News
Consultant Practice
Advanced Practice
Resources
Patient Group Directions
Advanced Practice in Prosthetics and Orthotics
IRMER Guidance
Advanced Practice for prosthetists and orthotists
Advanced Practice for employers
Regional support for Advancing Practice
NHS England has made a significant investment in the formation of a multi-professional Faculty in each of its seven regions, to drive change at a local level. The teams offer information and advice on all aspects of Advancing Practice, including how to access funding and the level of support available for supervisor costs:
Guidance and resources – Advanced Practice (hee.nhs.uk) – North East and Yorkshire
Midlands Guidance and Resources – Advanced Practice (hee.nhs.uk) – Midlands
Regional Faculty for Advancing Practice – North West – Advanced Practice (hee.nhs.uk) – North West
Guidance and resources – Advanced Practice (hee.nhs.uk) – East Midlands
London Faculty Guidance, Tools and Resources – Advanced Practice (hee.nhs.uk) – London
South West Resources – Advanced Practice (hee.nhs.uk) – South West
Tools and resources – Advanced Practice (hee.nhs.uk) – South East
Regional Faculties for Advancing Practice – Advanced Practice (hee.nhs.uk)
Frequently Asked Questions (FAQs)
General
What is the difference between enhanced and advanced practice?
Enhanced and advanced practice are different levels of professional practice. At each level of practice, a health and care professional’s ability to handle complexity and risk increases.
At an enhanced level of practice, practitioners will have additional knowledge and skills in a field of expertise. They will manage discrete aspects of a patient’s care, often particular to specific conditions and groups of patients.
At an advanced level of practice practitioners will have developed their knowledge, skills and expertise in their area of practice even further. They will be able to manage the whole episode of a patient’s care from the time they first present, through to the end of the episode.
What is the difference between an ‘advanced practitioner’ and an ‘advanced clinical practitioner’?
Advanced practice is a level of professional practice rather than a job title. In practice, a variety of titles, often interchangeable, are used for practitioners who practise at an advanced level. They include ‘advanced practitioner’ and ‘advanced clinical practitioner’.
‘Advanced clinical practitioner’ is sometimes used for advanced practice roles in specific clinical areas or for advanced practice roles which cut across care pathways and professional boundaries and utilise the knowledge and skills of practitioners from a range of different professional backgrounds.
Prosthetists and orthotists
How do I become an advanced practitioner?
Education and training in advanced practice is undertaken by health and care professionals with substantial professional experience. They will have already progressed into roles at the enhanced level of practice, most likely at Agenda for Change Bands 6 or 7, before undertaking training.
Advanced practice education and training has developed over time and there will be existing advanced practitioners who have followed different educational pathways in the past.
In England, becoming an advanced practitioner now involves being appointed to a trainee advanced practitioner post and completing a Master’s programme in advanced practice. The Master’s programme normally takes three years and involves both academic preparation and clinical preparation in the workplace, allowing the trainee to demonstrate all the required capabilities for advanced practice. Once the programme is completed, the trainee is then employed by their employer as a fully qualified advanced practitioner.
I already have a pre-registration Master’s degree in prosthetics and orthotics. Does this mean I am an advanced practitioner?
No.
Some prosthetists and orthotists will have completed a pre-registration Master’s degree in prosthetics and orthotics which allowed them to become registered with the HCPC. Their programme will have developed their academic skills at Master’s level and allowed them to demonstrate the threshold standards of proficiency for entry to the HCPC Register as a prosthetist and orthotist.
Any prosthetist and orthotist who has completed pre-registration education and training at degree or Master’s level would need to build their capability and post-registration experience before being appointed to a trainee advanced practitioner position and undertaking an accredited Master’s programme in advanced practice which addresses the required advanced level capabilities across all four pillars of practice.
I already have a post-registration Master’s degree in prosthetics and orthotics. Do I need to complete another Master’s programme if I want to be an advanced practitioner?
Yes.
Some prosthetists and orthotists may have undertaken post-registration Master’s degrees in prosthetics and orthotics or in other profession-focused areas to support their personal and professional development.
