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Allied Health Professional
Band 4 Assistant Practitioner
Consultation with Professional Bodies
Report authored by Laura Mizzi March 2020 Working group, through AHP Council, South Yorkshire and Bassetlaw Integrated Care System:
- Di Simpson (Professional Lead Therapies and Dietetics, The Rotherham Foundation Trust)
- Fiona Leahy (Clinical Head Children’s Physiotherapy & Occupational Therapy, Physiotherapy Professional Lead, Doncaster & Bassetlaw Teaching Hospitals)
- Laura Mizzi (Leadership Fellow, Health Education England, Yorkshire and the Humber; Speech & Language Therapist)
- Max Miah (Project Lead for New Roles, South Yorkshire Region Excellence Centre)
Contents
- Introduction
- Primary and Secondary Aims from Contacting Professional Bodies.......................................................
- Primary Aim
- Secondary Aim
- Status of Band 4 Assistant Practitioners within each Professional Body (Primary aim)
- Music Therapy..................................................................................................................................... British Association of Art Therapists, British Association of Drama Therapists, British Association of
- The College of Podiatry
- British Dietetic Association
- Royal College of Occupational Therapists...........................................................................................
- College of Operating Department Practitioners
- British and Irish Orthoptic Society
- Institute of Osteopathy
- College of Paramedics
- Chartered Society of Physiotherapy (CSP)
- British Association of Prosthetists and Orthotists (BAPO)
- Society and College of Radiographers
- Royal College of Speech and Language Therapists
- Workforce data (Secondary aim)
- Conclusion
- Appendix A: Contact Details of Professional Bodies
- Appendix B: National Standards, Profiles and Frameworks
- Appendix C: Approved Apprenticeship Pathways for an AHP qualification
- (Primary aim) Appendix D: Relevant Documents from Specific Professional Bodies for Assistant Practitioners
- Appendix E: Membership Categories of Professional Bodies
Primary and Secondary Aims from Contacting Professional Bodies
As part of the initial scoping work, all 14 AHP professional bodies were contacted (see Appendix A for a list of the professional bodies and contact details).
Primary Aim
The primary aim of contacting the professional bodies was to establish the status of Band 4 Assistant Practitioners and whether they had any guidance or documentation related to the Band 4 Assistant Practitioner role. This is a rapidly changing picture, however the intention was to examine the current information available in early 2020. The report will largely focus on the information discovered pertaining to the primary aim.
Secondary Aim
The secondary aim was to determine whether there was any data for employees working in a Band 4 role and for those who had, or were, completing the Level 5 apprenticeship.
Status of Band 4 Assistant Practitioners within each Professional Body (Primary
aim)
There are existing foundation degrees that are available through a Level 5 apprenticeship route. Regionally, this is via Sheffield Hallam University (Higher Education Institute; HEI) and delivered via Sheffield, Doncaster, Dearne Valley (Rotherham) and Barnsley colleges (Further Education Institutes; FEIs). The information below has either been provided by the professional body or sourced elsewhere.
British Association of Art Therapists, British Association of Drama Therapists, British
Association of Music Therapy
The professional bodies advised that qualified employees undertake a master’s (Level 7) programme and therefore begin their careers in a Band 6 or Band 7 role. This means that Assistant Practitioner roles are not thought to be common at present. However, this may change in the future with apprenticeship routes. A Healthcare Assistant Practitioner Apprenticeship with Specialism in Arts in Health, Level 5 Foundation Degree, has been trialled at Brunel University since 2018. This report has further details. Graduates are usually employed at a Band 4/5 role. The students’ final intentions are usually aimed towards activity coordinator, nursing and/or therapy roles. Further studying would be required if aiming for qualified status roles within nursing or therapy.
