Advanced Practitioner, First Contact Physiotherapist

Job responsibilities

Be the link between primary, community and acute services, when the patient is managed via primary care ensuring an integrated care pathway for individual patients that meets their needs. This will include provision of triage to other services and/or directly providing management and advice.

To lead on and develop effective communication between primary care services/GP practices and other relevant care providers. Educate on the role of the FCP, its impact on referral patterns and patient care pathways.

Maintain sound relationships with orthopaedic consultant teams, relevant MDT and physiotherapy services in community and acute settings. Where appropriate develop relationships with wider health and social care agencies, for example mental health teams, local authorities, third sector providers and patient groups.

To provide leadership to primary care multi-disciplinary teams on physiotherapeutic management of MSK conditions. This will include the provision of highly specialist advice on issues ranging from the provision of expert opinion on individual patient treatment options to be a primary contributor to MSK services and related pathway development.

Encourage collaborative working across the health economy and be a key contributor to the primary care networks providing leadership and support on MSK clinical and service development across the network.

Use local and national evidence-based practice to develop suitable research and audit programmes evaluating the effectiveness of the FCP programme. This will include communicating outcomes and integrating findings into own and wider service practice and pathway development.

Participate as a lead contributor to formal research projects evaluating the FCP role, including multi-provider and academic led research projects.

Provide education and expert training to specialist clinicians from a range of disciplines including supporting the development of FCP MSK specialists in own profession.

Clinical:

To be the first point of clinical contact for patients presenting with MSK conditions or symptoms, providing the patient with the primary assessment, diagnosis and management options for their condition.

Use advanced clinical practice skills and clinical reasoning to provide comprehensive diagnostic and treatment support to patients who present with complex musculoskeletal conditions and/or multiple pathologies and/or mental health and/or pain management needs.

Independently request diagnostic tests including routine and specialist x-rays, MRI imaging, ultrasound scans and blood and other pathology tests. Interpret the results alongside traditional physiotherapeutic assessment techniques and non-clinical information to aid clinical diagnosis and decisions on potential treatment options/clinical interventions.

Carry own caseload as an autonomous practitioner, providing direct clinical/physiotherapeutic care for patients with a range of complex Musculo-skeletal conditions and who may have significant other primary or secondary conditions/multipathologies.

Be able to decide when appropriate to use advanced clinical practice skills that may include:

If trained - to use joint/soft tissue injection therapy, including administration of prescription only medication [POM] to aid treatment.

If trained as a Non-medical prescriber - to prescribes safely and effectively within the agreed scope of practice.

Use professional judgement and advanced clinical reasoning skills to make decisions about safe and effective patient care in unpredictable situations, including when there is incomplete/contradictory information.

To be able to work autonomously as a lone practitioner.

Be able to demonstrate understanding of the impact of physiotherapeutic interventions on existing conditions and treatment programmes e.g., podiatric treatment, drug therapies, etc. Ensuring physiotherapy interventions are integrated and supportive of the whole treatment aims promoting a holistic approach to condition management.

Be able to clinically justify referral onto appropriate MSK pathways within the community or wider healthcare services. Including referral to the appropriate stage of the pathway and the use of social prescribing.

For patients that remain the responsibility of primary care services, take the lead for the management of the patients journey on their care pathway, acting as the link for the patient between primary care and other services/professionals.

Be able to justify clinically referrals to other specialist services. This will include referral to acute and specialist services such as surgical orthopaedics, rheumatology and neurology, other AHP services, nursing services and to the primary care medical teams. This requires advanced knowledge of the role of other specialist health professionals.

An ability to recognise RED flags, serious pathology and potential underlying non MSK related disease, that may present as MSK symptoms and to refer appropriately. When needed accelerate the patients referral to other health professionals/services.

Work in partnership with the patient at all times to attain maximum participation in treatment programmes. This will include working with patients from diverse social background and cultures and understanding how this will affect treatment proposals and models.

Develop integrated and tailored care programmes in partnership with patients:

Use effective shared decision making with a range of first line management options (appropriate for the persons level of activation)

Assess levels of Patient Activation to confirm levels of knowledge, skills and confidence to self-manage

Agree appropriate support for self-management through referral to rehabilitation focussed services and social prescribing provision.

Provide expert advice and act as source of expertise in the management of musculoskeletal conditions and provide a specialist advisory service to patients, specialist physiotherapists other specialist healthcare professionals and members of the primary care team. Including advising GPs on management of MSK conditions.

Provide advice, instruction and teaching on aspects of management of a condition to patients, relatives, carers and other health professionals.

Continually review and develop specialist clinical and diagnostic skills in response to service need.

