Evidence
Alert

A new framework for allied health professionals aims to promote a culture of research

Shaping Better Practice Through Research: A Practitioner's Framework’ is the first framework designed to help Allied Health Professionals (AHPs) in all roles and at all career levels carry out research.

The framework provides guidance on research activities, collaboration, how research relates to career development and how it informs practice. It could foster a stronger tradition of research among AHPs.

AHPs make up a third of the UK’s health and social care workforce, with skills ranging from emergency care to language therapy and dietary advice. This group has huge potential for using research-based practice to improve the health and wellbeing of their patients. But with little tradition of research in these fields, many AHPs need support.

The new, common framework attempts to unify disciplines, using language they all share, to build a stronger culture of research for all AHPs.

What’s the issue?

AHPs are a diverse group of health and social care professionals. They include physiotherapists, occupational therapists, radiographers, paramedics, dietitians, speech and language therapists, art, music and dance therapists, along with operating department practitioners and professionals specialising in feet (podiatrists), eyes (orthoptists), artificial limbs or devices (prosthetists/orthotists).

With a broad scope of influence on health and wellbeing, they are well-placed to impact the lives of individuals and populations. More than 65,500 AHPs work in the NHS, and they make up a third of the UK’s health and social care workforce. They play a critical role in ensuring that future developments in healthcare reflect the needs of the public.

These professions often come with high clinical caseloads and immense time pressure. They also lack a tradition of research. Many AHPs do not feel confident engaging in research. They may see their knowledge and skills as inferior to other healthcare professionals and as a result, need substantial support to develop research skills.

A culture of research brings benefits both to individuals and the system. Professionals say that having a research interest improves their job satisfaction and career progression.  Institutions where research is encouraged have been shown to have higher rates of patient satisfaction, better outcomes for patients, improved efficiency within the organisation and reduced staff turnover.

Existing research frameworks for AHPs are specific to the individual professions. They vary in their descriptions of research knowledge and skills. Researchers set out to bring these frameworks together in a single document. Their aim was to create a common framework to help AHPs at all stages of their career engage in research. This could help break down barriers to research activity and build a stronger research culture.

What’s new?

Researchers identified and analysed 19 existing AHP research frameworks. They converted this content into statements describing how the required levels of research skills increase in step with developing levels of seniority. So, a junior practitioner would be expected to have an awareness of research; a consultant practitioner would need advanced abilities.

The researchers organised these statements into themes. They then ran a workshop for stakeholders including AHP professionals, regional training providers, clinicians, national workforce planning policy representatives, and members of the NIHR Clinical Research Network and the Council for Allied Health Professions Research (CAHPR) strategy group. They made recommendations on how the common framework could be used in practice. It was adapted and added to during this process to create a final version.

‘Shaping Better Practice Through Research: A Practitioner Framework’ is the name of the final document. It provides advice on collaboration, career development and research-informed practice; and guidance on the following eight domains of research:

  • career development
  • research methods
  • carrying out research safely and effectively (delivery)
  • putting research results into practice
  • collaborating with others in research
  • management and leadership
  • education and training
  • strategy and planning

The framework describes four levels of research skills - Awareness, Core, Intermediate, Advanced – and looks in detail at aspects of these research domains. For example, ethics and informed consent is part of the safe delivery of research.  A junior practitioner at ‘Awareness’ level, understands confidentiality and can undertake consent and recruitment. An established practitioner at ‘Core’ level knows about legal requirements and can carry out a risk assessment. A clinical researcher at ‘Intermediate’ level can plan the ethical conduct of research. A consultant practitioner at ‘Advanced’ level has knowledge of licensing authorities.

Why is this important?

This is the first common framework designed to enhance and support AHP research.

Its unified approach and shared language could help drive research activity and evidence-informed practice across a variety of health and social care settings. Building a culture of research for AHPs could improve services for patients and increase career satisfaction for practitioners.

The framework could be used in workforce planning, policies, and guidance. It could be used in parallel with existing appraisal systems in career planning, and to support the integration of research results into everyday practice. It aims to stimulate discussion and reflection, and to move towards having a workforce that routinely carries out research.

What’s next?

The framework needs to be tested across a range of practice settings.

The current version could be further developed to give practical advice on what steps are needed to achieve the aims of the framework. The advice should be relevant to all settings and all levels of expertise, including entry-level. Featuring case studies in the framework may help with implementation. The researchers hope to secure further funding to pursue these developments and to consult a wider, international panel of AHP stakeholders.

You may be interested to read

The full paper: Harris J, and others. Developing a consolidated research framework for clinical allied health professionals practising in the UK. BMC Health Serv Res. 2020;20:852

The Council for Allied Health Professions Research (CAHPR) Research Practitioner's Framework: Shaping Better Practice Through Research: A Practitioner Framework, 2019

The NIHR Clinical Research Network’s Allied Health Professionals Strategy 2018-2020

NHS England report: Allied Health Professions into Action: Using Allied Health Professionals to transform health, care and wellbeing, 2017

Funding

This research was jointly funded by the NIHR Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (CLAHRC YH), and the Council for Allied Health Professions Research (CAHPR).

Commentaries

Study author

As an aspiring AHP researcher myself, I was excited to define the knowledge, skills and behaviours I had achieved to date and to understand what opportunities might give me the confidence to plan the next steps of my clinical-academic career. Developing this framework helped me consider this in a simple and structured manner, making it feel less intimidating and more achievable.

It was interesting to hear participant perspectives on how this framework might reflect the varying roles and range of practice environments experienced by AHPs and how this might influence future health and social research culture.

Jennifer Harris, Lead Senior Physiotherapist, Chesterfield Royal Hospitals NHS Foundation Trust

Physiotherapist and researcher

We are trying to enact what the framework is advocating. This framework will help to raise awareness of the role that AHPs can play in developing and delivering research. It has the potential to make an impact on the career pathways of AHPs interested in research and it could also raise awareness of how AHPs can become more actively involved. It provides much-needed support for practitioners to have the importance of research recognised in their job plans and job descriptions.

I hope the document will help to build on the AHP strategy in research and change the language of the current research landscape. We have to move from the typical dyad of nurses and doctors to a triad that includes AHP and beyond. AHPs need to be part of the infrastructure and this consolidated framework can assist with this goal.

Cherry Kilbride, Reader in Physiotherapy, Brunel University, London and Lead AHP for Research at the Royal Free London NHS Foundation Trust

Retired researcher

If adopted and utilised, this common framework could be influential in increasing the capacity for research. It could encourage a greater focus on the development and use of research findings in the health and social care field.

Adoption of the framework by the relevant professional bodies will be important. The framework will need championing and tests of its use in practice put in place. These might include, for example, using it to audit current AHP training programmes to identify whether graduates will have the expected level of competency, working with service managers to see how the framework can be used within personal professional development planning processes, and developing training modules around different elements of the framework.

However, the paper suggests the framework needs further development, which may lead to a loss of impetus.

Nicola Singleton, Bedfordshire

Conflicts of Interest

None declared.