The College of Podiatry
The professional body recognises Band 3 and 4 Podiatry Assistant Practitioner roles. The Band 3 Assistant Practitioner role is usually largely administrative, with some activities to support clinical work. The Band 4 Assistant Practitioner role usually includes direct clinical engagement with patients. Note that, whilst Chiropody remains a protected title, the preferred and modernised term across the profession and regulator is Podiatrist.
British Dietetic Association
The professional body recognises Band 4 Dietetic Assistant Practitioner roles.
Royal College of Occupational Therapists
The professional body recognises Band 4 Occupational Therapy Assistant Practitioner roles.
College of Operating Department Practitioners
The professional body recognises Assistant Theatre Practitioners: after successfully completing a Foundation Science Assistant Theatre Practitioner (or equivalent) foundation degree (Level 5), they are able to work in the circulating role and scrub role (for approved procedures only). Other Band 4 roles in operating theatres include Nursing Associates, who are regulated by the Nursing and Midwifery Council. A position statement was published on 23/03/20 from the Perioperative Care Collaborative regarding ‘The Role of the Perioperative Healthcare Assistant in the Surgical Care Team’.
Paramedics remain in a Band 5 role, but there are discussions to use the same model as England and Wales. In England and Wales, the Paramedic applies to the HCPC register and then applies to an ambulance service or other employer. They start on a Newly Qualified Paramedic pathway through a preceptorship, on a Band 5 role. The preceptorship takes up to 2 years, with a small percentage being fast-tracked. Once the person passes their preceptorship, they are moved to a Band 6 role, as it includes independent autonomous practice, discharging patients, and mentoring other employees.
Chartered Society of Physiotherapy (CSP)
The professional body recognises Band 4 Physiotherapy Assistant Practitioner roles. The CSP have developed a capability guide (see Appendix D), to showcase good governance for those undertaking delegated physiotherapy work. The CSP is also a trade union, therefore, are concerned that Band 3/ 4 employees may be either not working to full capability or working out of scope. The CSP feel that good governance ensures patient safety, but that Band 4 employees do not necessarily require regulation.
British Association of Prosthetists and Orthotists (BAPO)
The professional body recognises Band 4 Orthotist / Prosthetist Assistant Practitioner roles. In Prosthetics and Orthotics, a Band 4 role is typically labelled a clinical assistant, historically known as an LOP (Limited Orthotic Practitioner). At present, training is usually provided locally on an adhoc basis, with no formal qualification. However, the profession does endorse the generic Skills for Health Assistant Practitioner Apprenticeship Health Standards (see Appendix B). BAPO expect all clinical assistants to be trained to the standards of this curriculum, regardless of whether they have achieved this as a formal apprenticeship or through other local training means. It is necessary that the employer tops up these generic skills with Prosthetic and Orthotic specific knowledge and practical training relevant to the care provided.
Society and College of Radiographers
The professional body recognises Trainee Assistant Practitioner (mostly Band 3) and Radiography Assistant Practitioner roles (mostly Band 4). Four universities offer College of Radiographer approved Assistant Practitioner education programmes, two of which are in England. Two are at academic Level 4 and two at Level 5. This provides health care skills for Assistant Practitioners supporting either Diagnostic or Therapeutic Radiography. In terms of career progression, those who completed the Level 5 apprenticeship may be able to be fast-tracked to the second year of the Level 6 honours degree in Radiography. In the future, there may be an opportunity to educate and train an apprentice across regional centres, rather than for the apprenticeship being specific to a trust.
Royal College of Speech and Language Therapists
The professional body recognises Band 4 Speech and Language Therapy Assistant Practitioner roles. There is a case study of one employee (outside of South Yorkshire) being employed in a Band 3 role, before undertaking a Level 4 apprenticeship, and then moving to a Band 4 role as an Assistant Practitioner on completion of the apprenticeship. National Occupational Standards were undertaken, from Skills for Health, that were relevant to Speech and Language Therapy. These were targeted at communication (CHS157), Alternative and Augmentative Communication (CHS155.2014), dysphagia (CHS160), and daily living (SCDHSC0344). The competencies in physiological measurements were assessed on those most relevant to Speech and Language Therapy, such as calculating Body Mass Index, Malnutrition Universal Screening Tool, Mid-Upper Arm Circumference, and palpation of the swallow. This individual then subsequently completed a top-up for a full honour’s degree, assuming that this was required for progression to Level 6 study for Band 5 newly-qualified practitioner status.
