This paper considers the challenges of attempting to apply national quality standards for distance education onto online programmes designed for clinical practitioners. It addresses some of the quality frameworks available for UK Higher Education and their potential weaknesses in addressing learner needs. In contrast, we continue by describing how a framework constructed around a problem-based learning (PBL) approach has been used at City University to offer a more appropriate and robust mechanism for ensure quality standards in clinical practice education. The PBL approach offers adult learners a flexible and responsive method of learning whilst simultaneously meeting national quality guidelines. (Abstract by authors)