Allied health professionals, or AHPs, are the third largest clinical group in England after nurses and doctors, making up around 6% of the NHS workforce. Yet, when I was training as a speech and language therapist (SLT), I didn’t think about being part of this diverse group of 14 professions. Like many people, even AHPs themselves, I hadn’t realised AHPs are distinct from nurses and midwives, pharmacists, psychologists, and healthcare scientists.
My training programme had very little learning opportunities with multi-disciplinary colleagues, which contributed to the fact that, as a student, I did not consider the importance of interprofessional leadership. This is despite research suggesting face-to-face interprofessional learning can improve group dynamics and insight into other’s roles, and reduce tribalism1,2. Only through word of mouth did I find out about a regional interprofessional fellowship called the Future Leaders Programme. This sparked my interest in how the healthcare system manages interprofessional leadership, made me aware of the many systemic and cultural challenges3 that AHPs face, which can create a feeling of invisibility, and how those challenges can be tackled.
A key challenge is the lack of public and political awareness of what an AHP means. Many people think an AHP is a catch-all term to mean a clinician who is not a nurse or doctor. Additionally, people often don’t understand the varied roles, skills and knowledge that exist within each AHP profession. AHPs support people to live life to the full, from birth to the very end of their lives. For example, they maximise a person’s potential in mobility, communication, eating and drinking, and mental health.
I feel the lack of understanding has been exacerbated by the latest Government AHP recruitment campaign, which omitted some AHPs and also included nurses, who are not considered to be AHPs. Furthermore, the work of the Health and Social Care Select committee, who scrutinise the Department of Health and Social Care and other bodies, such as NHS England, often focus on the role of doctors and nurses in addressing complex health issues, rather than all clinical professions. Additionally, AHPs are not mentioned proportionately in quality and safety reports4 or systemic reviews5.
When professional groups are invisible to senior decision-makers, they will be excluded when addressing workforce planning, safe staffing levels, and/or how to address patient need and improve their flow through a pathway. Policymakers need to have a greater understanding of AHPs to avoid creating policies that ignore key professions and, therefore, may not be fit-for-purpose. Inadequate policies risk under-utilising AHPs, which will not help to deliver high-quality services for all and improve population health. Further AHPs may feel undervalued, which could impact on retention.
The absence of high-quality data on the AHP workforce compounds the issue of AHP visibility. In 2014, The Health Foundation and the Nuffield Trust6 identified this lack of AHP data and, sadly, over ten years later, very little has changed. For example, NHS England curate and publish vacancy data for doctors and nurses, useful for benchmarking. However, other professions’ data is not broken down into individual professions, settings, and regions. The NHS workforce statistics combine hospital and community staff. More details on individual AHP professions are needed. For example, the population demographic that the profession serves or the setting in which they work.
Greater visibility can be created through ensuring there is an increased granularity of AHP data at a regional- and provider-level and generating more evidence to demonstrate the impact and value of AHPs: their role in improving quality and safety and preventing death or serious harm, and where improvements are needed. AHPs are included in coroners’ reports, for example, highlighting the SLT role in preventing choking. However, better workforce planning would ensure AHP roles are appropriately funded and integrated into clinical teams to provide the best possible care and prevent unnecessary deaths and harm. We need to build on good practice. Multi-disciplinary audits are a start, which can demonstrate the valuable contributions of AHPs. For example, the Sentinel Stroke National Audit Programme captures the input of many AHPs across the stroke pathway.
Achieving interprofessional leadership is another challenge3,7-9. Currently, AHPs face a glass ceiling compared to other clinicians, due to the limited AHP-specific roles3,7-9, often needing to lose their professional identify to progress into very senior roles. The lack of interprofessional leadership contributes to AHPs lacking visibility and voice within the organisations that they are a vital part of3,7-9. Creating a structured way for AHPs to move into senior leadership roles is another important step towards increasing the visibility of AHPs and strengthening interprofessional leadership. Improving the system’s understanding of AHPs’ transferable skills can also help. Lord Darzi’s investigation into the NHS5 highlighted the need for significant systemic shifts to more preventative approaches and community-based interventions. AHPs have much to offer here, given their existing focus on health promotion and key roles in community teams. Therefore, it is imperative that AHPs have a seat at the table when considering the leadership needed to move this agenda forward.