Conclusion
It is notable that there are differences between each AHP profession’s approach to Band 4 Assistant Practitioners. Although, some professions do align more closely, such as Podiatry/Chiropody, Dietetics, Occupational Therapy, Physiotherapy, Prosthetists/Orthotists, Radiography and Speech and Language Therapy. It is perhaps understandable that there is this variety, given that AHPs do include a diverse range of professional groups, and alignment may not always be possible. Consideration of alignment between the AHP professional bodies approach to Assistant Practitioners should still be considered. This may be particularly important given recent NHS England/Improvement’s findings that AHP professions have a less structured career pathway compared to other professions. Greater alignment may, therefore, ensure better career development for the AHP workforce as a whole. In addition, Primary Care Networks are likely to place greater demand on the workforce, through the further development of Additional Roles Reimbursement. Currently, this includes the following AHP roles: first contact practitioner physiotherapists, occupational therapists, dietitians, podiatrists, and paramedics. This provides an exciting opportunity for AHPs to consider how they can work collectively to ensure the value of these new roles within the Primary Care Networks are optimised, within an agreed AHP career structure and framework. The landscape of apprenticeships is rapidly changing, therefore, the career pathway for Band 4 Assistant Practitioners may change again in the near future. In addition, it should be noted that not all Band 3-4 employees will wish to progress any further in their career.
Appendix A: Contact Details of Professional Bodies
Allied Health Professional Body Organisation Contact Details British Association of Art Therapists https://www.baat.org/ info@baat.org British Association of Drama Therapists https://badth.org.uk info@badth.org.uk British Association for Music Therapy https://www.bamt.org info@bamt.org The College of Podiatry https://cop.org.uk assistants@cop.org.uk British Dietetic Association https://www.bda.uk.com/ Online form Royal College of Occupational Therapists https://www.rcot.co.uk/ hello@rcot.co.uk College of Operating Department Practitioners https://www.unison.org.uk/at-work/health- care/representing-you/unison-partnerships/codp/ office@codp.org.uk British and Irish Orthoptic Society https://www.orthoptics.org.uk/ bios@orthoptics.org.uk Institute of Osteopathy https://www.iosteopathy.org/ enquiries@iosteopathy.org College of Paramedics https://www.collegeofparamedics.co.uk/ membership@collegeofparamedics.co.uk Chartered Society of Physiotherapy https://www.csp.org.uk/ Online form British Association of Prosthetists and Orthotists https://www.bapo.com/ enquiries@bapo.com Society and College of Radiographers https://www.sor.org/ Online form
Appendix B: National Standards, Profiles and Frameworks
National Standards, Profiles & Frameworks Link Skills for Health Assistant Practitioner Apprenticeship Health Standards, Level 5 https://haso.skillsforhealth.org.uk/standards/#standard- 360 https://haso.skillsforhealth.org.uk/wp- content/uploads/2017/04/L5-Assistant-Practitioner-health- standard.pdf Healthcare Assistant Practitioner Standards, Level 5 Developed by Royal College of Midwifery and Royal College of Nursing (not by any AHP professional bodies) https://www.instituteforapprenticeships.org/apprenticeship- standards/healthcare-assistant-practitioner/ NHS Employers National Job Profiles, Generic AHP https://www.nhsemployers.org/- /media/Employers/Documents/Pay-and- reward/Generic_Therapy.pdf?la=en&hash=8A52DC70F739D A51B0BAE06F68C28465E6491D National Occupational Standards https://www.ukstandards.org.uk/ NHS Wales Career Framework for Healthcare Support Workers supporting Nursing and AHPs http://www.nwssp.wales.nhs.uk/sitesplus/documents/1178/ HCSW%20Career%20Framework%20Nursing%20and%20Allie d%20Health%20Professions.pdf
Appendix C: Approved Apprenticeship Pathways for an AHP qualification
There are discussions around developing clear career pathways for apprenticeships. Therefore, this lists the approved apprenticeships between Levels 3-7. Note that the Level 5 apprenticeship for all AHPs is the generic one (see Appendix B for details).