If they wanted to become an advanced practitioner, they would still need to complete an accredited Master’s programme in advanced practice that has been mapped to the required capabilities, as outlined above. They might ask the education provider delivering the Master’s programme in advanced practice whether they can receive any credit for their previous Master’s level study. However, that would be a decision made by the education provider at their discretion, based on their policies for accreditation of prior (experiential) learning or ‘AP(E)L’
What is the difference between completing a Master’s in advanced practice and a Master’s in advanced practice degree apprenticeship?
Accredited Master’s programmes in advanced practice are delivered by universities. They are either conventional Master’s programmes or Master’s degree apprenticeship programmes.
Both types of programmes are very similar in content and structure and both will have been mapped against the required advanced-level capabilities across all four pillars of practice. The main difference is in how the programmes are funded.
Prosthetists and orthotists are unable to prescribe medicines. Does this mean that they cannot become advanced practitioners?
No.
The specific regulated professions that are able to access mechanisms to sell, supply, administer and prescribe medicines is set out in legislation. Prosthetists and orthotists are not currently able to train to become prescribers.
The ability to prescribe is not a requirement for, or an integral part of, advanced
practice education and training and is not a requirement to be able to practise at an
advanced level.
However, we know that employers may sometimes decide that being able to prescribe is an important requirement for specific advanced practice roles and to maximise the usefulness of advanced practitioners to some care pathways. This can limit opportunities for prosthetists and orthotists
Prosthetists and orthotists and their employers are encouraged to make best use of the existing mechanisms available to the profession, including Patient Specific Directions (PSDs) and Patient Group Directions (PGDs).
You can find more information about prescribing and advanced practice here.
What is the purpose of the ePortfolio (supported) route run by the Centre for Advancing Practice? Can I use this to train as an advanced practitioner?
NHS England’s Centre for Advancing Practice runs the ePortfolio (supported) route. This is a time-limited route to recognising existing, experienced advanced practitioners in England who are already in role, but who have completed different qualifications in the past or who completed their training before the Multi-professional framework for advanced practice was first published in 2017.
Eligible applicants are supported to produce a portfolio of evidence to demonstrate their advanced-level capabilities. If successful, they will be issued with a ‘digital badge’, an electronic certification which recognises their achievement at advanced-level.
This is a recognition route only, so is not a way of training to be an advanced practitioner.
How do I become an advanced practitioner?
Education and training in advanced practice is undertaken by health and care professionals with substantial professional experience. They will have already progressed into roles at the enhanced level of practice, most likely at Agenda for Change Bands 6 or 7, before undertaking training.
Advanced practice education and training has developed over time and there will be existing advanced practitioners who have followed different educational pathways in the past.
In England, becoming an advanced practitioner now involves being appointed to a trainee advanced practitioner post and completing a Master’s programme in advanced practice. The Master’s programme normally takes three years and involves both academic preparation and clinical preparation in the workplace, allowing the trainee to demonstrate all the required capabilities for advanced practice. Once the programme is completed, the trainee is then employed by their employer as a fully qualified advanced practitioner.
I already have a pre-registration Master’s degree in prosthetics and orthotics. Does this mean I am an advanced practitioner?
No.
Some prosthetists and orthotists will have completed a pre-registration Master’s degree in prosthetics and orthotics which allowed them to become registered with the HCPC. Their programme will have developed their academic skills at Master’s level and allowed them to demonstrate the threshold standards of proficiency for entry to the HCPC Register as a prosthetist and orthotist.
Any prosthetist and orthotist who has completed pre-registration education and training at degree or Master’s level would need to build their capability and post-registration experience before being appointed to a trainee advanced practitioner position and undertaking an accredited Master’s programme in advanced practice which addresses the required advanced level capabilities across all four pillars of practice.
I already have a post-registration Master’s degree in prosthetics and orthotics. Do I need to complete another Master’s programme if I want to be an advanced practitioner?
Yes.
Some prosthetists and orthotists may have undertaken post-registration Master’s degrees in prosthetics and orthotics or in other profession-focused areas to support their personal and professional development.
If they wanted to become an advanced practitioner, they would still need to complete an accredited Master’s programme in advanced practice that has been mapped to the required capabilities, as outlined above. They might ask the education provider delivering the Master’s programme in advanced practice whether they can receive any credit for their previous Master’s level study. However, that would be a decision made by the education provider at their discretion, based on their policies for accreditation of prior (experiential) learning or ‘AP(E)L’
What is the difference between completing a Master’s in advanced practice and a Master’s in advanced practice degree apprenticeship?
