Are We Enhancing or Advancing Practice for Allied Health Professionals in Urgent and Emergency Care?
There’s growing momentum behind developing Allied Health Professionals (AHPs) beyond their traditional roles. From Advanced Clinical Practitioners (ACPs) embedded in medical teams to new apprenticeships in Enhanced Clinical Practice, the ambition to elevate AHP capabilities is clear.
But as clinical education pathways evolve, so do the questions:
What’s the right route for individuals—and for AHPs as a whole?
How can services maximise the value of these roles at the lowest cost?
And how will these levels of practice really improve clinical care—not just educational credentials?
Understanding the Difference
Both Enhanced and Advanced Practice are underpinned by the four pillars of practice: clinical, leadership, education, and research. But they’re not interchangeable.
Enhanced Clinical Practice is about deeper, broader skills within an existing professional scope. It’s typically situated academically between Level 6 and Level 7 (postgraduate level) and offers a structured route to more autonomous practice—without needing to step outside your professional identity.
Advanced Clinical Practice, based at Level 7 (Master’s level), is often associated with formal ACP roles functioning within a medical model. However, some professions have adapted ACP roles to reflect more strategic, transdisciplinary approaches with greater autonomy and leadership.
There is much interest among AHPs for opportunities to enhance and advance their practice. Moreover, there is significant potential to develop urgent and emergency care pathways through these educational routes. However, each route offers opportunities and limitations—and ultimately, this will come at a cost to both services and the wider NHS.
The Apprenticeship Route—Opportunities and Obstacles for AHPs
Apprenticeships now provide a funded, structured path for clinicians to develop into either enhanced or advanced roles. But in practice:
Access to apprenticeships varies depending on organisational priorities and HEI course availability.
Protected CPD time is still a luxury in many overstretched teams.
Not all clinicians want—or need—a degree to demonstrate capability.
Academic routes offer rigour and recognition but may inadvertently exclude experienced clinicians and undervalue experiential learning from clinical practice.
This isn’t just about what qualifications offer—it’s about what individuals need, what services can support, and how we balance capability with confidence, and credibility with cost.
Blended Roles, Grey Areas—and Real Impact
In urgent and emergency care, AHP roles have already begun shifting toward enhanced and advanced practice. Transdisciplinary roles in Urgent Community Response, Admission Avoidance, and Acute Frailty Teams show what’s possible when Occupational Therapists and Physiotherapists develop each other’s capabilities and work collaboratively.
These blended roles sit in a grey area—not quite “uni-professional” enough for Enhanced Clinical Practice, nor “medical-model” enough for traditional Advanced Practice—but they work. They deliver timely, person-centred care when it’s most needed. But these roles require professional and educational safeguards to support clinicians and services in developing safe and sustainable practice.
That’s why we need a flexible, capability-led approach to development—one that aligns with personal growth, service needs, and system priorities.
Reimagining What’s Possible for AHPs in Urgent and Emergency Care
There are also deeper structural barriers to Advanced Practice. The medical model demands clinicians to be able to prescribe. However, independent prescribing rights remain limited to only a handful of AHP professions (Physiotherapists, Podiatrists, Chiropodists, Paramedics, Dietitians, and Radiographers). Workarounds like Patient Group Directives and non-pharmacological prescribing exist—but this limitation has denied me and other peers many ACP job opportunities. Excluding some AHPs from ACP roles will also delay or deny patient access to timely AHP-led care when they may most need it.
There’s also a risk of conflating “advanced” with “medicalised” roles. While these are crucial in many settings, we risk losing experienced AHPs to medical-style pathways at a time when their unique value is needed the most. AHPs can offer non-pharmacological, person-centred, and preventative-focused alternatives that are essential in shifting modern care models from hospital to community, and from sickness to prevention.
Reimagining AHP roles within urgent and emergency care pathways—where AHPs can have more autonomous practice without necessarily needing to prescribe—could therefore radically reshape how we think about their value and impact at both enhanced and advanced levels.
What’s Next—And How I’m Supporting It
Having completed multiple post-registration qualifications and portfolio-based accreditations, I’ve seen both the value and the limitations of formal education in progressing practice. I’ve also seen experienced clinicians avoid career progression due to the barriers of academic learning. It’s clear that we need more than frameworks and qualifications—we need a range of practical, inclusive, and profession-sensitive development routes.
That’s why I’m supporting this by refreshing my courses to align with the Enhanced Practice agenda and provide supplementary or alternative learning opportunities for AHPs working in Urgent and Emergency Care. I am developing a core capability framework—mapped across a number of relevant enhanced and advanced practice capability frameworks and anchored in the four pillars of practice—to offer a range of learning activities that meet the needs of both clinicians and the service.
This modular approach will offer clinicians a flexible programme to build confidence and capability—whether preparing for a future formal educational or apprenticeship route or seeking to progress in their current role without the commitment of higher education. Most importantly it will adopt a train the trainer style to support a sustainability and maximise clinical outcomes.
To keep up to date with this development and find out more, visit www.tetracks.co.uk or follow me on social media.
The Takeaway
There is huge potential in the role of AHPs in urgent and emergency care pathways. Both enhanced and advanced clinical practice frameworks and apprenticeships offer opportunities and limitations. To maximise outcomes AHP professionals and services will require a more flexible and capability-led approach to learning and development.
Let’s therefore not force a binary choice between “enhanced” or “advanced” practice. Instead let’s design development pathways that nurture ambition, celebrate diversity, and empower AHPs to grow—on their terms, in their current and future roles, while delivering exceptional care and thriving in a system under pressure.