Allied Health
Professional Body
Approved Apprenticeships
British Association of Art Therapists The Level 7 apprenticeship for Arts therapists (refers to all 3 professions) has been approved: https://www.instituteforapprenticeships.org/apprenticeship- standards/arts-therapist-degree/ These are the only professions that only have a Level 7 qualified status degree. British Association of Drama Therapists British Association for Music Therapy The College of Podiatry The Level 6 apprenticeship for Podiatry has been approved: https://www.instituteforapprenticeships.org/apprenticeship- standards/podiatrist-degree/ British Dietetic Association The Level 6 Apprenticeship degree for Dietetics has been approved: https://www.instituteforapprenticeships.org/apprenticeship- standards/dietitian-degree/ Royal College of Occupational Therapists The Level 6 Apprenticeship degree for Occupational Therapy has been approved: https://www.instituteforapprenticeships.org/apprenticeship- standards/occupational-therapist-integrated-degree/ College of Operating Department Practitioners The Level 6 Apprenticeship degree for Operating Department Practitioners has been approved: https://www.instituteforapprenticeships.org/apprenticeship- standards/operating-department-practitioner-integrated-degree/ British and Irish Orthoptic Society There is not an Apprenticeship standard for Orthoptists. Institute of Osteopathy There is not an Apprenticeship standard for Osteopaths. College of Paramedics The Level 6 Apprenticeship degree for Paramedics has been approved: https://www.instituteforapprenticeships.org/apprenticeship- standards/paramedic-degree/
Appendix D: Relevant Documents from Specific Professional Bodies for Assistant
Practitioners (Primary aim)
Please check the websites of the professional bodies for the most up to date information. Allied Health Professional Body Relevant Documents The College of Podiatry https://cop.org.uk/assistant-practitioners/training-of-assistant- practitioners/ British Dietetic Association (BDA) https://www.bda.uk.com/practice-and-education/nutrition-and-dietetic- practice/dietetic-roles/dietetic-support-workers.html (For BDA members only) Dietetic Support Worker & Assistant Practitioner Roles: Dietetic Support Worker & Assistant Practitioner Roles.pdf Royal College of Occupational Therapists (RCOT) The Career Development Framework: Guiding Principles for Occupational Therapy: https://www.rcot.co.uk/cpd-rcot Band 4 (Level 5) apprenticeships will likely map to Career Levels 3 and 4 for each pillar in the RCOT Career Development Framework. Note that this framework outlines principles at different career levels to support learning and development, rather than competencies, as there are already National Occupational Standards available. Therapies Assistant Practitioner Apprenticeship Framework in Wales: https://acwcerts.co.uk/web/framework/therapy-assistant-practitioner RCOT also contributed to this consultation. College of Operating Department Practitioners The Perioperative Care Collaborative Position Statement: The Role of the Perioperative Healthcare Assistant (PHCA) in the Surgical Care Team https://www.unison.org.uk/content/uploads/2020/03/Position-Statement- on-the-roles-of-the-Perioperative-Support-Team-.pdf Sets out the principles and guidance relating to both the PHCA scope of practice and their undertaking of delegated interventions and tasks in perioperative roles. Contains the Surgical Care Team Role Boundaries for the PHCA, Assistant Theatre Practitioner, Registered Nursing Associate, and Registered Scrub Practitioner. College of Paramedics Paramedic Education Based Evidence Project: https://www.collegeofparamedics.co.uk/downloads/PEEP-Report.pdf
