The Royal College of Podiatry's response to the BMA survey results on Advanced Practice
The Royal College of Podiatry recognises the importance of ongoing debate around Advanced Practice roles within the NHS, but believes that the conclusions drawn from the recent BMA survey risk presenting a partial and potentially misleading picture
The Royal College of Podiatry recognises the importance of ongoing debate around Advanced Practice roles within the NHS, and agrees unequivocally that patient safety must remain the central priority in all workforce decisions. However, the conclusions drawn from the recent BMA survey risk presenting a partial and potentially misleading picture of advanced practice across healthcare professions.
The survey reflects opinion rather than objective evidence of patient harm. While 63.8% of respondents expressed a view on equivalence between Advanced Practitioners and doctors, fewer than one third (27.5%) identified Advanced Practitioners as posing a risk to patient safety. Most other findings did not reach a majority consensus. Presenting these results as indicative of widespread safety concerns risks overstating the issue and shaping a narrative that is not supported by robust data.
Advanced practice within podiatry is a well established, regulated, and evidence-based component of NHS care. Podiatrists working in advanced roles routinely assess, diagnose, and manage complex foot and lower limb complications, including high risk diabetes and vascular foot disease, and musculoskeletal pathologies. Many also practise as independent prescribers within clearly defined scopes, supported by internal governance frameworks and competency standards aligned to national guidance.
The Royal College of Podiatry shares concerns where any professional, regardless of discipline, is expected to practise beyond their competence, particularly in pressured service environments. However, this is a matter of workforce planning and governance, not an inherent flaw in the advanced practice model itself.
It is also vital to distinguish between generic Advanced Practitioner roles and highly specialised professions such as podiatric surgery. Podiatric surgeons undergo extensive, structured postgraduate training, with formal annotation and clearly defined surgical competencies. They are not deployed as interchangeable members of a generic Advanced Practitioner workforce, nor should they be characterised as such. Conflating these roles risks undermining established, safe, and effective surgical services.
Podiatrists in advanced practice roles are integral members of multidisciplinary teams across the NHS, improving patient access, reducing delays in care, and delivering high quality, evidence based interventions. The focus should be on strengthening governance, clarifying scope, and supporting professional development, not on broad generalisations that risk eroding confidence in a workforce that is demonstrably contributing to patient care.
The Royal College of Podiatry calls for a balanced, evidence-led discussion that reflects the diversity, capability, and proven value of advanced practice across all professions.