Accredited Master’s programmes in advanced practice are delivered by universities. They are either conventional Master’s programmes or Master’s degree apprenticeship programmes.
Both types of programmes are very similar in content and structure and both will have been mapped against the required advanced-level capabilities across all four pillars of practice. The main difference is in how the programmes are funded.
Prosthetists and orthotists are unable to prescribe medicines. Does this mean that they cannot become advanced practitioners?
No.
The specific regulated professions that are able to access mechanisms to sell, supply, administer and prescribe medicines is set out in legislation. Prosthetists and orthotists are not currently able to train to become prescribers.
The ability to prescribe is not a requirement for, or an integral part of, advanced
practice education and training and is not a requirement to be able to practise at an
advanced level.
However, we know that employers may sometimes decide that being able to prescribe is an important requirement for specific advanced practice roles and to maximise the usefulness of advanced practitioners to some care pathways. This can limit opportunities for prosthetists and orthotists
Prosthetists and orthotists and their employers are encouraged to make best use of the existing mechanisms available to the profession, including Patient Specific Directions (PSDs) and Patient Group Directions (PGDs).
You can find more information about prescribing and advanced practice here.
What is the purpose of the ePortfolio (supported) route run by the Centre for Advancing Practice? Can I use this to train as an advanced practitioner?
NHS England’s Centre for Advancing Practice runs the ePortfolio (supported) route. This is a time-limited route to recognising existing, experienced advanced practitioners in England who are already in role, but who have completed different qualifications in the past or who completed their training before the Multi-professional framework for advanced practice was first published in 2017.
Eligible applicants are supported to produce a portfolio of evidence to demonstrate their advanced-level capabilities. If successful, they will be issued with a ‘digital badge’, an electronic certification which recognises their achievement at advanced-level.
This is a recognition route only, so is not a way of training to be an advanced practitioner.
Webinar
Enhanced Practice
Resources
Patient Group Directions
Enhanced Practice for employers
Enhanced Practice for P&O
Advanced Practice in Prosthetics and Orthotics
IRMER Guide
Frequently Asked Questions (FAQs)
What is the difference between enhanced and advanced practice?
Enhanced and advanced practice are different levels of professional practice. At each level of professional practice, a health and care professional’s ability to handle complexity and risk increases.
At an enhanced level of practice, practitioners will have additional knowledge and skills in a field of expertise. They will manage discrete aspects of a patient’s care, often particular to specific conditions and groups of patients.
At an advanced level of practice practitioners will have developed their knowledge, skills and expertise in their area of practice even further. They will be able to manage the whole episode of a patient’s care from the time they first present, through to the end of the episode.
More information on the difference between enhanced and advanced practice can be found in the employer’s guide to the Enhanced Clinical Practitioner apprenticeship.
Can completing education and training for enhanced practice lead to advanced practice?
Completing the Enhanced Clinical Practitioner apprenticeship or other pathways into enhanced practice might be one step on a career journey to advanced practice, or enhanced practice could be a fulling career destination in its own right.
Advanced practice education and training is different from the Enhanced Clinical Practitioner apprenticeship or other pathways into enhanced practice. To become an advanced practitioner, prosthetists and orthotists would need to be appointed to a trainee advanced practitioner position. They would then complete a Master’s degree in advanced practice which is normally three years in duration and includes both academic content and supervised clinical practice in the workplace. More information about advanced practice is available here.
Someone who has completed the Enhanced Clinical Practitioner apprenticeship at level 7, or other relevant Master’s level qualifications, might ask an education provider delivering the Master’s in advanced practice to give them some credit for their previous study through Accredited Prior (Experiential) Learning (AP(E)L) which might reduce the duration and content. This will, however, be a case-by-case decision for the education provider based on their own requirements for recognising prior experience and learning.
What is the purpose of NHS England’s enhanced level practice schema for prosthetists and orthotists?
NHS England has published an enhanced level practice schema and indicative curriculum for prosthetics and orthotics.
