Specialist Rotational Physiotherapist

Job overview

An exciting opportunity to join the B6 Rotational Physiotherapy Scheme across The Royal Brompton Hospital and Paediatric Respiratory services at The Evalina, St Thomas Hospital, gaining respiratory experience from a variety of rotations.

Each rotation is 9 months and includes Cystic Fibrosis, Chronic Respiratory, Paediatrics and Critical Care and Cardiothoracics. There is a comprehensive training program on each rotation and an emphasis on quality improvement and research across the trust with 10 days of study leave a year allocated to each staff member.

Main duties of the job

To participate in the Band 6 rotational scheme which involves working across the Trust on different hospital sites in a range of critical care, ward settings and out-patient clinics.

To provide a specialist physiotherapy service in respiratory medicine, cardiothoracic surgery/cardiology services, paediatric respiratory and surgical services.

To independently perform advanced physiotherapeutic assessment of patients with diverse presentations and complex physical and psychological conditions to provide a diagnosis and deliver an individualised and specialised treatment programme of care.

To manage own patient caseload and be responsible for a defined area of service or a particular patient type, working without direct supervision.

To undertake all aspects of clinical duties as an autonomous practitioner with freedom to act on own interpretation of data.

Supervise, educate and assess the performance of physiotherapy students

Supervise, educate and assess the performance of junior physiotherapy staff to ensure theoretical and clinical knowledge meets departmental standards.

Undertake evidence-based audit, formulate guidelines and research projects to further own and department clinical practice within each rotation.

Detailed job description and main responsibilities

Communication

• To ensure a patients’ understanding of their physiotherapy intervention in order to gain valid, informed consent and to be able to work within a legal framework with patients who lack the ability to consent to treatment.
• To use a range of verbal and non-verbal communication tools when communicating with patients /carers. This will include communication with people with complex communication difficulties such as deafness, dysphasia, dementia, mental health problems, speak English as a second language or who have difficulty accepting their diagnosis/prognosis.
• To deal sensitively with patients who have high levels of anxiety and aggression caused by pain, dementia or limited mobility
• To communicate sensitive personal information to patients regarding their treatment progression where motivation and reassurance are required to gain co-operation with programmes of care
• To provide and receive sensitive and/or complex information to individual members of staff and in multidisciplinary group meetings and ward rounds
• When working on the emergency duty on-call rota, provide specialist advice to medical and nursing staff and other members of the multi-disciplinary team regarding patients’ respiratory condition.

Patient/customer care (both direct and indirect)

• To be professionally and legally accountable for all aspects of own work and those being supervised by you, including the management of patients in your care.
• Analyse multiple sources of information to undertake a comprehensive assessment of patients including those with diverse or complex presentations/pathologies.
• To use advanced clinical reasoning skills and manual assessment skills to provide an accurate diagnosis and/or establish impairments and disabilities of patients
• To use clinical reasoning, understanding of medical diagnosis and knowledge of treatment options to plan and implement individual physiotherapy treatment programmes.
• To have a comprehensive working knowledge of physiotherapy adjuncts such as IPPB, oscillating PEP, PEP, etc. and indications / contraindications for use across a range of respiratory conditions
• To use and have a comprehensive working knowledge of manual physiotherapy techniques
• To deliver individual and group patient education and exercise classes and be responsible for the safety of patients during these classes
• To take partial responsibility in organising and delivering specialised group and individual exercise programmes, including pulmonary rehabilitation and cardiac education classes
• To continually evaluate the effectiveness of treatment interventions e.g. exercise programmes using clinical reasoning and outcome measures. To progress patient management/intervention accordingly.
• Co-ordinate, organise and participate in assessment of patients and holistic treatment programmes with other multi-disciplinary team members
• To independently evaluate progress for patients with complex pathologies, reassess, modify and progress or discontinue individual treatment programmes as required
• To manage clinical risk within own patient caseload to self, patient and environment.
• To use clinical reasoning, understanding of medical diagnosis and knowledge of treatment options to plan and implement the use of Non-Invasive Ventilation (NIV)
• To be responsible for the selection and set up of NIV. To independently select model and mode of ventilation, and appropriate interface according to individual need
• Physiotherapy staff may co-ordinate transfers between sites/other Trusts of critically ill patients on non-invasive ventilation through the competent use of the machine and battery pack when appropriate.
• Analyse and interpret complex situations to formulate accurate prognoses and recommend best course of intervention, developing comprehensive discharge plans
• To analyse and review patient progress on NIV, to independently modify ventilation settings, interface selection. To take the clinical lead in the weaning from NIV, liaising with the MDT as appropriate
• To participate in active management of long-term patients with a tracheostomy and be responsible for their physical rehabilitation and ventilation progression.
• To be responsible for patient and family/carer education of NIV including use of and maintenance of equipment.
• To be responsible for carrying and responding to a bleep. As required to immediately change planned activity without prior knowledge. To give specialist advice to junior staff or MDT members over the telephone.
• To be an active member of the respiratory overnight and weekend on-call rota. To act as clinical lead for the working weekend team and, when necessary, provide support and advice for junior staff and peers whilst they are on call.
• Whilst on call to work without supervision and support, maintaining associated records as an autonomous practitioner.
• When working on the on-call and weekend rota, undertake the assessment and treatment of acutely ill patients with respiratory problems who may have a highly complex presentation. Maintain associated records as an autonomous practitioner.
• Act sensitively to the needs of patient and family in highly distressing and emotional circumstances including care of the terminally ill/ dying and bereavement.

