AGENDA FOR CHANGE NHS JOB EVALUATION SCHEME

JOB DESCRIPTION

1. JOB IDENTIFICATION

Job Title: Physiotherapist

Reports to: Team Lead

Department, Ward or Section: Physiotherapy Department

Operational Unit/Corporate Department: / South and Mid and divisions

Job Reference: GENIMFUAHPSPHYS02

No of Job Holders: TBC

Date: May 2019

2. JOB PURPOSE

To provide an efficient and effective Physiotherapy Service, to patients referred to the Physiotherapy Service in the Raigmore /South and Mid divisions.

To provide a high standard of Physiotherapy, consistent with both local and national standards.

This post could be static or part of the Physiotherapist rotations which can be throughout any hospital in Raigmore /South and Mid divisions. This post may include on-call and weekend work depending upon the particular department.

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3. DIMENSIONS

Physiotherapy in NHS is currently divided into Raigmore, South & Mid and North & West Divisions.

The acute service unit is based at .

All Physiotherapy posts are part of Multidisciplinary teams in the Hospital or the Integrated Community teams.

Rotational posts can be in Raigmore Hospital, Invergordon County Community Hospital, , Dingwall, (RNI) Inverness, Nairn Town and County Hospital, or any other community site within the South and Mid and Raigmore divisions. The rotations may include all physiotherapy specialties, including paediatrics and mental health.

4. ORGANISATIONAL POSITION

Operational Unit Allied Health Professional lead

Team Manager Operational Unit Professional Lead Physiotherapist

Team Lead

Physiotherapist (This post)

Line management HCSW Day to day supervision/delegation Professional accountability

5. ROLE OF DEPARTMENT

To provide a comprehensive range of in-patient, out-patient and community physiotherapy services.

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Chartered Physiotherapists use their expertise and skills in assessment, movement, exercise, electrotherapy, facilitation techniques and manipulation to effectively treat, rehabilitate and advise clients with a wide range of health problems. They work with people of all ages who have lost some degree of movement or ability through injury, surgery, pathological change or illness. Ultimately, the aim of Physiotherapy is to help patients resume as active and independent a lifestyle as possible through individual intervention or as part of a multidisciplinary team.

It is the objective of all Physiotherapy staff in NHS Highland to provide the highest quality of patient care possible. As part of an on-going Physiotherapy departmental quality assurance programme, staff are actively involved in setting, maintaining and improving standards. This is primarily aimed at:

1. Improving the range and quality of services available. 2. Ensuring patient needs are best met.

The Physiotherapy Department also supports undergraduate and pre registration training and professional development of BSc and MSc Physiotherapy students.

6. MAIN TASKS, DUTIES AND RESPONSIBILITIES

CLINICAL

 To provide effective and efficient Physiotherapy Services for patients referred to physiotherapy in Raigmore/South and Mid division. To organise follow-up physiotherapy out-patient services on patient discharge/transfer, where appropriate.

 To be able to perform physiotherapeutic assessment to patients with diverse presentations and multi-pathologies and use developing clinical reasoning skills and manual assessment techniques to provide an accurate diagnosis of their condition.

 To interpret and analyse clinical and non-clinical facts to form a diagnosis in a wide variety of conditions; e.g. musculoskeletal, respiratory, neurological, surgical, and cardiovascular problems. To recommend the best course of intervention and to develop comprehensive treatment plans. To follow through treatment plans using evidenced base practice and clinical reasoning. To reach desired outcomes using validated outcome measures and modifying treatment where appropriate. To constantly re-assess and adjust physiotherapy interventions as clinically indicated. To assist the multidisciplinary team in making appropriate decisions regarding appropriate treatment and management of the patients conditions.

 To provide this treatment in the most appropriate location for that therapeutic intervention.

 On a daily basis provide spontaneous and planned advice, teaching and instruction to patients and other professionals to promote understanding of the aims of physiotherapy and to ensure a consistent approach to patient care.

 To be responsible for assessment and management of clinical risk within own caseload and to observe the Health and Safety at Work Act at all times by bringing defects of equipment to the notice of the appropriate authorities and reporting any accidents to staff or patients appropriately and as soon as possible.

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 To be professionally and legally responsible and accountable for all aspects of own work including the management of patients. To ensure a high standard of clinical care for patients and to assist colleagues less experienced and/or Physiotherapy Assistants to do likewise.

 This post will involve being part of the on call rota at Raigmore Hospital.

 To maintain accurate, comprehensive and up-to-date documentation in line with legal, Chartered Society of Physiotherapy (CSP) and Departmental requirements, and communicate assessment and treatment results to the appropriate disciplines in the form of reports and letters and to assist colleagues less experienced and/or HCSW’s to do likewise. To respond efficiently to unplanned events (e.g. staff shortages), which may require a change to work schedule.

PROFESSIONAL

 To maintain own clinical professional development (CPD) by keeping abreast of new research evidence and developments and incorporate them, as appropriate, into care programmes and maintain a portfolio which reflects personal development.

 Maintain and develop current knowledge of evidence-based practice, developing specialist knowledge of particular conditions and patient types (relevant to each rotational placement) and to seek advice from Senior Physiotherapy colleagues, as required.

