wanted to head toward a clinical route, but I didn’t know what exactly. I completed the care certificate to help me get started, and it was during the course that I got to shadow podiatrists and nurses working with diabetic patients. I was keen to learn more and completed the Cambridge Diabetes Education Programme, when I discovered the podiatry apprenticeship opportunity. I took a leap of faith, applied, and got the job. I
I am lucky to work with another apprentice, Lucy. We support one another to overcome the challenges of coming from a non-clinical area. We keep each other motivated, learn from each other, and have together found the balance between studying and doing the practical work. It takes a lot of dedication and hard work but can be done.
Lucy Beaumont’s apprenticeship journey
Although my mum works in podiatry, it didn’t occur to me initially to follow in her footsteps. I embraced my artistic side and completed a surface pattern and textile design degree but soon realised it wasn’t my passion. I secured a job as a medical secretary in a GP practice in Bradford, where I had the opportunity to learn about different specialisms and this inspired me to explore my options further in a clinical role.
I supported my parents’ private foot clinic with reception cover, which also allowed me to shadow podiatry up close within a private setting. My mum is a podiatrist and my stepdad a foot health practitioner, who both upskilled within their NHS careers.
Having admin experience at the GP Practice and further shadowing experience within a private podiatry clinic helped me to gain a better understanding of just how vital this area of clinical practice.
Seeing the work ethic and passion my parents showed their patients was truly inspiring, and I’m so proud to see the careers they’ve built for themselves. I wanted to do the same.
When the apprenticeship route became available, I jumped on the opportunity. I knew it was the perfect route for me as I learn best through using practical skills. I’m grateful that my employer decided to employ both Phoebe and I, even though there was only initially a single job post. I think they could see the benefits of having good peer support and was keen to for us to have that.
We’ve found that as we progress further through our apprenticeship, we’re often teaching the traditional BSc route podiatry students, who ask for our advice on procedures. They value our practical experience, and we learn from them too. It’s clear that the best course for anyone thinking about podiatry depends on their learning style!
Ruth Clausen’s apprenticeship journey
Ruth is an assistant practitioner in podiatry at Torbay and South Devon NHS Foundation Trust. She has been working as an assistant practitioner since 2014 and helped with the implementation of vascular clinics.
Using previously acquired competencies she can perform total contact casting for diabetic plantar wounds. Assisting people of all ages, backgrounds with their feet to help maintain healthy feet is very rewarding from the simple aspects to helping to protect the limb of a person. Ruth has been given the opportunity to extend her knowledge and skills and continue her learning journey onto becoming a registered podiatrist.
Ruth is currently undertaking the podiatry degree (BSc) apprenticeship, which is delivered as a blended learning programme with one day a week online learning from lectures, directed clinical learning, exams and giving presentations.
Ruth spends one day a week with a clinical educator within the podiatry service to gain the knowledge and skills to become a podiatrist. This involves working in ulcer clinics, assessment, biomechanical and nail surgery clinics, enhancing practical and academic learning.
Being a degree apprentice means she still works within the department and still gets paid and this route will guarantee a band 5 job at the successful completion of the course.
- Watch this webinar on how employers can use apprenticeships to grow the NHS workforce.
- Use NHS Employer’s poster to promote apprenticeship opportunities in your organisation.
- NHS England’s information on apprenticeships for AHP support workers and their AHP support workforce: grow your own workforce strategies guidance.
Other routes into podiatry
Podiatrists returning to practice
Some podiatrists may have taken time out from their careers for many reasons such as to raise children, travel, study, or care for relatives. It is beneficial to support them with transitioning back to the workplace effectively, to ensure their wellbeing, progression, and retention.
The Armed Forces community
The Armed Forces community comprises both individuals who have served in the Armed Forces and individuals affiliated with the Armed Forces, including military family members and dependents. The values held by members of the Armed Forces community also align closely with the NHS ways of working and values, with particular emphasis on service, commitment and respect. By supporting members of the Armed Forces community into employment and within the workplace, you can support members of an overlooked and undervalued community, and broaden your recruitment pools into podiatry.
