the value of the consultant physiotherapist role€¦ · consultant physiotherapist education and...
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The value of the consultant physiotherapist role
University Hospital Southampton
Beth Vallet Tom Pointing Emma Coleman Lisa RobertsClinical pillar Research Leadership Education
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Consultant roles
• AHP consultant role (in 2000)
• 1st physio consultant (Dr Paul Watson) appointed 2002
• 4 pillars: Clinical practice (50%); Education; Leadership; and Research
Clin
ical
Res
earc
h
Lead
ersh
ip
Edu
cati
on
50% 17% 17% 17%
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‘What is the value of the consultant physiotherapist role to healthcare?’
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Research questions…
1. What career pathways have consultant physiotherapists taken to attain their current posts?
2. What is the perceived contribution of the consultant physiotherapists’ role to the 4 pillars:
- Clinical practice - Research and evaluation of practice - Leadership - Education
3. What are the achievements of the UK consultant physiotherapists?
Clin
ical
Res
earc
h
Lead
ersh
ip
Edu
cati
on
50% 17% 17% 17%
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Methods
• Developed topic guide with n=22 consultants May 2018
• Email from Chairs of consultants’ network (N=92)
• Consultants reply if interested
• Sent a brief data sheet to record outputs
• Qualitative: semi-structured telephone interviews
• Pilot (n=3)
• Main data collection (3 interviewers)
• Analysis & dissemination (ongoing)
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Data sheet
• Place of work (community, secondary care etc)
• Hours per week contracted / worked
• Qualifications
• Specialism
• Date appointed
• Estimated hours worked and % spent in each of the 4 pillars
• Achievements…
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Key interview topics
• Career pathway
• Key contributions and time spent in each of the 4 pillars
• Enjoyments and frustrations in the role
• Future of the role
• How the consultant role differs from other advanced practice roles …
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Results
• Data sheets n=42 Interviews n=38
• Duration of interview: 17–70 minutes
53%
18%
18%
5%
2%2%
2%Specialities
Musculoskeletal
Neuro
Respiratory
Ortho
Older people
Critical care
Rheumatology
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0
1
2
3
4
5
6
7
2002 2004 2006 2008 2010 2012 2014 2016 2018 2020
Nu
mb
er o
f C
on
sult
ants
Year Appointed to Consultant Post
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0
5
10
15
20
25
30
35
40
<15 15-22.5 23-30 30.5-37.5 38-45 45.5-50 50.5-55 >55
Nu
mb
er o
f C
on
sult
ants
Number of Hours
Hours Worked
Contracted
Actual
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Consultants’ achievements (n=42)
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Pillars
17%
17%
50%
17%
‘IDEAL’
16%17%50%17%Education Leadership Clinical Research
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Pillars
17%
17%
50%
17%
‘IDEAL’
16%17%50%17%Education Leadership Clinical Research
14%
28%
44%
14%
ACTUAL
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Pillars
17%
17%
50%
17%
‘IDEAL’
16%17%50%17%Education Leadership Clinical Research
14%
28%
44%
14%
ACTUAL
17%
27%
36%
20%
DESIRED
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Consultant
PhysiotherapistEducation
and clinical
development
Research,
evaluation of
practice and
service
development
Professional
leadership and
consultancy
Expert and
clinical practice
‘I see a handful of people with … very complex needs after they leave whatever ward because no one else really knows what to do with them.’ [P023]
‘It’s really important that you cover all those things like the research, the clinical, the teaching … it’s also being able to really drive change.’ [P004]
‘A consultant role is not an operational manager job it's a strategic management job’[P019]
‘‘So at the moment I’ve got quite a lot of research commitments … so I am spending a lot of time outside my working time to accommodate that.’ [P020]
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‘… “Boundroids” – someone who is able to move across
boundaries, do the right thing and not worry about organisational constraints.’
[P009]
Education
and clinical
development
Research,
evaluation of
practice and
service
development
Professional
leadership and
consultancy
Expert and
clinical practice
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“So I think the path to a consultant post is not necessarily an easy one or a
straightforward one.” [P002]
“I was essentially left to carve the role out for myself, really.” [P043]
“I was also doing advance practice physiotherapy in supporting band 7’s and doing complex physio caseload and doing a degree of
strategic management and strategic stuff”. [P019]
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Distinction between consultant & AP roles
• Added value = clinical leadership
• Complex patients / clinical reasoning skills
• More holistic
• Leading service innovations
• More of a research role
• Aspiration to or already have a PhD
• Teaching / education / supporting others / building confidence
• Horizon scanning
• Strategic insight
• Looking at the bigger picture, outside own Trust
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“I went to the AP [event] last week and advanced practitioners are meant to have these 4 pillars as well so I’m not sure how
we differentiate?” [P002]
“They’ve got about 4 pillars because they stole it from us! [laughs], which is fine.
We’re happy to share it [laughs], but I think that’s what’s caused some of the confusion,
because they’ve based quite a lot of it on work that was already in existence in the
consultant stuff.” [P003]
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Consultants’ reflections
• Overlap in the 4 pillars: Desire to ↓ clinical
• Research is heavily valued by consultants, less so by managers
• Expert practitioners, working with the most complex patients
Change agents, role models, team builders and leaders
Key attributes = strategic view and horizon scanning
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Dissemination so far…
World Confederation for Physical Therapy – May 2019
Outputs & perceptions of ´Consultant Physiotherapist´ roles. Poster no. 131
Feedback to Consultants and CSP – May 2019
Two papers in preparation:
1. Career pathway & how role differs from advanced practice
2. Outputs & perceptions of the role
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• Largest evaluation of the consultant physio role ever undertaken
• Identifies the contributions that UK consultant physios make to healthcare
• Highlights diversity in roles, lack of career pathway, qualifications and challenges of delivering expert practice across the 4 pillars
• Consultants believe their strategic views and horizon scanning differentiate the role from other advanced practice roles
• There needs to be clarity between consultant and AP roles
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Contact: Lisa Roberts, [email protected] @LPhysioprofClinical Professor of Musculoskeletal Health & Consultant Physiotherapist
University Hospital Southampton