Can Leadership Unite the AHP Workforce?

Ava

Welcome to the podcast. I’m Ava, and I’m joined by David. In this episode, we are focusing on leadership, professional identity and the collective voice of the allied health professions. In England, allied health professionals, or AHPs, comprise 14 distinct professions and form the third largest clinical workforce in the NHS. Yet despite their size and contribution, AHPs have historically been described as a fragmented workforce, often divided by professional boundaries, organisational structures and unequal access to leadership.

David (2)

Today, we are discussing a 2026 study by Pippa Hales and colleagues that examines an important question: what role does leadership play in helping 14 different professions feel part of a meaningful AHP collective?

Ava

That is an interesting question because being placed within the same workforce category does not necessarily create a shared professional identity. A physiotherapist, dietitian, orthotist, paramedic or diagnostic radiographer may have a very strong connection to their own profession, but may not automatically identify themselves as part of a wider AHP community.

David (2)

Exactly. The AHP label exists within NHS policy and workforce planning, but this paper asks whether that collective identity is genuinely experienced by the people working within it. The researchers were particularly interested in whether AHP leadership helps create connection, belonging and collective influence, or whether leadership can sometimes reinforce the same divisions it is intended to overcome.

Ava

The study used a constructivist grounded theory methodology. This approach was chosen because relatively little is known about how clinical AHPs experience leadership in relation to collective identity. The researchers conducted individual, semi structured interviews with 22 registered AHPs working clinically in the NHS in England.

David (2)

The participants represented 11 of the 14 recognised AHP professions. They included occupational therapists, physiotherapists, speech and language therapists, diagnostic radiographers, art therapists, operating department practitioners, dietitians, a podiatrist, a paramedic, an orthotist and music therapists. Ten participants had been registered for five years or less, while 12 had more than five years of experience. This allowed the researchers to consider perspectives from both early career and more experienced practitioners.

Ava

Importantly, the study excluded people working exclusively in non-clinical strategic leadership positions. The intention was to centre the experiences of clinical AHPs and explore how leadership is perceived and experienced by members of the wider workforce, rather than asking established leaders to evaluate their own leadership structures.

David (2)

The analysis identified four interrelated concepts: broadening perspective, connecting across AHPs, experiencing inequality within the AHP collective and experiencing underrepresentation. Let’s begin with broadening perspective.

Ava

Participants described how early career AHPs are understandably focused on developing the knowledge and technical skills required within their own profession. That professional focus is essential. However, the study found that without deliberate opportunities to learn about other AHP professions, clinicians may remain within professional silos.

David (2)

And the important point is that a broader AHP perspective did not necessarily develop automatically with time. Leadership was seen as central to creating opportunities for clinicians to understand other professions, recognise the interdependence of their work and develop a sense of belonging to something larger than their individual profession.

Ava

One participant described how cross-professional meetings were largely restricted to management levels, with little opportunity for Band 5 or Band 6 clinicians to engage with the wider AHP community. This suggests that early career structures may unintentionally reinforce professional separation at the very point when a broader identity could begin to develop.

David (2)

That leads directly to the second concept: connecting across AHPs. Participants generally valued the idea of a wider AHP community, but many described limited opportunities to form meaningful relationships across professional boundaries. They often looked to leadership to establish the forums, networks and shared activities through which those connections could develop.

Ava

The visibility of AHP leadership appeared to be particularly important. Of the 22 participants, ten knew that their organisation had an AHP lead. Three said that it did not, and seven were unsure. Six of the seven participants who were unsure were early career AHPs who did not express a strong AHP identity.

David (2)

One participant said that they had never heard of an AHP lead in their organisation, although the researchers later confirmed that one existed. That is quite revealing. Creating a leadership position does not automatically make that leadership visible, accessible or meaningful to the workforce.

Ava

In contrast, participants who had experienced engaged and proactive leadership described feeling drawn into the AHP community. Some spoke positively about leaders who made direct contact with professions, created opportunities for connection and provided a visible voice for AHPs within the organisation.

David (2)

The message appears to be that leadership cannot remain distant or purely strategic. For a collective identity to develop, AHPs need to see their leaders, understand their purpose and feel that those leaders are actively connecting the different professions.

Ava

The third concept was inequality within the AHP collective. This is particularly important because a collective identity can only be meaningful when all the professions within it feel recognised and valued. Several participants felt that AHP leadership and initiatives were dominated by the larger or more established professions, particularly physiotherapy and occupational therapy.

David (2)

For smaller professions, the experience could be very different. One participant described how podiatrists were rarely visible in senior AHP leadership roles. Others felt that their professions were remembered only after the larger professions had already been considered. That creates a difficult situation. People are being asked to identify with the wider AHP collective while simultaneously feeling overlooked within it.