Using volunteers to support podiatry is not only cost effective, it also helps to expose potential candidates to podiatry. Some trusts have used this as an innovative way to create new talent pipelines and tackle workforce needs. For example, when Bradford District Care NHS Foundation Trust (BDCFT) faced difficulties recruiting to hard-to-fill AHP roles such as podiatry, they recruited volunteers to support staff. Read the full case study.
International recruitment is a legitimate part of an organisation’s workforce supply strategy. Employers could consider recruiting from abroad to help resolve workforce supply gaps, but it is useful to familiarise themselves with some of the considerations in our NHS international recruitment toolkit first. A previous international recruitment campaign by NHS England successfully recruited podiatrists from abroad into the NHS.
- Read about the successes of NHS England’s International Podiatrists Programme
- Access a guide for employers on the recruitment of oversees allied health professionals.
- Use NHS Employers’ international recruitment toolkit to plan or review your oversees recruitment activity.
- See NHS England’s resources on supporting transition of AHP international recruits into the NHS workforce.
- Our infographic shows different routes available for organisations to train allied health professionals, as outlined in this section.
- Updated guidance on recruitment of young people.
- Royal College of Podiatry’s Podiatry career framework.
Planting the seed early
Engagement with schools
Partnerships with local schools and communities can support you to strengthen your workforce supply and attract new people into careers in the NHS, inspiring them to become podiatrists.
Engaging with your local schools, faith groups, sports clubs and other community groups such as youth clubs, cubs, guides, cadets etc, can help young people understand from an early age the variety of roles available in the NHS and the different career pathways they can take. Highlighting podiatry at this stage could be valuable in attracting new talent to the profession and helping tackle workforce shortages. It is important to include this in your workforce planning, as it helps you to develop a pipeline of new people.
Offer work experience placements and volunteer roles.
Highlight the new T Levels as an option and entry route into a career in the NHS.
Showcase the podiatry apprenticeship as a different route, alongside the traditional university degree.
Arm your podiatrists with the right resources, and opportunities to take part in these campaigns to promote their work.
T levels placements
T Levels are two-year technical courses for people aged 16 to 19 and are delivered by schools and further education colleges. 20 per cent of the programme is spent in an industry placement with an employer, which last a minimum of 315 hours (approximately 45 days). While completing the industry placement the students are not employed and therefore are not required to be paid, but employers are encouraged to provide students with placements to increase interest in professions such as podiatry and where possible opportunities to join the bank to work as healthcare support workers or equivalent.
T Level programmes give students a real understanding of what it is like to work in the sector and enables them to gain knowledge, skills, and behaviours necessary for employment in their field of study before they go on to train for a specific role through one of the degree options outlined above.
The T Level for health and healthcare science deliver the essential knowledge and skills to work in health or science and can provide a pathway for pursuing a career in podiatry. The Department for Education has announced a package of additional funding and support for T Level providers and employers. Employers can claim funding for legitimate costs associated with hosting a T Level industry placement student, such as set-up costs, equipment and staff training by following guidance on the Gov.uk website.
Offering work experience can help open the doors to new talent pipelines. NHS England outline the benefits for employers in their NHS work experience toolkit:
- develop your future workforce
- work with the local community, providing an opportunity to engage, inspire and inform people
- develop staff - it’s a chance for all staff to build management skills
- gain fresh insights - see your organisation through someone else’s eyes
- increase staff engagement - colleagues get a genuine buzz from inspiring people.
Implementing this approach can help get people interested in podiatry. The guide has useful hints and tips on how to get started, and what employers should consider when offering work experience.
Developing your existing workforce
Benefits for your staff and patients
Developing your existing workforce is key to creating a good skills mix and retaining your staff. It plays a big part in job satisfaction, through recognising and valuing your staff and helping with the increasing cost of living. It benefits patients by offering a wider range of services, increasing access to specialised health services and reducing health inequalities, as well as offering timely interventions that reduce waiting times.