The schema is aimed primarily at education and training providers and its purpose is to help support the design and delivery of postgraduate education and training for enhanced level practice – both apprenticeship and non-apprenticeship pathways.
The schema includes descriptors for enhanced level practice in prosthetics and orthotics across different care pathways. These can help employers and prosthetists and orthotists understand what enhanced practice looks like in the profession.
Prosthetists and Orthotists
How do I become an Enhanced Clinical Practitioner?
Enhanced practice is a level of professional practice which already exists in prosthetics and orthotics. It is not a job role, title or salary band. Although the published standard for the apprenticeship uses the title ‘Enhanced Clinical Practitioner’, this is not a title that is or will be used in practice.
There are different pathways for prosthetists and orthotists to practise at an enhanced level. This includes post-registration and postgraduate qualifications and courses together with significant relevant experience. As an additional pathway, there are now apprenticeship programmes which prepare prosthetists and orthotists to practise at this level.
Prosthetists and orthotists wanting to develop at an enhanced level of practice should speak to their employers to discuss their career aspirations and how they can best be supported.
Do I have to complete the Enhanced Clinical Practitioner apprenticeship to get a role at band 6?
No.
The Enhanced Clinical Practitioner apprenticeship is one additional, structured pathway for enhanced practice. It is likely to be most suitable for those who are newly promoted, or working towards a job role (normally at Band 6) that requires them to develop the complex knowledge and expertise required to handle more complex patient presentations.
There are other pathways into enhanced practice roles which include completion of post-registration and/or postgraduate qualifications or courses together with significant relevant experience. Prosthetists and orthotists should discuss with their employers which career development pathways might be available and suitable for them.
I am already employed as a Band 6 senior orthotist. Is the Enhanced Clinical Practitioner apprenticeship for me?
Maybe.
The Enhanced Clinical Practitioner apprenticeship is most suitable for prosthetists and orthotists who are newly promoted or who are working towards a job role (normally at band 6) that requires them to develop the complex knowledge and expertise required to handle more complex patient presentations.
For some prosthetists and orthotists who are already practising at enhanced level, the apprenticeship might not be necessary or helpful because it would not provide them with significant additional skills and knowledge. They may have already completed post-registration education and training and have significant experience and knowledge.
Good career conversations with employers will help prosthetists and orthotists identify whether the apprenticeship might be right for them, or alternatively, whether other career development opportunities including other qualifications or CPD will be more relevant.
Employers
How can we pay for the Enhanced Clinical Practitioner Apprenticeship?
An employer with a payroll over £3m will pay the apprenticeship levy and will be able to use these funds to pay for employees to undertake the apprenticeship.
An employer with a payroll under £3m will not pay the apprenticeship levy. There are other options that these employers can use to pay for employees to complete apprenticeships:
Levy transfer. Subject to certain limits, levy-paying employers can transfer a percentage of their apprenticeship funds to other employers. This might be an option to explore for non-levy paying employers who are delivering services under contract to a levy-paying NHS Trust.
Co-investment. Employers are usually eligible for government funding that will cover at least 95% of the cost of an apprenticeship course. Employers pay a co-investment of 5% direct to the education provider.
Apprenticeship funding arrangements may change. More information about current options is available here.
Employers will need to cover the costs of:
Employing the apprentice staff member
Supporting the apprentice’s workplace learning
Any costs attached to releasing apprentices to undertake their off-the-job learning.
What responsibilities do employers have for employees who are completing the Enhanced Clinical Practitioner apprenticeship?
Apprenticeships are a partnership between an apprentice, their employer and an education provider.
Employers need to provide clinical governance, help supervise and develop the apprentice’s clinical skills and provide time and support for their off-the-job learning.
All apprenticeships comprise a mix of learning within an apprentice’s job role and off-the-job learning. The minimum amount of off-the-job learning is 20% of an apprentice’s working week (or one day per week based on a five day working week). There is flexibility in how the off-the job learning is delivered – for example, it could be one day a week or on a more consolidated ‘block release basis’. Apprenticeship programmes often make use of online learning, which increases flexibility.
Employers interested in investing in their employees to complete the apprenticeship should discuss with education providers how they might be able to help. There is a list of education providers delivering enhanced clinical practitioner apprenticeship programmes here.
