As healthcare systems face rising demand, increasing complexity and workforce pressures, enhanced practice is becoming an important part of podiatry services across the UK. 

Sitting between core and advanced practice, enhanced practitioners provide a critical layer of expertise that helps improve patient access, strengthen services and create new opportunities for professional development.  

By developing specialist skills, greater autonomy and broader responsibilities, enhanced practitioners are helping to determine the future of podiatry while delivering more holistic care for patients.

What is enhanced practice? 

Enhanced practice sits between core practice and advanced clinical roles. 

It lets podiatrists develop greater expertise within a particular area of practice, while continuing to build their clinical, leadership, research and educational skills. 

Enhanced practitioners often work with more autonomy, make more complex clinical decisions and act as an important bridge between generalist and specialist services. 

Most importantly, they help patients access care at the right time. 

For practitioners, enhanced practice provides an opportunity to develop skills and competencies in a structured and recognised way while remaining closely connected to patient care. 

What does enhanced practice look like?  

Enhanced practice is not simply about doing more. It is about practising with confidence, accountability and evidence-informed decision-making. 

Development takes place across the four pillars of practice: 

• clinical care 

• research 

• leadership and management 

• education 

Enhanced practitioners may demonstrate: 

• enhanced clinical reasoning and complex decision-making 

• expanded procedural and diagnostic capability 

• greater autonomy and accountability for patient outcomes 

• evidence-informed practice through critical appraisal 

• engagement in research, audit and service evaluation 

• leadership in service development and quality improvement 

• influence on standards, pathways, and policy 

• contribution to team and system-level change 

• support for workforce development and learning 

• commitment to reflective practice and continuous professional development  

“Enhanced practice is about recognising the capabilities podiatrists are already developing in practice” says Hayley Edgington, a lecturer in podiatry from the University of Salford. 

“Formalising them into structured, supported pathways benefits clinicians, service development, staff retention and ultimately improves outcomes for patients.”  

Without clearly defined frameworks, enhanced practice risks becoming inconsistent across services. This can lead to disparities in patient care, uncertainty for clinicians and fewer opportunities for professional development. 

Why is enhanced practice needed? 

Healthcare services today – including podiatry – are facing significant hurdles.  

Demand for care continues to rise, patients are presenting with increasingly complex needs and workforce shortages remain a concern across many parts of the health and social care system. 

Enhanced practice offers a practical response to these pressures by enabling clinicians to work at the top of their scope of practice while being supported through structured learning, mentorship and professional development.  

“We cannot meet future service demand using traditional boundaries alone” says Kim Wilde, a lecturer in podiatry and non-medical prescribing from the University of Salford.  

“Enhanced practice enables podiatrists to expand their contribution, particularly within musculoskeletal and high‑risk foot pathways”. 

The benefits of enhanced practice  

Improved patient access 

Patients can be assessed and managed more efficiently, helping to reduce delays in care.  

More efficient pathways can minimise unnecessary referrals and support earlier intervention, improving outcomes and the patient experience.  

Workforce efficiency  

Enhanced practice helps services make better use of skills across the workforce. 

By identifying gaps in provision and developing expertise where it is needed most, organisations can improve efficiency and create opportunities for innovation.  

Career satisfaction 

Enhanced practice provides clearer routes for professional progression. Greater autonomy, increased responsibility and recognised development pathways can contribute to improved job satisfaction and support retention within the profession.  

Service resilience  

Distributing enhanced capability across a wider workforce helps services become more adaptable and sustainable. 

Rather than concentrating expertise within a small number of advanced practitioners, enhanced practice strengthens capacity across teams and supports continuity of care. 

Richard Keating from Coventry University highlights the wider impact: 

"Enhanced practice strengthens the entire clinical pathway. It strengthens the individual in not just their clinical pillar but also their education, leadership and research pillars. This will result in podiatrists being more present within the context of the wider workforce, helping to drive necessary change and improve patient care." 

For patients, this often means more joined-up care, fewer appointments and a more holistic experience. 

What does this mean for podiatrists? 

For many podiatrists, enhanced practice offers an opportunity to deepen expertise without necessarily pursuing an advanced or consultant-level role. 

It provides a recognised framework for developing clinical, leadership, research and educational skills while maintaining a strong focus on patient care. 

For some clinicians, enhanced practice may become a long-term destination in its own right. For others, it may provide a stepping stone towards advanced clinical practice or consultant-level roles. 

Either way, it creates good opportunities for growth within the profession. 

Supporting enhanced practice in podiatry services 

The success of enhanced practice depends on more than individual ambition. It also requires organisational support, investment and clear career pathways. 

For services, one of the bigger opportunities is moving away from informal skill acquisition and towards structured development frameworks that provide clarity around progression, competence and recognition. 

“Managers play a vital pivotal role in creating the conditions necessary for enhanced practice to thrive” says Hayley Edgington. 

“Without clear organisational support, it is challenging for individuals to sustain their development or effectively demonstrate their progress across the pillars of practice.” 

To support enhanced practice successfully, organisations should focus on:  

• creating defined role frameworks aligned with national guidance 

• supporting access to postgraduate education, accreditation and credentialling pathways 

• embedding structured supervision, mentorship and peer review 

• aligning job planning with enhanced responsibilities  

• ensuring governance arrangements are robust, transparent and supportive of safe practices 

Kim Wilde believes that collaboration is essential. 

“Education providers and health and care services need to work in partnership. Career pathways should not feel abstract. They should be visible, achievable and directly linked to service needs.” 

Richard Keating adds: 

“If we want to retain talent within podiatry, we must offer meaningful progression. Enhanced practice provides that middle ground where clinicians can grow without needing to leave clinical practice.” 

The future of podiatry 

Enhanced practice is becoming an increasingly important part of podiatry today. 

By investing in structured development pathways, strengthening collaboration between education and service providers and supporting clinicians to grow across all four pillars of practice, the profession is better able to meet future demand while continuing to improve patient care. 

For podiatrists, enhanced  practice offers more recognition and progression, as well as the chance for their professional impact to expand.  

For services, it supports greater flexibility, resilience and efficiency.  

For patients, it helps create more accessible, responsive and holistic care. 

As the profession continues its evolution, enhanced practice is likely to play a substantial role in the future of the profession.

Miski Sucule's story

Find out how an enhanced practice programme reignited one podiatrist's love for the profession.