Back to information hub

Case Study – Birmingham Community Healthcare NHS Foundation Trust (2 of 4)

NHS Trust supports the creation of a new role in the independent sector to cut waiting lists for NHS podiatry services in South Birmingham with the role of a Nail Carer and accredited qualification

The Level 2 Award in Nail Cutting and Care has been developed, driven by the need to reduce waiting times and provide a better service to those needing more complex care. South Birmingham NHS (now Birmingham Community Healthcare NHS Foundation Trust) raised the threshold for access to its podiatry services, discharging more than 4,000 patients who simply required their nails cutting.

It was important to find a way to help these discharged patients get access to routine nail care because good foot and nail health offers benefits including improved mobility and a reduced risk of falls in the elderly. Through talking to patient groups representing older people across Birmingham, as well as GP Commissioning groups, NHS Commissioner Marion Rogerson identified the opportunity to create the role of Nail Carer, which could provide a routine, safe, affordable, and accessible service to low-risk patients, but which would be based outside the NHS.


  • Through making a difficult decision to discharge low-risk patients, the NHS has helped to create a new role which is benefiting both the patients and the Nail Carers themselves more than 120 people have completed the qualification so far people such as nurses, beauticians, pharmacy technicians, and care workers have been able to add Nail Caring as an extra qualification into their current role; and as a result, have gained a transferable skill and added job satisfaction.
  • Independent Nail Carers have set up their own businesses and found clients. They are able to work flexibly – around childcare for example – and create their own income an estimated 5,000 clients are registered with Nail Carers across Birmingham and many clients see a nail carer on average six times a year – much more often than they would have been able to access NHS podiatry services – at a time and place to suit them, and at an affordable cost regular care reduces the likelihood of patients suffering pain or discomfort and may help decrease the risk of falls due to ill-fitting footwear. For some housebound individuals, it is also a welcome social occasion.

“Our patients’ welfare is of huge concern to us. We want to be able to refer them to a service which, although not provided by the NHS, we can be confident is safe and effective, and less costly than a private podiatrist.”

Marion Rogerson, former South Birmingham CCG Commissioner – responsible for cross-city development

South Birmingham NHS’s initial aim was to set up a course for Nail Carers which would train individuals to properly assess patients, refer them to a more specialist service if necessary, and cut and care for their nails. “We wanted the course to have added value,” says Marion, “So people needed to be trained in providing health and safety advice too.”

South Birmingham NHS Trust already had links with Birmingham Metropolitan College, and Marion made contact with the College’s Health and Beauty Associate Director Louise Lakin, who was keen to pursue the idea. Louise researched and planned the training modules, producing a course that met all of South Birmingham NHS’s requirements. The College was then able to award its own Certificate in Nail Care.

“We invested a lot of time, energy, and resources in developing the role of Nail Carer,” says Marion. “We realised that it had the potential to transfer across the UK, so we approached role development specialists, Skills for Health. We recognised their ability to make contact with awarding bodies, and to get the course on to a national agenda.”

Our healthcare workforce consultants, in collaboration with stakeholders from South Birmingham PCT (now Birmingham and Solihull Clinical Commissioning Group), Birmingham Community Healthcare NHS Trust, and Birmingham Metropolitan College, created a Transferable Role Template for the Nail Carer role, listing the National Occupational Standards, career framework level and scope of the role which defines it.

We facilitated a meeting between the Birmingham stakeholders and Awarding Organisations (AOs), supporting the AOs to develop new units and work out a structure for the new qualification. It emerged as a Level 2 Award in Nail Cutting and Care, a 12credit qualification on the QCF.

“We couldn’t have achieved this without the team at Skills for Health to help us in preparing the documentation, which was essential in ensuring that the Nail Carer qualification was applicable across the awarding bodies.”

Marion Rogerson former South Birmingham CCG Commissioner – responsible for cross-city development

As the UK’s Sector Skills Council for health, we help health sector employers across the UK optimise the potential of their workforce. Our proven solutions address not just improved productivity but also the quality of health and healthcare.