Webinar
BAPO Webinar: Prosthetic and orthotic clinical educators resource launch event
Details
Join us for 90 minutes to celebrate the launch of the BAPO P&O Clinical Educator Network and supporting resources. This event will mark the launch with an overview of the work plus guest speakers talking us through some of the essential wrap around resources that BAPO has produced during 2024.
This webinar is for P&O clinical educator network members and non-members who may be considering joining, plus P&O academic educators, plus anyone else interested in the work.
BAPO membership for 2025
Dear Member,
We hope this finds you well and that you have had a successful year making a difference to the lives of so many people. We are proud at BAPO of all our members’ achievements and celebrate your incredible work.
Thank you for continuing to be a member of BAPO this year, your support is greatly valued. Your professional body has also had a busy year. In March we started working on the NHSE-commissioned programme of work which is the largest programme of work BAPO has undertaken. It includes projects covering a wide range of areas including pre-registration curriculum, practice-based placements, simulation, the support workforce, preceptorship and foundation support, the educator workforce, career resources and information, EDI, apprenticeships, embedding education and training into commissioning, and job planning. You will seen several resources BAPO has launched from this programme of work, and you will see many more over the coming months.
As well as this important work we have also been busy with events and courses. We held regional conferences in Cardiff and Tamworth both of which were sell-out successes. A huge thank you to everyone who attended and contributed and to our exhibitors who made it possible for us to hold these events.
We also held our inaugural BAPO P&O Awards in September and we had a wonderful evening celebrating the profession and presenting a Lifetime Achievement Award to the inspirational Lynne Rowley who will be sadly missed by all who knew her. Our Patron, Alex Brooker, also made an appearance by video to present the BAPO Hero Award to Sandra Sexton. We hope to see you at the awards in 2025.
You will have seen from the weekly newsletter that our offering of education courses has increased and in 2025 we are taking this to a new level when members will have the opportunity to attend a wider range of courses. As well as the very popular KAFO and MSK courses, we will deliver an Anatomy course and Going Digital & 3D Printing. We are also developing courses on X-ray/Imaging, OA/Knee and Clinical Note Keeping with many more under discussion. Keep an eye on the newsletter for more information and please book quickly as the courses sell out. We deliver these courses with the support of OETT for which we are very grateful.
However, it is also that time of the year again when memberships are renewed. Inflation affects all organisations and BAPO is no different, so our Executive Committee has reluctantly agreed on a small increase in membership fees of 2%. For a full member, this is approximately £7 per year, or 60p per month so we feel this still represents great value for money. As ever we are working to control our costs so that we pass on as little as possible to our members.
To help with affordability you can of course pay by monthly Direct Debit if you don’t already do so, and if you email us we will send you the mandate form. To ensure you receive all our communications and membership benefits it is important that the information we hold for you is accurate. Please log in to BAPOnline to pay for your 2025 subscription and update your details. This information will help us continue to develop the services we offer to members. If you have any problems logging in we are here to help so please email enquiries@bapo.com or call us on 0141 561 7217.
Once you have your renewal confirmation you will be able to access your member discounts and member areas of the website.
The Executive Committee thanks you for your ongoing support. The community that you are part of is unique and changes so many lives for the better, and BAPO will continue to shine a light on the issues that matter to you and the great work that you do.
Global Advanced Practice Summit
Abstracts are now open for the Global Advanced Practice Summit. This virtual 24-hour event is designed to connect advanced practitioners from around the globe.
Early bird tickets are on sale until December 31st
Announcing the Launch of the UK Limb Difference Research Community
We are thrilled to announce the development of a groundbreaking initiative: the UK Limb Difference Research Community. This community aims to bring together amputees, individuals with limb differences, their supporters, industry professionals, and researchers in the field of prosthetics to foster a collaborative and inclusive environment.
Our primary motivation is to ensure that research is driven by the needs and perspectives of amputees and individuals with limb differences. By creating mechanisms for stakeholder-led research, we aim to make the research process more inclusive, relevant, and clinically transferable. Additionally, we are committed to establishing channels for researchers to share ongoing projects and outcomes with the wider community, ensuring transparency and engagement. This initiative will bridge the gap between researchers and stakeholders, enhancing overall involvement and interest in prosthetics research within the limb difference community.