Implementing internal development pathways and having regular continuous professional development (CPD) conversations as part of one-to-ones and/or supervision discussions, help staff achieve their goals. Line Managers should consider that development can include other areas, as well as clinical work. Podiatrists have potential in research, education, managerial, and leadership positions, such as leading a team of podiatrists, developing services and offering service improvement solutions. They can use their knowledge and expertise to effectively inform the development of podiatry service, such as Bedfordshire’s podiatry service transformation earlier on in this guide.
Creating clear internal career paths can encourage staff to stay. Career paths are not always linear or set in stone and can look different in services. Below is an example of what a career development journey could look like.
Example development pathways
- Podiatry support worker
- Entry-level podiatrist
- Specialist podiatrist
- Team leader, advanced podiatry
- Surgical trainee
- Specialist registrar in podiatric surgery
- Consultant podiatrist/podiatric surgeon
Developing your staff also means supporting and training them to understand the scope of practice of other AHPs and medical professionals. This helps to ensure better collaboration and teamwork and results in a smoother transition along the patient care pathway. Read The Podiatrist’s article on the importance of shattering silos.
A career in research
Clinical research provides evidence to inform clinical decisions, which is vital for ensuring the best possible care for patients. Podiatrists have a role in clinical research via clinical academic and research roles within an NHS setting. The NHS England/NIHR Integrated Clinical Academic (ICA) Programme for non-medical professions offers a development route for this. Watch The Royal College of Podiatry’s video on Why Podiatrists do Research.
- NHS Employers’ web pages on developing staff career pathways to support workforce supply and supporting in-work progression.
- NHS Employers’ new improving retention guide supports line managers and employers to consider the key areas which affect workforce retention, including development.
- RCPod’s web page on careers in podiatry.
- RCPod’s web page on becoming a researcher in podiatry.
- NHS England’s Maximising Leadership Learning in the Pre-Registration Healthcare Curricula.
- Guidance on creating effective leaders from the Leadership Academy.
Growing your experienced staff
Supporting your staff to specialise
Building on the competencies of your experienced staff can help you offer a more specialised service to patients and retain your talent. Having the right supervision and support staff, and ensuring staff have adequate time to learn and to implement their learning, can make this a success.
“Focus on the development of your staff at all levels. Think about your more experienced staff too, who may be interested in specialising, or trying new technologies. I have recently helped secure funding for two podiatric surgical fellowships in the south west. I’m certain the service will reap the benefits of the investment through meeting the needs of wider patient groups to enable speedy access to care, and of course, keeping staff happy because they are being given the opportunity to develop.” Angie Abbott, head of podiatry and orthotics services (acute and community) at South Devon NHS Foundation Trust
A specialism example: podiatric surgery
Podiatric surgery is the surgical management of the bones, joints and soft tissues of the foot and associated structures. A podiatric surgeon is a highly skilled clinician who in addition to a first degree in podiatric medicine continues to study at a Master’s degree level in podiatric surgery.
The journey to becoming a podiatric surgeon begins by gaining experience working as a podiatrist alongside developing an interest in podiatric surgery by reading, networking and obtaining membership support by joining the local RCPod Regional Deanery group. RCPod outlines the required training and demonstrates a typical career pathways into this speciality in more detail.
Suzanne Taylor is a podiatric surgeon working in the musculoskeletal service at Sussex NHS Trust. Her role is to keep people mobile and active and out of hospital, working alongside her other colleagues in physiotherapy and pain management.
Suzanne says: “One of the reasons I love podiatry is that I really can see how foot surgery can help people in pain every day. The job is so very varied, and every person who comes in has a different complication, I describe my role as a detective, unpicking all the clues to which complex structure in the foot or lower leg is causing the pain or the deformity.
“Several investigations are in my toolbox, from using a doppler to assess whether my patient has adequate circulation for ulcer healing, to MRI scans to investigate a deeper foot or joint problem, such as septic arthritis or Charcot neuroarthropathy. I prescribe for my patients without needing them to visit their GP, and therefore many of my colleagues work in A&E, minor injury units, ulcer clinics, vascular surgery departments and limb salvage services.
