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01-12-2014 | Research | Uitgave 1/2014 Open Access

Journal of Foot and Ankle Research 1/2014

The impact of workforce redesign policies on role boundaries in ‘generalist’ podiatry practice: expert views within the professional body

Journal of Foot and Ankle Research > Uitgave 1/2014
Samantha J Stressing, Alan M Borthwick
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Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SS undertook the research, wrote the initial drafts and undertook editing. AMB guided the initial ideas to development, helped steer the design and revised and re-wrote the revisions following initial review. Both authors read and approved the final manuscript.



Demographic changes and a predicted rise in the prevalence of chronic illness have led to a range of health policies in the UK (and elsewhere) focused on workforce flexibility and extended roles for the allied health professions. Whilst much academic attention has been paid to extended specialised roles for allied health professionals such as podiatrists, little work has addressed the likely impact of these policy changes on non-specialist, ‘generalist’ podiatry practice. This study aimed to explore expert professional views on the impact of role flexibility on generalist podiatry practice.


Expert podiatry practitioners drawn from within the professional body, the Society of Chiropodists and Podiatrists/College of Podiatry were recruited to 3 focus groups and 4 individual semi structured interviews and the data subject to a thematic analysis.


Three key themes emerged, reflecting concerns about the future of generalist podiatry practice in the NHS, a perceived likelihood that generalist care will move inexorably towards private sector provision, and a growth in support worker grades undermining the position of generalist practice in the mainstream health division of labour. Up skilling generalist practitioners was viewed as the strongest defence against marginalisation.


An emphasis on enhanced and specialised roles in podiatry by NHS commissioners and profession alike may threaten the sustainability of generalist podiatry provision in the state funded NHS. Non-specialist general podiatry may increasingly become the province of the private sector.

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Reviewer acknowledgement

Reviewer acknowledgement 2013