Furthermore, we are dedicated to turning research into action. Our goal is to ensure that developments are implemented to improve prosthetic services and enhance the lives of amputees and individuals with limb differences.
This initiative is being co-produced by the charities LimbPower, Steel Bones, and Finding Your Feet, which represent amputees and the limb different community, and the University of Southampton. It is supported by BACPAR, ISPO, and BAPO.
If you are UK based, have an amputation/s or limb difference or you know someone who has limb difference and would like to join the community you can access our Facebook group here: https://fb.me/g/51kJTpdOk/GKvZUFDg
If you are interested in supporting the development of the community sign-up to our information launch session here: https://amputeeresearchfocusgroup.eventbrite.co.uk
If you are undertaking research in the field of prosthetics and would like to learn more, please contact Alix Chadwell at: a.chadwell@soton.ac.uk
Looking to the future
This member-only resource guides you through your responsibility as a future HCPC registrant when it comes to fulfilling their standards for CPD and how to evidence this as part of the regular cycle of re-registration every two years.
The Orthotic Education & Training Trust funds (a) the education and training of Orthotists, Orthotic Technicians and Orthotic Managers, and (b) the training of Technicians regarding orthotic devices. It is not open to pre-registration learners, but it’s worth knowing about for future reference.
At the very start of your career journey, it’s not always easy to plan or guess how it will unfold. This resource might provide some inspiration. It explains the idea of ‘advanced practice’ generally, and how Enhanced and Advanced Level Practice specifically are emerging in P&O. It explores what these career levels might offer you as a professional and what they can mean for the people who access your services.
Continuing professional development resources and events
BAPO Mentoring Programme
Find out more about BAPO’s mentorship programme, which is available to members at any stage of their their career (including learners) to enable them to gain personalised guidance on a range of topics.
“Broughton W and Harris G. (2022) (Eds.) on behalf of the Interprofessional CPD and Lifelong
Learning UK Working Group. Principles for Continuing Professional Development and Lifelong Learning in Health and Social Care.”
Learning UK Working Group. Principles for Continuing Professional Development and Lifelong Learning in Health and Social Care.”
CPD and lifelong learning are necessary for the development of everyone who works in health and social care. This document sets out princiles that you can apply to help you manage and take ownership of your own CPD to meet the HCPC requirements that apply once you are registered.
BAPO Events
BAPO offers regular webinars and short courses. Check out the latest offerings and how to register for them via these links. These events are open to members and non-members.
BAPO YouTube channel
The BAPO YouTube channels contains a range of video resources spanning subject areas such as BAPO Learning, dementia awareness, interviews with members of the P&O workforce, and BAPO event highlights.
BAPO Teatime Talks (in Education Resources within member only section of webiste)
BAPO runs regular TeaTime Talks and other virtual events for members. You can find out about forthcoming events and (if you are a member) register for then here.
BAPO Student Series Webinars (in Education Resources within member only section of website)
These member-only video resources cover topics such as clinical note-keeping and consent, what the Health and Care Professions Council (HCPC) is and how to register with it when you qualify, and continuous professional development.
BAPO (2024) A guide for preparing and presenting posters at conference (in member only section of website)
This member-only resource provides guidance and advice about preparing poster presentations for all kinds of conferences. These are essential skills to develop as part of the research pillar of practice. And they’re potentially very useful for any of your assessments that involve a poster presentation.
BAPO (2024) Keeping up to date with evidence-based practice: A guide to searching research databases (in member only section of website)
This step-by-step guide will help you develop your skills and confidence in literature searching in research databases. These are essential skills to develop as part of the research pillar of practice. And they’ll help a great deal with your current studies.
BAPO Conferences
BAPO runs a number of annual regional conferences around the UK. Students and apprentices are welcome to join in. Find out more here.
BAPO Awards
BAPO makes a number of annual awards to members of the professional community, including Student of the Year. Check out details here.
Preparing for jobs in prosthetics and orthotics
Responding directly to a need identified by learners, this comprehensive resource guides you through the different elements you will need to consider to ensure that you are well-prepared to apply for jobs and participate in job interviews in prosthetics and orthotics.