An Exploration of the Skills Required for the 21st-century Prosthetist and Orthotist

Background: Prosthetists and orthotists comprise one of the smaller allied health professions. Previous UK analyses have described workforce size, service provision, vacancies, and retention; however, less is known about current skills and competency gaps. Objective: To map self-reported skills among the UK prosthetic and orthotic workforce, identify perceived competency gaps, and explore skills considered necessary for future practice. Methods: This was a secondary analysis of a national UK workforce survey conducted between September and December 2022. Qualified prosthetists, orthotists, and dual-practicing clinicians were included. Descriptive statistics summarized the current competence, perceived future requirements, and the gap between them. Items were grouped into several conceptual domains, and descriptive bands were applied to aid the interpretation of competence levels and the size of the gap. Results: The analysis included 641 respondents: 419 orthotists, 177 prosthetists, and 45 dual-practicing clinicians. The most frequently reported current competencies were person-centered care, effective communication and behavior change strategies, and material science. Lower competence was reported in artificial muscles, robotics, prescribing rights, mental health and well-being checks, trauma-informed care, public health, research, and leadership and management. Commonly identified future requirements included communication and behavior change, person-centered care, three-dimensional imaging, new materials, digital competency, public health, computer-aided design, motion analysis, and leadership and management. The largest gaps were observed in mental health and well-being checks, three-dimensional printing, X-ray interpretation, rapid manufacturing technologies, new materials for product design, and artificial muscles. Conclusions: The UK prosthetic and orthotic workforce reports strength in core clinical and interpersonal domains; however, important gaps remain in public health, mental health, research, leadership, and emerging technologies. Future readiness requires coordinated action across education, professional development, competency frameworks, and workforce planning. Clinical Relevance Statement: This study identifies skills that need to be strengthened to support prevention-focused, psychologically informed, technologically responsive, and evidence-based care. The findings can guide curricula, professional development, and service planning so that clinicians are better prepared for future service needs.