“Other services thinking of developing a podiatric surgery service could look at some of the innovative ways that podiatric surgeons and podiatrists can contribute to the multi-disciplinary team to improve the foot health and activity of the nation and relieve pressures experienced in other services.”
- NHS England’s legacy mentoring web page.
- Read NHS England’s guide for late career AHPs supporting students in practice-based learning.
- Take inspiration from how trusts have launched a legacy mentor retention scheme for nurses.
Developing legacy podiatry posts - “Why not consider offering legacy podiatry educator posts to your soon-to-retire podiatry staff? This role enables more junior podiatrists to absorb the knowledge and expertise of experienced staff, support new starters and learners and in turn we have retained more talent.” Angie Abbott, head of podiatry and orthotics services (acute and community) at South Devon NHS Foundation Trust
Adding value at system level
Podiatry in primary care
In primary care settings, podiatrists can add value as first contact practitioners (FCPs) or advanced practitioners. Both are integral to creating sustainability within podiatry services in primary care. The FCP role aims to supports GPs in integrated care systems by being a triage service to optimise the patient care pathway and ensure patients are seen by the right clinician in the right place at the right time. Advanced practitioners in podiatry can provide specialist knowledge in a subject area of interest, and are clinicians educated to Masters level.
There are resources available to help you build a career and training pathway for clinicians moving into FCP and advanced practitioner roles. This approach creates a pipeline of registered podiatrists, ensuring the right level of practice, and helps to retain podiatrists in primary care.
NHS England’s road map to FCP and advanced practitioner roles provides a step-by-step guide to developing both these roles. Employers can use this information to help build pathways to develop your podiatry teams from level 6 to level 7 and beyond, targeting training and development opportunities.
Using advanced practitioners in a GP practice
A good practice example from Helen Beaumont-Waters, Advanced Practitioner, GP Surgery, Bradford
While working in a busy doctor’s surgery, the practice trained and supported Helen to complete a Masters's in advanced practice. Her role involves working independently to assess, diagnose and treat patients with undifferentiated and undiagnosed conditions, ordering appropriate investigations when necessary. Home visits, pathology interpretation and contributing to the quality improvement activities of the practice are also part of Helen’s role. The practice is situated in a low socio-economic area with a high degree of poverty, which has an additional impact on many of their service users who often have co-morbidities and complex needs.
Her team is one of the largest in the locality with nine qualified advanced practitioners and four in training. Coming from a multi-skilled background including podiatrists, paramedics and nurses, the team brings a unique skill set to the practice, with everyone having speciality training and interests which benefit patient care. The advanced practitioner team can see most patients within general practice and have a GP nominated as the daily lead to assist with patients who may present with conditions outside of their competencies. Having an advanced practitioner team enables the GPs to deal with complex cases and run specialist clinics.
“Having a podiatry background has enabled me to develop my musculoskeletal skill,and my diabetes and wound care competences enable me to advise and support the practice and district nursing teams with more complex cases. I use my transferable podiatry skills to manage these successfully, and I would urge all employers to consider podiatrists to progress into advanced practitioner roles.” Helen Beaumont-Waters, Advanced Practitioner, GP Surgery, Bradford
- Read more about the role of podiatrists in primary care on RCPod’s web page.
- Read about how you can effectively recruit and implement advanced practitioners using the governance maturity matrix.
Effective supervision and support
Effective supervision and support help upskill less experienced staff and build clinical competence and confidence. Having access to advice from more experienced staff helps ensure the psychological safety of staff and, ultimately, patient safety.
A preceptorship is a period of structured transition for the newly registered practitioner. During this time, they are supported by a preceptor to develop their confidence as an autonomous professional.
The potential benefits of preceptorship for new registrants include developing confidence; positive socialisation in the working environment; increased job satisfaction; feeling valued, respected and invested in by their employer; increased commitment to the employer and profession. All of these are linked to patient satisfaction, quality of care, retention and enhanced recruitment.
