The alternative format PhD, in which doctoral candidates produce a thesis composed of a series of peer reviewed publications, is growing in popularity internationally. However, across the HE (HE) system in the United Kingdom (UK), universities have been slower to adopt the alterative thesis format. This paper presents a systematic narrative review to understand the development of institutional-level policies pertaining to the alternative thesis format across UK HE institutions (n = 135), identifying best practice and opportunities for improvement. The paper evidences a fragmented policy landscape in which there is a notable lack of consistent and coherent policy and guidance across institutions, that may in fact compound existing inequalities in doctoral provision. Recommendations are made to encourage the design of institutional policies that support PhD candidates to opt for the alterative format thesis where appropriate, with wide ranging implications for the HE sector.