Be accountable for own decisions and actions via HCPC registration and professional standards.

Allocated time to plan and organise the FCP service efficiently, ensuring delivery inline with service expectations.

Integrate the FCP role into the wider primary care team, proactively working with the primary care team to build robust relationships and integrate working practices. Attending primary care strategic and practice level meetings to represent FCP/physiotherapy when appropriate.

Be the FCP/physiotherapy lead on the development of referral guidelines for MSK and MSK related conditions from primary care to other NHS services that will direct referrals to other primary care services, community, secondary and tertiary [specialist] services.

Lead or be a primary contributor to the development of MSK pathways across the primary care network, NHS providers across the health economy. This includes contributing to pathways that are not primary MSK pathways, but which have MSK interventions along the pathway.

Work collaboratively with the primary care team, including working across the Primary Care Network [PCN] and also in partnership with business managers, professional managers and lead clinicians of secondary, community and other care providers to improve service delivery and meet the identified needs of the local patient population.

Use influence and contribution to the PCN to promote the contribution of FCPs to MSK services in primary care and to the wider related services in the health economy.

Work with the primary care team, public health professionals and other agencies to introduce a strand of service provision that highlights preventative strategies for local populations, patient groups and individuals.

Participate and lead in ensuring a professional culture of peer networking and support underpinned by active engagement in peer review and embracing evidence-based practice.

Demonstrate a detailed knowledge of wider health, healthcare and social care agencies related to MSK conditions and physiotherapy.

Review and develop organisational and service policies that support the maintenance of good clinical governance, manage risk and ensure patient safety is paramount.

Take responsibility for the introduction, monitoring and review of service standards for MSK primary care services. Including clinical, professional and service standards.

Be aware of and able to demonstrate of how the FCP role contributes to the achievement of key performance indicators [KPIs] for MSK primary care services.

Where service improvement is required in order to achieve standards and KPIs be a lead contributor to identifying where services need to be changed.

Take forward operational change within primary care MSK services to deliver improvements in service standards.

Work within the FCP service, contributing to the development of musculoskeletal physiotherapy and related services across the healthcare economy.

Represent the FCP primary care service at internal primary care meetings and at external forums/service meetings including CCG and other strategic regional forums involved in the development of FCPs and/or MSK pathways.

When introducing change, be aware of and responsible for identifying and managing alternative/contradictory views expressed by services and specialist clinicians. For example, when negotiating and explaining proposals to change to service design, organisation and skill mix in primary care and related MSK services.

Participate in or lead investigation into complaints and clinical errors/incidents when appropriate.

Skills, Knowledge & Competencies

Essential

• Excellent written communication skills.
• Excellent IT skills in Microsoft Office applications.
• Able to work with and influence other grades of staff and professions Ability to use own initiative.
• Excellent organisational skills.
• Ability to work as part of a team.
• Ability to prioritise workload, work accurately under pressure, and meet deadlines.
• Ability to problem solve and think laterally.
• Good all-round clinical knowledge and practical clinical skills.
• Knowledge of national guidance .
• Demonstrated commitment to CPD.
• Strict adherence to patient confidentiality legislation.
• Responds well to constructive feedback.
• Empathetic & sensitive to patients & members of staff.
• Deals with patients & staff with honesty & integrity.
• Ability to work flexibly and reliably.
• Ability to travel to study days/other work locations using own or public transport.

Desirable

• Ability to develop services in designated area.
• Teaching and tutoring skills.
• Ability to affect and manage change with an ability to motivate others.
• Team building skills.
• Ability to manage time, people, and resources to deliver outcomes.
• Identifies and manages risk.

Experience

Essential

• Working in an Advanced Practice role e.g. Orthopaedic triage, First Contact Practitioner, working at a senior level in a musculoskeletal service and treating patients with complex and chronic presentations, using a biopsychosocial approach and via both individual and group rehabilitation.
• Evidence of extensive role in the clinical education and supervision of less experienced staff, students, and assistants including conducting appraisals
• Experience and direct involvement of redesign within a service.
• Experience in delivering training and supervising others.
• Audit and / or practice research experience
• Experience collaborative working in multidisciplinary settings.
• Experience of working through change in the workplace and recognition of the impact of change on behaviours and processes.

Desirable

• Project management
• Experience of policy, guideline, and service development
• Risk management
• Staff management

Qualifications

Essential

• HCPC Registration
• Completion of an appropriate level 7 MSc in Advanced Physiotherapy Practice or equivalent.

Desirable

• M-Level leadership module.
• Completion of M-level post-graduate non-medical prescribing course.
• Completion of M-level post-graduate Injection Therapy course.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).