Driving change in child health services: the role of OT Advanced Practitioners

Lucy’s experience as an OT Advanced Clinical Practitioner Trainee 

The scary thing is that people listen to me! The Advanced Clinical Practitioner (ACP) role means people want to hear what I have to say.’ 

Lucy Webber is Children’s Community Occupational Therapy Lead at University Hospitals Plymouth NHS Trust and a Trainee ACPi. She and two colleagues from the child development team (a speech and language therapist and an ADHD nurse) are nearing the end of their three-year training. Their roles were funded by NHS England with the aim of transforming the local autism pathway and addressing long waits for assessment, diagnosis and support.  

Lucy says: 

The ACP role is a great opportunity to work strategically, to deal with the things that frustrate me.'

 This includes collaborating with paediatricians and other members of the multidisciplinary team to streamline services to provide more timely, relevant support for autistic children.  

A passionate advocate for children, young people and families, Lucy is using her ACP role to carry out surveys and audits to better understand what people need and want from the service. She’s using these insights to help shape meaningful service improvements. Lucy’s also been working with schools and health visitors to help them navigate and use support pathways effectively. The goal is to ensure referrals are appropriate and everyone has fair and equal access to the services available.   

Lucy and her ACP colleagues are allocated one study day per week, but protecting this time can be challenging. For example, Lucy was called back into her clinical role to support a Local Authority Ofsted inspection, meaning she had to request an extension for an assignment deadline. This highlights the importance of having ongoing support of both the academic team and service managers – ensuring that ACP Trainee development remains a priority, even in the face of operational pressures.  

Currently enrolled in the ACP course at Plymouth University, Lucy is navigating a programme originally aimed at nurses and not specifically tailored for child health professionals. Because of this, Lucy and her colleagues have worked with the academic team to ensure the course content and assessments meet their role and workplace requirements. As an example, the assessment includes an objective structured clinical examination - OSCE - which was adapted to reflect a child health environment: ‘When we did the OSCEs it needed to mimic what we do at work, so we asked for two examiners, one to be the young person and one to be the parent’. Future ACP courses aligned with the new paediatric and child health curriculum framework are likely to offer a more tailored and relevant learning experience, better equipping practitioners to meet the needs of infants, children and young people. 

Despite these challenges, Lucy is enthusiastic about the opportunities that ACP roles offer for children’s occupational therapists: ‘I could see how other professionals were doing the ACP role, and I wanted to wave the flag for OT. It is a challenge, but I think OTs have got those skills and I can see I cover all the pillars in my day-to-day job’.  

Lucy goes on to say: 

The ACP role brings professional recognition and credibility, within multidisciplinary teams alongside nurses, physiotherapists and paramedics. It places occupational therapists on equal footing within these teams, strengthening our voice and influence. One of the unexpected highlights has been meeting so many fantastic people from other professions whilst completing the course - all navigating complex roles with passion, compassion and a shared drive for quality improvement. There’s a real sense of a united, powerful strong multi-disciplinary team of ACPs working together for better patient care. Ultimately, the course doesn’t just develop your clinical skills - it earns you the right to lead change.’ 

For Lucy, the true value of the Advanced Practitioner role lies in its ability to bridge the gap between clinical expertise, leadership and service development. It’s this unique contribution that she believes will make a lasting difference to infants, children and young people: ‘We’re looking forward to finishing the course and planning together as a team of ACPs to improve services for children and young people’. This sense of a shared purpose and forward-thinking approach reflects the transformational potential of Advanced Practitioners not just as individuals, but as catalysts for meaningful change across the child health system.   

Find out more 

Download the NHSE paediatric and child health advanced practice area specific capability and curriculum framework (PCHCF).  

Read the PCHCF implementation guidance: Paediatric and child health advanced practice area specific capability and curriculum framework (PCHCF) | RCPCH 

Read the Multi-professional framework for advanced practice in England (2025)  

Learn more about workplace supervision for ACPs: Supervision - Advanced Practice