 To be actively involved in the collection of appropriate data and statistics for the use of the department on a daily basis.

 To provide support, guidance, clinical education and training to Physiotherapy Assistants, where appropriate.

 To be responsible for keeping up to date with mandatory training, i.e. Basic Life Support, Manual Handling, Fire Lectures, Hydrotherapy Evacuation, Violence and Aggression and On-call training.

 To participate in the staff appraisal scheme TURAS and Personal Development Plan (PDP) and be responsible for complying with agreed personal development programmes to meet set knowledge and competencies.

 To comply with NHS Highland and Departmental policies and procedures and to maintain the strictest levels of confidentiality at all times to include General Data Protection Regulations (GDPR).

ORGANISATIONAL

 To be responsible for organising and planning own caseload, to meet patient priorities and service needs. Regularly readjust plans as situations change/arise.

 To assist with the supervision and delegation of appropriate tasks to the Physiotherapy HCSW’s.

 To be responsible for equipment used in carrying out physiotherapy duties and to adhere to departmental policy, including competence to use equipment and, where appropriate, to ensure the safe use of equipment by others through teaching, training and supervision of practice.

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7a. EQUIPMENT AND MACHINERY

Be competent in the use of a wide range of equipment. Ensure that equipment in use is clean and safe, and regularly monitored for safety as per professional and organisational standards of practice

To understand, prescribe and ensure safe use of any relevant Physiotherapy Equipment; could include electrotherapy, exercise equipment, orthotics/appliances, prosthetics, mobility aids and assisted ventilation Walking aids. Detail of equipment will be held locally and will depend on the work area. Note: New equipment may be introduced as the organisation and technology develops, however training will be provided.

7b. SYSTEMS

The following are examples of systems which may be used when undertaking the role: IT Equipment –Personal Computer, phones, mobile phone, telehealth units, teleconference, videoconference.

Maintaining patient records– documenting all patient interventions and non-direct contacts e.g. TRAK/PMS, PACS, SCI store, Learn Pro, MORSE. Datix to report any incidents. Use of intranet to access information within NHS Highland including physiotherapy shared drives. e-mail for communication. Note: New systems may be introduced as the organisation and technology develops, however training will be provided

8. ASSIGNMENT AND REVIEW OF WORK

The Team Lead responsible for the provision of clinical Physiotherapy Services within the unit in which the post holder is working, is the potholder’s immediate clinical line manager.

The Team Lead will delegate duties and approve planned leave in the first instance. However, the post holder is ultimately responsible to the Physiotherapy Service Manager, who will authorise leave, post graduate training requirements and record sickness absence.

Clinical caseload/workload is assigned and reviewed by the potholder’s immediate clinical line manager.

The post holder is expected to organise and plan his/her own clinical workload/caseload effectively and efficiently. Guidance and support will be provided by their immediate clinical line manager or senior colleagues as appropriate, if and when required.

The post holder will, in the absence of their immediate clinical line manager or senior colleagues, organise and plan; and where appropriate supervise the workload/caseload of Physiotherapy HCSW’s and/or Physiotherapy students in his/her work location.

Formal performance appraisal will be undertaken by a Senior Physiotherapist within the Unit/area the post holder is working in. Objectives will be set and agreed at the start and will be formally assessed at mid and end of each rotation.

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9. DECISIONS AND JUDGEMENTS

The post holder will have responsibility for assessing, diagnosing/verifying diagnosis and implementing appropriate treatment programmes for patients under his/her care. He/she will work autonomously, making clinical decisions within their scope of practice. Guidance and support will be readily available from senior colleagues, as required.

The post holder for the majority of duties will be expected to work unsupervised. He/she is expected to set treatment goals, to devise and implement individual treatment programmes; and to decide on continuation, review or discharge of the patient. Guidance and support will be readily available from senior colleagues, as required.

The post holder can delegate tasks to HCSW’s. Clinical tasks delegated to the HCSW’s will be under supervision with the exception of associate practitioner Band 4 HCSW’s.

Case load will be regularly reviewed by a Senior Physiotherapist in the area the post holder is working in.

10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB

 Undertaking a physically and mentally demanding job whilst taking care to safeguard own emotional and physical health and safety, as well as that of patients and colleagues.

 Participating in multi-professional teams, ensuring a professional opinion is expressed which may not be agreed by other members of the team, some of whom may be more experienced.

 Adjusting to the transition from Student Physiotherapist to qualified Physiotherapist.

 Awareness that one’s role and effectiveness affects the functional outcome for patients.

11. COMMUNICATIONS AND RELATIONSHIPS

The post holder will:

Patients and relatives/carers  Communicate highly complex clinical information effectively and appropriately with patients and their relatives or carers using a range of verbal, non-verbal, written and presentation skills. This may involve conveying complex terminology into lay terms. The communication skills of persuasion, motivation, explanation and gaining valid consent will be used on a wide variety of patients.  Interact with patients, relatives and carers and multidisciplinary team to provide specialist advice and receive information regarding assessment, diagnosis, prognosis and treatment to encourage compliance and maximise patient care.  Utilise appropriate methods and aids e.g. audio visual aids or music, when working with patient’s in groups for either education or exercise purposes.  Deal with verbal complaints.

