Specialist Physiotherapist

Job responsibilities

The programmes : Out-patient programmes and one to one treatments which are psychologically informed or that are based on principles of Cognitive behavioural therapy, Acceptance and Commitment therapy and mindfulness.

Job Summary : To use highly specialised clinical reasoning skills to provide specialist assessment and treatment of complex patients as an autonomous practitioner within Optimise Pain Rehabilitation Service.

To provide high quality clinical input for persisting pain patients.

To be able to unravel the complexity of the impact of pain and identify which blending of therapies are required to address both the psychological and physical effects of pain.

Principle Duties and Responsibilities

Clinical

1. To be professionally and legally accountable and responsible for all aspects of own work including the management of individual caseload, working within accepted codes of professional conduct and clinical guidelines to minimise clinical risk.

2. To demonstrate highly advanced theoretical knowledge of anatomy, physiology, and pathology and utilise highly developed clinical reasoning skills to accurately determine clinical diagnosis and prognosis in a wide range of mixed and complicated conditions requiring rehabilitation, often in situations where conflicting evidence is present (e.g. medical masqueraders), resulting in realistic, patient centred goals and treatment plans in line with evidence-based practice.

3. To undertake as a specialist autonomous practitioner, comprehensive assessments of highly complex patients presenting with multiple pathologies, using advanced bio psychosocial clinical reasoning skills, expert knowledge of evidence based practice, and advanced rehabilitation expertise to interpret and analyse clinical and non-clinical facts, which may include very personal, emotive or contentious information. Demonstrate critical awareness of knowledge in the field and at the interface between different specialities. Create a research-based diagnosis to problems by integrating knowledge from new or interdisciplinary fields and make judgements with incomplete or limited information. Develop new skills in response to emerging knowledge and techniques.

4. To monitor and reassess therapeutic input and patient status in order to progress and adjust treatments effectively and develop comprehensive discharge plans referring to specialist services as indicated.

5. To take a lead professional role in a highly specialist area by providing expert advice and support to physiotherapists and other healthcare professionals.

6. To be responsible for producing and developing guidelines, protocols and policies pertinent to specialist area from government directives (e.g. NHS plan / NICE Guidelines etc)

7. To plan and organise own time including patient care, training, supervision and meetings.

8. To be responsible for the competent use of exercise and gym equipment, and patient appliances as indicated, and to report any defects or malfunctions to the Team Leader.

9. To participate in the service Clinical Governance and Clinical Supervision programmes.

10. To develop comprehensive discharge plans.

11. To be responsible for writing clinical letters, reports and discharge letters issued to patients and outside agencies.

12. To advise patients, employers and occupational health departments on the appropriate time to return to work, sports and other activities. To issue AHP fit notes.

13. To manage clinical risk within own caseload and within the pain rehabilitation service. To be able to undertake a suicide risk assessment and follow the pathway for suspected cauda equina. To report safeguarding issues and refer to appropriate teams.

14. To assess patients attending Optimise Pain Rehabilitation Unit and refer to the most appropriate programme, including assessment for hydrotherapy, physiotherapy, one to one sessions. To participate in the running of the Balanced Life and Get Back Active programmes including hydrotherapy and manage complex patients on a one to one basis.

15. To decide (in consultation with colleagues if necessary) whether to treat, co-manage or refer. e.g. reason referral requirements to crisis team, community mental health or pain clinical psychology; be able to unravel the complexity of the impact of pain and identify which blending of therapies are required to address both the psychological and physical effects of pain.

16. To provide post programme reviews for participants.

17. Demonstrate academic and theoretical knowledge of pain neurophysiology (e.g. pain gate, neuroplasticity, peripheral and central sensitisation, centrally generated and maintained pain; role of sympathetic, parasympathetic, immune systems and genetics, pathology of peripheral neuropathies, CRPS, phantom pain, etc)

18. Demonstrate understanding of core concepts of Acceptance and enhancing psychological flexibility; cognitive defusion (how our thoughts / language becomes fact); contact with the present moment; the observing self (Mindfulness); reconnecting with values; encouraging sustained committed action. Differentiate between struggling and acceptance.

19. To be familiar with a range of psychological approaches used in pain management such as mindfulness, motivational interviewing, ACT, CBT etc and to be competent in the delivery of treatment in groups using principles from such approaches.

20. Demonstrate ability to use activity/exercise sessions as an opportunity for patients to be exposed to difficult thoughts, emotions, and bodily sensations. Ability to facilitate patients in managing these when they arise, in keeping with values and workability.

21. To participate in the evening and on call rota.

Communication

1. To communicate in simple terms complicated concepts about pain mechanisms and ...