As a result of policy initiatives in the mid-1980s, the Department for Education and Employment has been encouraging the development of national occupational standards and National and Scottish Vocational Qualifications (N/SVQs) in all occupational sectors within the UK. For the health and social care sector, these developments give rise to a number of issues and concerns. Using Health Promotion as an example of an area of professional practice within health and social care, this paper explores the relationship between academic assessment and the assessment of National and Scottish Vocational Qualifications; the relationship between the academic and the National and Scottish Vocational Qualification model of credit accumulation and transfer; and the relationship between qualification, licence to practice and competence in practice. Subsequently, it examines the development of the reflective professional practitioner and the relationship between 'competence' and notions of 'excellence' and 'expertise' in professional practice. Finally, it considers the role of knowledge and understanding in professional practice and the role of academic institutions in the development of a professional practitioner.