Job responsibilities
Job
Overview
To
work closely with the GPs and the wider multidisciplinary team, particularly
the Urgent Care/ Home Visiting Nurse- working mainly in urgent home visits,
care home visits and some surgery based work. You will also be involved in
developing care plans for patients and MDT working.
Be the first point of
clinical contact for patients presenting with MSK conditions or symptoms. Responsible for assessing, diagnosing and treating
patients presenting with undifferentiated illness, and patients with complex
needs. Use effective clinical reasoning skills to triage, assess, differentiate
and diagnose simple and complex musculoskeletal issues. Seeking professional
advice and referring to other Healthcare professionals when required,
Prioritise health problems and intervene
appropriately to assist the patient in complex, urgent or emergency situations,
including initiation of effective emergency care.
Diagnose and manage both acute and chronic
conditions, integrating both drug- and non-drug-based treatment methods into a
management plan.
Demonstrate
with GP support, safe, clinical decision-making and expert care for patients.
Manage a substantial caseload of patients with
acute and chronic musculoskeletal issues.
Scope of the Role
1.
Be
the first point of clinical contact for patients presenting with MSK conditions
or symptoms, providing the patient with the primary assessment, diagnosis and
management options for their condition.
2.
Use
advanced clinical practice skills and clinical reasoning to provide
comprehensive diagnostic and treatment support to patients who present with
complex musculoskeletal conditions and/or multiple pathologies and/or mental
health and/or pain management needs.
3.
Be
the link between primary, community and acute services, when the patient is
managed via primary care ensuring an integrated care pathway for individual
patients that meets their needs. This will include provision of triage to other
services and/or directly providing management and advice.
4.
Lead
on and develop effective communication between primary care services/GP
practices and other relevant care providers.
5.
Initiate,
develop, and maintain relationships with MDTs, orthopaedic and physiotherapy
consultant teams in the community and acute settings.
6.
Where
appropriate, develop relationships with wider health and social care agencies,
for example mental health teams, local authorities, third sector providers and
patient groups.
7.
Provide
highly specialist advice on issues ranging from the provision of expert opinion
on individual patient treatment options to be a primary contributor to MSK
services and related pathway development.
8.
Work
independently, without day to day supervision, to assess, diagnose, triage, and
manage patients, taking responsibility for prioritising and managing a caseload
of the practices registered patients.
9.
Work
as part of an MDT in a patient facing role, using their expert knowledge of
movement and function issues, to create stronger links for wider services
through clinical leadership, teaching and evaluation.
10.
Develop
integrated and tailored care programmes in partnership with patients, providing
a range of first line treatment options including self-management, referral to
rehabilitation focussed services and social prescribing.
11.
Make
use of their full scope of practice, developing skills relating to independent
prescribing, injection therapy and investigation to make professional
judgements and decisions in unpredictable situations, including when provided
with incomplete or contradictory information. Take responsibility for making
and justifying these decisions.
12.
Manage
complex interactions, including working with patients with psychosocial and
mental health needs, referring onwards as required and including social
prescribing when appropriate.
13.
Implement all aspects of effective clinical governance for
own practice, including undertaking regular audit and evaluation, supervision
and training.
14.
Develop integrated and tailored care programmes in
partnership with patients through:
a.
effective
shared decision-making with a range of first line management options
(appropriate for a patients level of activation)
b.
assessing
levels of Patient Activation to support a patients own level of knowledge,
skills and confidence to self-manage their conditions, ensuring they are able
to evaluate and improve the effectiveness of self-management
interventions,particularly for those at low levels of activation
c.
agreeing
with patients appropriate support forself-management through referral to
rehabilitation focussed services and wider social prescribing as appropriate
15.
Designing
and implementing plans that facilitate behavioural change, optimise patients
physical activity and mobility, support fulfilment of personal goals and
independence, and reduce the need for pharmacological interventions.
Clinical
16. Assess, diagnose, plan, implement and evaluate treatment/interventions
and care for patients presenting with an undifferentiated diagnosis, and
patients with complex needs.
17.
Clinically examine and
assess patient needs from a physiological and psychological perspective, and
plan clinical care accordingly.
18. Prioritise health problems and intervene appropriately to assist the
patient in complex, urgent or emergency situations, including initiation of
effective emergency care
19.
Request
and progress investigations (such as x-rays and blood tests) and referrals to
facilitate the diagnosis and choice of treatment regime including, considering
the limitations of these investigations, interpret and act on results and
feedback to aid patients diagnoses and management plans.
20.
Carry
own caseload as an autonomous practitioner, providing direct clinical/ physiotherapeutic
care for patients with a range of complex musculo-skeletal conditions and who
may have significant other primary or secondary conditions/multi-pathologies.
21.
Make
clinical decisions when appropriate to use advanced clinical practice skills
that may include:
a.
joint/soft
tissue injection therapy, including administration of prescription only
medication [POM] to aid treatment.
b.
joint
aspirations
c.
non-medical
prescribing
22.
Use
professional judgement and advanced clinical reasoning skills to make decisions
about safe and effective patient care in unpredictable situations, including
when there is incomplete/contradictory information.
23.
Be
able to demonstrate understanding of the impact of physiotherapeutic
interventions on existing conditions and treatment programmes e.g. podiatric
treatment, drug therapies, etc.
24.
Ensure
physiotherapy interventions are integrated and supportive of the whole
treatment aims promoting a holistic approach to condition management.
25.
Be
able to clinically justify referral onto appropriate MSK pathways within the
community or wider healthcare services. Including referral to the appropriate
stage of the pathway and the use of social prescribing.
26.
For
patients that remain the responsibility of primary care services, take the lead
for the management of the patients journey on their care pathway, acting as
the link for the patient between primary care and other services/ professionals.
27.
Be
able to justify clinically referrals to other specialist services. This will
include referral to acute and specialist services such as surgical
orthopaedics, rheumatology and neurology, other AHP services, nursing services
and to the primary care medical teams
28.
Recognise
RED flags, serious pathology and potential underlying non-MSK related disease,
that may present as MSK symptoms and to refer appropriately. When needed
accelerate the patients referral to other health professionals/services
29.
Work
in partnership with the patient at all times to attain maximum participation in
treatment programmes. This will include working with patients from diverse
social background and cultures and understanding how this will affect treatment
proposals and models.
30.
Provide expert advice and act as source of
expertise in the management of musculoskeletal conditions and provide a
specialist advisory service to patients, specialist physiotherapists other
specialist healthcare professionals and members of the primary care team, including
advising GPs on management of MSK conditions.
31.
Provide
clear advice, instruction and teaching on aspects of management of a condition
to patients, relatives, carers and other health professionals.
32.
Continually
review and develop specialist clinical and diagnostic skills in response to
service need.
33.
Communicate
effectively and appropriately with patients and their carers. This will include
explaining the diagnosis, prognosis and treatment choices available to manage
multi-pathology and complex conditions. It will also involve communicating
limitations on treatment outcomes and managing expectations of patients with
chronic or life limiting conditions.
Please see attached Job Description for full details.