The length of preceptorship may be flexible for some in terms of individual needs or organisational requirements, but the recommended length of a preceptorship programme is 12 months from the date of joining the organisation. Some organisations may choose to include preceptorship as part of a postgraduate training programme, which offers structured development for up to two years, post-registration.
Protected time should be allocated for both the preceptor and the preceptor and supported by the organisation.
Using technology to help
Audio-visual headset technology allows podiatrists to connect with each other virtually, in real time, in the local region, or request the advice or support of other healthcare professionals. It enables newly qualified podiatrists to support with high-risk procedures from the start, relieving service capacity.
Read more about how Clare Westwood Surridge, podiatry team leader for Provide CIC in Mid Essex has implemented the technology into her podiatry service. Clare’s team uses the technology to virtually support two band 5 podiatrists with procedures when there are no other experienced podiatrists available to support them in person. Funding was received through NHS England’s digital productivity funding stream, which was available at the time. It has been helpful with preceptorship and is enabling them to develop and work towards band 6 roles with the aid of virtual supervision.
You can view Provider’s standard operating procedure for the technology, and the preceptorship programme for band 5 podiatrists, on the organisation’s website and watch this video about waerable technology.
The role of a compassionate culture
Building a compassionate culture where colleagues can be open and honest with each other and prioritise staff wellbeing is key in a better experience in the workplace. Managing your staff compassionately and meeting basic wellbeing needs of staff is crucial. This includes ensuring they get enough breaks and feel a sense of belonging to the organisation.
Enabling a healthy work-life balance is part of having a compassionate approach. Giving staff access to flexible working opportunities and supporting their caring responsibilities will help staff to thrive both in the workplace and beyond.
- Michael West’s blog on teamworking, psychological safety and compassionate leadership.
- Approaches to compassionate leadership at East Suffolk and North Essex NHS Foundation Trust.
- Supporting the wellbeing needs of NHS staff.
- What NHS organisations are doing to support staff to work flexibly.
- Flexible working common myths in the NHS.
- The Podiatrist article on how employers can support the wellbeing of Muslim podiatrists in Ramadan.
- The Podiatrist: Supporting podiatrists with burnout and mental health
Listening to your staff
“Listen to the needs of your staff and think about how you can support their wellbeing. Enabling your staff to work flexibly, supporting caring responsibilities and maintaining a balanced lifestyle is important for retaining your staff. Having to pick up your kids from school or simply wanting to work part-time hours shouldn’t stop people from considering clinical careers.
“By offering staff as much flexibility as possible and understanding the importance of life beyond work helps attract and retain staff. Enabling staff to work annualised hours helps staff that have school-age children to stay in the profession.
“Staff have regular one-to-one chats with their team leaders and annual reviews /appraisals are staff-led to support their career development. New graduates are offered a place on a supportive preceptorship scheme. Staff can participate in rotational schemes so that they are undertaking a variety of roles and are able to retain skills or acquire new skills.”Angie Abbott, head of podiatry and orthotics services (acute and community) at South Devon NHS Foundation Trust
Developing Portfolio Careers
Portfolio careers are built around a collection of skills and interests. Employees could have multiple jobs and employers outside of their usual role/profession. This can sometimes mean giving employees the flexibility to dedicate time to other clinical or non-clinical interests. For others, it may mean working for both the NHS and the private sector. Enabling and promoting this approach is more likely to retain employees in the NHS and in podiatry through enabling employees to fulfil a better work life balance and engage in other interests.
- The Saks report published by RCPod (2021)The standards for the foot health workforce
- The healthcare apprenticeships website on Skills for Health
- NHS England has produced an apprenticeship procurement toolkit for employers
- NHS England’s information on apprenticeships for AHP support workers and their AHP support workforce: grow your own workforce strategies guidance.
- HCPC’s requirements for returning to practice
- Information on T level industry placements and getting started on our website
- NHS Employers’ web pages on developing staff career pathways to support workforce supply and supporting in-work progression
- NHS England’s legacy mentoring web page.
- NHS Employers’ web page on preceptorships for newly qualified staff.
- Supporting the wellbeing needs of NHS staff.