The government’s pending 10-year plan offers an opportunity for the system to improve interprofessional leadership, improve population health, and ensure a better return on investment. AHPs can help lead this change, given how closely they work with service users, through a person-centred approach, and their impact on people’s activities of daily living and quality of life. I would encourage AHPs to actively look for leadership roles across the system. Also, more AHPs need to be confident in connecting with their local, regional and national networks, ensuring that a wide range of AHP voices are heard during system transformations. Meanwhile, organisations need to commit to improving leadership structures across an AHPs’ career pathway, ensuring that AHPs have better visibility and voice. This will help to ensure that AHPs are present during decision-making and are considered during systemic reviews. Organisations need to produce more granular AHP data at a regional and provider level, and generate more evidence on, and promote, the impact and value of AHPs. This data and evidence need to be translated into better policies and services that include the full range of clinical professions.
References
(1) Gunaldo T, Witmeier K, Mazumder H, Duffy S, Baudoin C, Sauviac H, et al. Analysis of interprofessional education perceptions at the team level: A study across three student cohorts. Journal of interprofessional education & practice. 2025; 39 100741. 10.1016/j.xjep.2025.100741.
(2) G V, Vos JAM, Christoph LH, de Vos R. The effectiveness of interprofessional classroom-based education in medical curricula: A systematic review. Journal of interprofessional education & practice. 2019; 15 157–167. 10.1016/j.xjep.2019.01.007.
(3) Mizzi L, Marshall P. Inequitable barriers and opportunities for leadership and professional development, identified by early-career to mid-career allied health professionals. BMJ Leader. 2024; 8 (3): 245–252. 10.1136/leader-2023-000880.
(4) Mid Staffordshire NHS Foundation Trust Public Inquiry. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. The Stationery Office. 2013. https://www.gov.uk/government/publications/report-of-the-mid-staffordshire-nhs-foundation-trust-public-inquiry#:~:text=This%20document%20contains. .
(5) Darzi A. Independent Investigation of the National Health Service in England. 2024. https://assets.publishing.service.gov.uk/media/66f42ae630536cb92748271f/Lord-Darzi-Independent-Investigation-of-the-National-Health-Service-in-England-Updated-25-September.pdf. .
(6) Dorning H, Bardsley M. Quality Watch: Focus on allied health professionals – Can we measure quality of care? 2014. https://www.health.org.uk/reports-and-analysis/reports/qualitywatch-focus-on-allied-health-professionals. .
(7) NHS England, NHS Improvement. Investing in chief allied health professionals: insights from trust executives – A guide to reviewing AHP leadership for trust boards and clinicians. 2019. https://www.england.nhs.uk/wp-content/uploads/2021/08/investing-in-chief-ahp-leadership.pdf. .
(8) Colesby C. How are Allied Health Professionals represented at board level in NHS Trusts in the West Midlands? Clinical governance. 2024; 29 (3): 284–295. 10.1108/IJHG-05-2024-0055.
(9) Eddison N, Healy A, Darke N, Jones M, Leask M, Roberts GL, et al. Exploration of the representation of the allied health professions in senior leadership positions in the UK National Health Service. BMJ leader. 2024; 8 (2): 119–126. 10.1136/leader-2023-000737.
Author
Laura is a speech and language therapist by background and currently undertaking an MSc dissertation in Health Policy, focused on the inequities in the professional diversity of palliative and end-of-life-care teams.
Declaration of interests
I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: From September 2022-December 2024, I was a policy and strategy trainee as part of the NHS Graduate Management Training Scheme. I am a non-practising member of the Royal College of Speech and Language Therapists (RCSLT).
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