Enhanced clinical practice
BIOS is proud to launch the Orthoptic Enhanced Level Practice Schema and Model Curriculum – a significant step forward in defining meaningful and structured career pathways for the orthoptic profession.
The Enhanced Clinical Practice (ECP) model sits between preceptorship and advanced clinical practice. It formally recognises and supports orthoptists who are already delivering complex care, demonstrating professional judgement, and working autonomously within multi-professional teams — even if they don’t yet hold an advanced title or role.
What is enhanced practice?
Enhanced Practice is a nationally recognised level of clinical practice within the Allied Health Professions (AHPs), endorsed by NHS England and supported across all four nations of the UK. Practitioners at this level:
- Apply profession-specific knowledge and expertise to manage complex cases and clinical risk
- Act autonomously and with influence, even without formal authority
- Demonstrate leadership through clinical reasoning, critical thinking, and evidence-based decision-making
Enhanced-level practitioners are vital to the delivery of high-quality, person-centred care. This level of practice may be a stepping stone to advanced practice or a valuable career destination in its own right.
Why this matters for orthoptics
Historically, the orthoptic profession has lacked a clearly defined pathway between newly qualified roles and advanced clinical practice — leaving a gap in career progression and recognition for experienced clinicians.
To help close this gap, the first Orthoptic Enhanced Clinical Practice (ECP) Schema was developed in 2024 by Gemma Arblaster, Joshua Simmons, and Martin Rhodes, establishing a foundational definition of Enhanced Practice within the orthoptic context.
In 2025, Kim Stuart of Coventry University and Louise Henstock of the University of Salford were commissioned to further develop and align the schema with national standards set out in the NHS England AHP Enhanced Practice Framework. This alignment ensures national consistency and provides a robust, profession-specific model to support structured career development, workforce planning, and retention within the orthoptic profession.
This new model enables orthoptists to:
- Advance their careers while remaining in hands-on clinical roles
- Gain formal recognition for delivering care at an enhanced level
- Access structured development pathways across clinical practice, leadership, education, and research
What’s in the Orthoptic ECP Model Curriculum?
- A clear definition of Enhanced Practice in the context of orthoptics
- Profession-specific domains and capabilities to support professional development
- Practical guidance for employers, supervisors, and educators
- Alignment with national frameworks, including HCPC standards and the AHP career structure
The curriculum embraces core national principles: inclusivity, values-driven leadership, and local system transformation — while celebrating the depth, skill, and impact of orthoptic practice.
Explore the Curriculum
The Orthoptic Enhanced Practice Model Curriculum supports clinicians, educators, and employers in embedding enhanced-level practice within services and teams.
Originally published by NHS England as part of the Enhanced-Level Practice AHP Schema, the schemas and model curricula are for use by Higher Education Institutions (HEIs) to support the development of profession-specific approved programmes within their institution.
Explore other areas
Resource library
Search our library of standards, guidelines and other resources covering the full scope of orthoptic practice.
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Groups & networks
Our groups and networks cover specialisms and areas of interest across orthoptics.
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New graduate & preceptorship
Resources to support you in your first few years of practice. This includes the BIOS preceptorship programme, career progression guides, new graduate CPD events and guidance on HCPC payment and registration.
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