School of Medicine, Primary Medical Care, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST UK.
Centre for Innovation and Leadership in Health Sciences, Faculty of Health Sciences, University of Southampton, Building 45, Highfield, Southampton, SO17 1BJ UK.
J Foot Ankle Res. 2014 Dec 14;7(1):52. doi: 10.1186/s13047-014-0052-7. eCollection 2014.
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.
人口结构变化和预计慢性疾病患病率上升，导致英国（和其他地方）出台了一系列关注劳动力灵活性和扩大相关健康职业角色的卫生政策。虽然学术界对足病治疗师等相关健康专业人员的扩展专门角色给予了很多关注，但很少有工作涉及这些政策变化对非专业的、“通科”足病治疗实践的可能影响。本研究旨在探讨专家专业人士对角色灵活性对通科足病治疗实践的影响的看法。
从专业机构，即足病治疗师协会/足病学会中招募专家足病治疗师参加 3 个焦点小组和 4 个单独的半结构化访谈，对数据进行主题分析。
出现了 3 个关键主题，反映了对国民保健制度中通科足病治疗未来的担忧、普遍认为通科护理将不可避免地转向私营部门提供、以及支持工作人员职级的增长破坏了通科实践在主流卫生分工中的地位。提升通科从业者的技能被视为防止边缘化的最强防线。
NHS 委托人和专业人员对足病学中强化和专门角色的强调，可能会威胁到国家资助的国民保健制度中通科足病治疗的可持续性。非专业的通科足病治疗可能会越来越成为私营部门的领域。