Ava

The study does not suggest that strong profession-specific identities are a problem. In fact, it recognises that clinicians can maintain a strong identity as an orthotist, dietitian, paramedic or occupational therapist while also belonging to the wider AHP collective. The problem arises when the collective appears to value some professions more than others.

David (2)

Inclusive leadership therefore requires more than bringing everyone under the same title. Leaders must understand the distinct roles, challenges and contributions of all 14 professions. They must also avoid assuming that an approach developed around one or two professions will automatically represent the entire workforce.

Ava

The paper includes a positive example of an AHP leader who was a physiotherapist spending a day with an operating department practitioner because the leader recognised that they did not fully understand the profession. That action was valued because it demonstrated curiosity, humility and a genuine effort to understand a profession beyond the leader’s own background.

David (2)

And that is a practical example of inclusive leadership. No AHP leader can begin with detailed knowledge of every profession. But they can actively seek that knowledge, build relationships and ensure that the smaller and less visible professions are not marginalised.

Ava

The fourth concept was underrepresentation, particularly at senior organisational levels. Participants described occasions when AHPs were not directly represented within important decision-making forums. In some organisations, another professional group, often nursing, was expected to speak on behalf of the AHP workforce.

David (2)

The participants were not necessarily critical of the individuals trying to provide that representation. Their concern was whether someone from another professional group could realistically understand and articulate the experiences of 14 different AHP professions, particularly when that individual already had substantial responsibilities for their own workforce.

Ava

One participant explained that although their organisation had a supportive AHP lead, that person did not sit on the board in the same way as the nursing lead. Another questioned why medical and nursing leadership could be represented at board level while AHP leadership remained outside the room.

David (2)

That absence was not experienced simply as a professional status issue. Participants connected it directly to patient care. When AHPs were not represented in senior decision making, some felt that the needs of their patients, and the services those patients depended upon, were also less visible.

Ava

This is an important distinction. AHP leadership is not only about career progression or professional recognition. It is also about ensuring that the expertise of AHPs informs decisions about services, workforce, resources and patient pathways.

David (2)

The findings suggest that leadership can either strengthen or weaken collective identity. Visible, inclusive and engaged leaders can help clinicians broaden their professional perspective, connect across disciplines and feel part of a collective with a shared purpose. In contrast, absent or inconsistent leadership, unequal representation and limited senior influence can reinforce fragmentation and diminish the perceived value of belonging to the AHP workforce.

Ava

The study also makes clear that collective identity cannot be created through policy documents alone. National strategies can define the AHP workforce and describe its shared ambitions, but identity is constructed through everyday experiences of inclusion, recognition, connection and representation.

David (2)

That means leadership must actively shape the identity rather than assume it already exists. Leaders need to communicate what the AHP collective is, why it matters and how belonging to that collective complements rather than replaces an individual profession’s identity.

Ava

The authors present a conceptual synthesis of leadership practices that could support a stronger collective AHP identity. These include defining and communicating a shared purpose, understanding all the professions within the AHP group, protecting individual professional identities, creating opportunities for cross-AHP connection and managing tensions within and between professions.

David (2)

They also emphasise that leaders must embody the AHP identity themselves and adapt to the changing and complex nature of healthcare systems. Different leaders will contribute in different ways. Senior organisational leaders may shape strategy, visibility and representation, while local leaders and supervisors influence the everyday experience of inclusion, respect and collaboration.

Ava

The study does have limitations. Although participants represented 11 professions, orthoptists, osteopaths and dramatherapists were not included. Their experiences may introduce additional perspectives, particularly because smaller professions can experience distinct challenges around visibility and representation. The findings also reflect the experiences of clinical AHPs rather than the perspectives of people working exclusively in strategic leadership positions.

David (2)

The authors therefore call for further research examining the relationship between leadership, collective identity, workforce retention and attrition. They also suggest exploring how AHP leaders understand their own identity as leaders and whether that aligns with the experiences of the clinical workforce they represent.

Ava

The central message from this study is that a large workforce does not automatically become a united or influential workforce. The 14 AHP professions can maintain their individual expertise and professional identities while also developing a stronger collective voice. But that requires leadership that is visible, inclusive, representative and genuinely connected to every profession.

David (2)

For leaders, the challenge is not simply to speak for AHPs. It is to create the conditions in which all AHPs, including those from the smallest and least visible professions, feel seen, valued and able to contribute to a shared purpose.

Ava

We encourage AHPs, managers, educators, policymakers and healthcare leaders to read the full paper. The complete title is “Elevating the allied health professions workforce: leadership’s role in shaping professional identity.” It was published in BMC Health Services Research in 2026, volume 26, article 327. The authors are Pippa Hales, Nebil Achour, Olivia King and Hilary Engward.

David (2)

Thank you for listening. We hope this discussion encourages further reflection on what inclusive AHP leadership looks like and how every profession can be meaningfully represented within the collective.

Ava

Until next time, goodbye.