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The value of the consultant physiotherapist role University Hospital Southampton Beth Vallet Tom Pointing Emma Coleman Lisa Roberts Clinical pillar Research Leadership Education
The value of the consultant physiotherapist role
University Hospital Southampton
Beth Vallet Tom Pointing Emma Coleman Lisa RobertsClinical pillar Research Leadership Education
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%
‘What is the value of the consultant physiotherapist role to healthcare?’
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%
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)
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…
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 …
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
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
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
Consultants’ achievements (n=42)
Pillars
17%
17%
50%
17%
‘IDEAL’
16%17%50%17%Education Leadership Clinical Research
Pillars
17%
17%
50%
17%
‘IDEAL’
16%17%50%17%Education Leadership Clinical Research
14%
28%
44%
14%
ACTUAL
Pillars
17%
17%
50%
17%
‘IDEAL’
16%17%50%17%Education Leadership Clinical Research
14%
28%
44%
14%
ACTUAL
17%
27%
36%
20%
DESIRED
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]
‘… “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
“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]
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
“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]
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
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
• 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
Contact: Lisa Roberts, [email protected] @LPhysioprofClinical Professor of Musculoskeletal Health & Consultant Physiotherapist
University Hospital Southampton
