Introduction Interprofessional leadership is the vision of NHS and essential to sustain the NHS in pressured times. Furthermore, the Messenger Review (2022) states that collaborative and inclusive leadership is fundamental for high-quality patient care. The study focused on Allied Health Professionals (AHPs), which is an umbrella term for 14 distinct professions who represent the third largest clinical workforce in the NHS in England. A literature review indicated that AHPs are under-represented in senior leadership positions; the causes of which are likely multi-factorial. Historically, the NHS’s senior leadership has primarily comprised of non-clinical, medical, and nursing management, due to the legal requirements for Trust boards. Furthermore, the lack of leadership development and career infrastructure for AHPs, at early to mid-career levels, likely results in a lack of a talent pipeline for diverse senior leadership. The impact is an inequity in opportunity and voice compared to other healthcare professions, such as nurses and doctors.

Aims and objectives of the research project or activity This study interviewed AHPs, who identified themselves to be at early to mid-career levels. The study’s aims were: to establish the barriers and opportunities to leadership and career development, faced by AHPs seeking to move onto middle or senior leadership positions; to reveal the priority placed on leadership development by AHP employees, at early to mid-career positions; to identify how organisations can facilitate AHP leadership development. The study attempted to represent the voices of AHPs, which can be lacking in both organisations and research.

Method or approach The sampling was purposive. The inclusion criteria were being a member of one of the 14 AHP professions, who identified themselves to be in early- to mid-career positions, in England. Focus groups (FGs) were undertaken with 27 participants, representing 8 of the 14 AHP professions, in June 2021. The FGs were directed by a topic guide, developed using a deductive theoretical approach, based on the literature, and shared prior to the FG. The qualitative data from the FGs was analysed using thematic analysis (TA). This involved generation of initial semantic codes, using a theoretical approach: deductive TA, based on the topic guide, and then inductive TA, drawn from the raw data. The participants represented all seven NHS England regions, which provided geographical representation. However, the results cannot be generalised to the whole AHP population, due to the qualitative nature of the FGs and the population size.

Findings The TA generated 4 themes: leadership qualities across seniorities and specialisms; the importance of leadership development; the barriers to AHP leadership development and career progression; and the opportunities for AHP leadership development and career progression. Further TA identified 3 overarching themes: equitable and interprofessional leadership development; an equitable and structured AHP career pathway; and having AHP leadership at a strategic and/or very senior level. These overarching themes were subsumed under the umbrella category: equity of opportunity and voice.

The individual AHPs, who had been developed, reported feeling valued by their organisation and able to contribute to high-quality care. However, despite the vision of interprofessional working, all participants reported a historical or current negative organisational culture for AHPs and an inequity of opportunity, compared to other professionals. This inequity of access to structured leadership and career development impacts on both individual AHPs and the diversity of leadership within organisations. Organisational recommendations were developed to facilitate all AHPs’ leadership and career development, and to address the lack of AHPs’ voice at senior levels.

Key messages Compared to other professional groups, AHPs are not offered an equitable leadership and career development. Therefore, further work is needed to ensure interprofessional representation, within senior leadership levels, to ensure diversity of thought. Senior leaders should be mindful of these organisational structural barriers, when developing new policy and strategies aimed at developing and retaining their workforce.

The results significantly add to a neglected area of research and are relevant when considering the NHS Long Term Workforce Plan. The CAHPO’s AHPs Strategy for England 2022–2027 commits to AHPs championing and promoting diverse and inclusive leadership, as an enabler to achieve its areas of focus. This study suggests that the strategy’s recommendations are not yet making an impact in practice or influencing the AHP leadership landscape. A longitudinal study in 5 years’ time could interview the same professionals from this study and/or a new group to determine the system changes.