Allied Health Professional Body Relevant Documents Chartered Society of Physiotherapy (CSP) Support workers as an integral part of the physiotherapy workforce: A policy briefing from the CSP: https://www.csp.org.uk/system/files/documents/2020- 02/001718_policy_briefing_final.pdf This sets out the CSP policy position with regards to support workers, their value to the profession, and what the CSP believes needs to happen for the support worker workforce to fulfil its potential. Optimising capability in the physiotherapy support worker workforce: https://www.csp.org.uk/publications/optimising-capability-physiotherapy- support-workforce This framework, from the CSP, outlines how support workers might achieve the full capabilities necessary to work at a variety of practice levels and progress in their careers and guides the development of support worker roles. Accountability and delegation to support workers: A quick reference guide for the physiotherapy workforce: https://www.csp.org.uk/system/files/publication_files/001670_Mobile% st%20Version.pdf CSP guidance on accountability and delegation. Principles for assuring the provision of safe, high quality physiotherapy interventions in the context of delegation to support workers: https://www.csp.org.uk/publications/principles-underpinning-delegation- physiotherapy-support-workers The CSP have developed 5 principles for developing governance arrangements, in order to contribute towards safeguarding support workers and the quality of physiotherapy interventions delivered by support workers.
Allied Health Professional Body Relevant Documents Radiography Workforce UK Census: The objectives were to establish the size, structure, nature and vacancy rate of the workforce in order to inform workforce planning. These documents present an analysis of the census results and compares them to similar censuses carried out annually from 2010 to 2017. Therapeutic Radiography Census, 2018: https://www.sor.org/sites/default/files/document- versions/final_cor_radiotherapy_radiographic_workforce_uk_census_2018_ report_v2_0.pdf View a spreadsheet, providing details of the figures underpinning the report, and view the survey carried out to inform the final document. Diagnostic Radiography Census, 2018: https://www.sor.org/sites/default/files/document- versions/diagnostic_workforce_census_2018.pdf Cancer Research UK – Non surgical cancer treatments workforce report, 2018 : https://www.cancerresearchuk.org/about-us/we-develop-policy/our-policy- on-cancer-services/non-surgical-cancer-treatments-workforce Royal College of Speech and Language Therapists (RCSLT) Band 4 national profiles for Speech and Language Therapists: https://www.nhsemployers.org/-/media/Employers/Documents/Pay-and- reward/Speech_and_Language_Therapists.pdf?la=en&hash=2F5B442B011E 58004696613ED9F3104A7F836ACF; RCSLT Support Practitioner Competencies Framework: SLT competencies_framework_support_practitioner_framework-out ofdate.pdf Note that this is no longer available from the RCSLT website as it is now out of date.
Appendix E: Membership Categories of Professional Bodies
There are a variety of membership categories across the professional bodies. This list provided is not exhaustive. There are 5 professional bodies which do not offer membership to employees in a Band 4 role, if they do not have qualified status.
Professional Body Registered
(HCPC /
General
Osteopathic
Council)
Students
Trainees
Assistants
(also referred to as
associate)
People affiliated to
the profession
(also referred to as
associate)
British Association of Art Therapists √ Trainee X Associate British Association of Drama Therapists √ Student X Associate British Association of Music Therapy √ Trainee X Associate The College of Podiatry √ √ Associate X British Dietetic Association √ Student Associate Affiliate Alliance Royal College of Occupational Therapists √ Student Associate X College of Operating Department Practitioners √ Student X X British and Irish Orthoptic Society √ Student Associate Academic Institute of Osteopathy √ √ X Affiliate College of Paramedics √ Student Associate (CoP advised that this refers to Assistants, other non-paramedics, and for company membership)