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Physiotherapy Staff (internal/external to Hospital)

 Consult more experienced staff for advice.  Arrange follow-up Physiotherapy and provide appropriate details for transfer of patients for on- going care elsewhere.  Delegate tasks clearly to HCSW’s.  Attend and actively participate in Physiotherapy department meetings, in-service training/ PLT sessions etc.

Multi disciplinary Team (Medical, Nursing, AHP staff, Social Work, Porters etc.)

 Attend Ward rounds/Team meetings and input into Multidisciplinary Team (MTD) discussions and decision making processes regarding patient progress, discharge or transfer.  Within the MSK service the post holder will be expected to liaise with the referrers e.g. GP’s or Orthopaedic Consultants.

Other Agencies (local Authority, Voluntary Sector)

 Liaise with other agencies to optimise patient care and ensure efficient service delivery, as required.

The post holder will also be expected to:

 Maintain accurate and up-to-date documentation in line with legal, professional and departmental requirements and communicate assessment and treatment results to the appropriate disciplines in the form of reports and letters.

12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB

Physical Demands:

 Manual handling of patients on a daily basis. This may include assisting patients with significant physical, cognitive or behavioural impairment. Patients may be very immobile, obese or unwilling to move, e.g. patients who require support for lengthy periods – often from lying to sitting position, sitting to standing and back in one session, or positioning of unconscious patients, e.g. in Intensive Therapy Unit.  Assisting patients with walking and stair practice – this may include sudden and unpredictable changes in direction of movement, or faints/falls which require physical support and/or safe lowering to the floor to avoid injury to patient and staff. This may include the higher risk areas of walking outdoors or using public stairways.  Frequent use of equipment such as hoists, walking aids, tilt tables which require manipulation and dexterity, often manoeuvring within confined spaces.  May spend short periods using IT equipment – requires awareness of own postures and correct positioning of equipment/seating etc. 7

Physical Skills:

 Manual physiotherapy techniques, several times a day, including facilitation of movement and/or joint/limb manipulation. This requires a level of dexterity gained through supervised experience and post-graduate training. It requires response to sensory feedback, and co-ordination of movement to maximise rehabilitation potential and reduce risk of injury.  Physiotherapy observation skills, assessment skills, and attention skills. Physiotherapists must be able to assess patient’s mood, physical ability, cognitive ability and engagement. The physiotherapist must be able to maintain concentration under pressure, constantly observing patients during rehabilitation and making fast judgements in response to patients needs.

Mental Demands:

On a regular basis:  Responding to frequent changes in patients’ condition – this requires being alert in order to undertake high standard of clinical reasoning, involving constant assessment and decisions regarding patient management.  Managing and prioritising workload/caseload.  Dealing with abusive patients or carer – this may be physical and/or verbal abuse.  Dealing with lone working.

Emotional Demands:

On a regular basis dealing with:

 Patients who have long term chronic illness or progressive conditions.  Patients who are in pain.  Emotionally labile and/or depressed patients.  Terminally ill patients.

Environmental Demands:

 Frequent exposure to 1. bodily fluids, e.g., sputum, urine, faeces, blood, vomit 2. transmittable diseases and infections, i.e. Hepatitis B, TB, MRSA; 3. body odours.  Occasional exposure to fleas and lice.  Occasional exposure to potentially dangerous and unpleasant conditions during home visits.  Occasional exposure to violence and aggression.

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13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB

Current Band 5 Physiotherapist position or core student placements.

Health and Care Professions Council (HCPC) registered Physiotherapist, with either a Diploma or BSc/MSc Degree in Physiotherapy.

Able to demonstrate clinical reasoning, reflection and clinical effectiveness.

Effective communication skills, including verbal, non verbal, listening and written skills.

The post holder will be required to demonstrate excellent team working skills and possess the ability to work using own initiative.

Competent IT skills.

Driving license and own transport is desirable.

14. JOB DESCRIPTION AGREEMENT

I agree that the above Job Description is an accurate reflection of my duties and responsibilities at the date of signing.

Job Holder’s Signature: Date:

Manager Date:

PERSON SPECIFICATION

POST___Band 5 Physiotherapist

FACTOR ESSENTIAL DESIRABLE

WORK EXPERIENCE Wide range of student or previous band 5 experience Ability to pass on relevant skills including musculoskeletal, neuro to other HP’s rehab., care of the elderly and rheumatology COPD assessment and treatments.

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QUALIFICATIONS  Basic Education Degree or equivalent in CSP Member ship Physiotherapy  Further Education Registered with HCPC  Professional

KNOWLEDGE AND SKILLS Ability to reflect Clinical Reasoning Information technology skills Ability to set and work to agreed objectives Organisational Skills.. Good time management skills Evidence of learning including CPD portfolio.

Personal Qualities Willing to work in diverse areas. Ability to recognise and manage Responsible pressure/stress Keen, enthusiastic, positive and forward thinking with a flexible approach. The capacity to communicate clearly with other health professionals within and out with the base situation.

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