Policy & Service development

• To comply with Trust clinical guidelines and the Chartered Society of Physiotherapy (CSP) codes of professional conduct at all times
• To monitor own and others quality of practice.
• Represent physiotherapy service and individual patients at the multi-disciplinary team meetings, discharge planning meetings, case conferences and ward rounds to ensure the delivery of a co-ordinated multi-disciplinary service. This will include active discussion of patient care with suggestions to modify treatment plan, patient progress and discharge planning
• Actively participate in the rotational appraisal system as appraiser. To be responsible for setting agreed objectives and providing guidance to junior staff
• Actively participate in the staff appraisal scheme as an appraisee and be responsible for complying with agreed personal development plans to meet set competencies
• Make recommendations to clinical lead/manager of service for changes to practice in the department. May lead the implementation of specific changes to practice or contribute to service protocols.

Resource management

• To be responsible for the safe and competent use of all therapy equipment in line with departmental standards. To be responsible for the safety of the patient and self when using any equipment.
• To be responsible for the safe and appropriate provision of therapy aids and equipment to patients in line with departmental standards.

People management

• To take delegated responsibility from the Band 7 and / or Clinical Lead physiotherapist for managing patients with particular conditions and be responsible for providing specialist physiotherapy assessment and treatment plans for patients with these conditions within each rotation.
• To take delegated responsibility from the Band 7 and / or Clinical Lead physiotherapist for the co-ordination and supervision of departmental patient caseload for junior staff and assistants on a daily basis.
• Deputise for the Band 7 in their absence, in any area, taking responsibility for daily operational management of the team, allocating and organising the workload of junior and assistant staff to meet service priorities on a daily basis
• To be responsible for teaching student physiotherapists to a graduate level on physiotherapeutic skills and their knowledge within core clinical areas. To manage the workload of students during their placement
• To be responsible for appraising student physiotherapists to a graduate level on their placement. To formulate objectives and provide a structure for achievement of their goals.
• To be an active member of the in-service training programme by attendance at and participation in individual and group training sessions, external courses and peer review.
• To play an active role in the education of junior physiotherapy staff and other members of the MDT in NIV.
• To supervise junior, assistant and student physiotherapists in record keeping and documentation according to Chartered Society of Physiotherapy (CSP) and Trust standards.
• To be responsible for organising and planning own caseload to meet service and patient priorities, readjusting plans on a daily basis to meet organisational requirements. To help junior physiotherapy staff to understand and respond to these requirements

Applicant requirements

You must have appropriate UK professional registration.

This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.