title: The impact of workforce redesign policies on role boundaries in 'generalist' podiatry practice: expert views within the professional body.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Medicine, Primary Medical Care, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST UK.
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: Stressing
authors.affiliation: Centre for Innovation and Leadership in Health Sciences, Faculty of Health Sciences, University of Southampton, Building 45, Highfield, Southampton, SO17 1BJ UK.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Borthwick
keywords: Generalis; Podiatr; Role boundar; Workforce redesign