Development Pathway of a Physiotherapist to an Extended Scope Practitioner Role - Essay Example

? DEVELOPMENT PATHWAY OF A PHYSIOTHERAPIST TO AN EXTENDED SCOPE PRACTITIONER ROLE By Lecturer: of Affiliation: and : Date: Development Pathway of a Physiotherapist to an Extended Scope Practitioner Role Introduction The role of a physiotherapist has changed significantly for the decades and the single most considerable change was the shift from working under instructions to primary care status. Physiotherapy is an applied science that consists of its own knowledge base, its own education system and practical applications, which are based on that knowledge. Psychotherapists are in a unique position; thus professions have nowadays attempted to expand their roles in allied health professions (AHPs). AHPs are health care profession and they make up to the 60 percent of the total healthcare workforce (Higgs and Titchen, 2001, p. 56). The role of Allied Health Professionals (AHPs) in the healthcare sector is to make the health care system to function effectively through offering varied services that ranges from diagnostic, technical, direct patient care, therapeutic and many other supportive services. Although, AHPs vary across states because in U.K, allied health professions are recognized by the National Health Service (NHA) to include orthotics, diagnostic radiography, podiatry, dietetics and environmental health officers and among others. The research on physiotherapy links developing practices and theories; thus the scope of this profession encompasses those areas that its members are competent, educated and insures to deliver better services. For the physiotherapists practicing the extended scope practitioners (ESP), the elements that extend their scope fall outside the broad general scope of the physiotherapist professions. Thus, the project evaluates the research and theoretical underpinning on an aspect of the extended scope of physiotherapy practice role for allied health professions. Study Objectives The research evaluates the theoretical underpinning of physiotherapy practice on the Extended Scope Practitioners (ESP) role for allied health professions. The study examines the significant roles of extended scope practitioners for allied health professions. The study attempts to find out the impact of extended scope practitioners on a range of stakeholders and other health professionals It also provides recommendations vital for expanding and changing roles of healthcare professionals within the current health care environment. The Theoretical Underpinning of Physiotherapy Practice on the Extended Scope Practitioners Role for Allied Health Professions Extended scope practitioners roles within physiotherapy encompass varied tasks, which may have been previously carried out by the medical professions. Members are always employed in both primary and secondary care settings to carry out different tasks, and the delivery of health care services in undergoing significant transformation in U.K and many countries across the globe; thus a gradual change in ESP role has also been made (Higgs and Titchen, 2001, p. 61). Within the U.K, the National Health Services system have attempted to offer a comprehensive range of health care services including a specific focus on recognizing the roles of extended scope practitioners. For instance, the delivery of healthcare services in allied health professions is undergoing rapid transformation. The trend is particularly apparent in nursing professions and also the rehabilitation professions where clinicians have began to assume their roles, which are outside their usual scope of clinical practice while working in a multidisciplinary team. There have been increasing forces towards the expansion of a supple labor force in the recent. This is where numerous professions have been able to take on wide-ranging roles traditionally perceived as the realm of one profession (NHS Wales and Wales, 2004, p. 17). The information about psychotherapist in extended roles has grown tremendously for the past three decades with some recent studies attempting to evaluate the impact of new roles on the wellbeing and outcome of patients (Sarah and Fiona, 2011, p. 138; Pearson, Field and Jordan, 2009p. 71). Widespread changes are now taking place in the planning and the provision of health care services across many states. Multiple factors are driving these changes including the rapid needs of an ever increasing population especially the aging population, advanced medical facilities or technologies, advanced medical capabilities and complex workforce issues. For instance, in the early 21st century physiotherapy, U.K is among states experiencing the unprecedented challenges to its practice and professional issues as it attempts to respond to both changes in health-care design and delivery. A developing role for physiotherapist involves targeting patients who will benefit most on a cost efficient basis in the healthcare sector (Malloch and Porter-O'Grady, 2006, p. 37).This requires a further development of an effective evaluation and diagnostic skills, as well as, reliable screening tools to help practitioners in decision making process in order to enable them deliver appropriate outcomes. The new role, extended scope practitioner, formerly recognizes opportunities for healthcare professionals to develop significant skills, which are beyond their traditional roles and this is supported by the charter society of physiotherapy (Chartered Society of Physiotherapy, n.d, p. 7). Although such roles are developing in some states, this kind of developments needs to be incorporates formally into the U, K career structure for physiotherapists. Additionally, McPherson (2006, p. 240) reveals that the U.K National Health Services has viewed the creation of the host of new roles especially the extended scope practitioners as the significant aspects in the health care sector. The information about the roles of nurse in the ESP has grown tremendously for the past few decades because of the changing technology, cost containment, changing workforce tasks and many other issues. The government for AHPs has also promoted role enhancement; however, evidence about the nature and impact of these roles should be taken into considerations. This is vital because it will enable the psychotherapists to ensure that the benefits of ESP and risks are minimized in the health care settings. It will also help nurses or medical practitioners to deliver effective and quality services in all areas; thus improving the health of patients, as well as, meeting the demanding needs of patients effectively. A number of factors appear to contribute to the growing interest of health professionals in ESP Pearson, (Field and Jordan (2009, p. 102). For instance, in nursing, meeting the modernization agenda, increased job satisfaction, retention and many others are among the driving factors for the increased interest on health professions in ESP. The research study regarding ESP in physiotherapy profession found that extended scope practitioner for AHPs can be more effective than standard interventions or services (Higgs and Titchen, 2001, p. 56). AHP groups have a developing concern fuelled by the experience in physiotherapy practitioner where extended practice and evidence for its impact is more established; the alleged benefits of extended practice include the better level of job fulfilment, job maintenance, a sense of independence and advanced profession prospects. Pearson, Field and Jordan (2009, p. 71) argue that AHPs extended practice is significant especially where there are work shortages; thus the role extension may be welcomed. The Significant Roles of Extended Scope Practitioners for Allied Health Professions One of the significant role for extended scope practitioners is contacting for patient care including single assessment; thereby, improving the outcomes of patients. The role extension within health disciplines is a significant aspect that can enable health professions to overcome varied challenges such as changing work pattern, changing demographics of patients, patient centeredness and many other issues. Therefore, role extension is seen as a talent escalator where practitioners move up to the talent escalator within the span or range of their disciplines to advance it through training programs (Sarah and Fiona (2011, p. 139). Some disciplines in allied health professions require extended scope of practice initiatives; thus these initiatives are opportunistically created in response to achieving the local demands and requirements. The literature is usually encouraging about the extended scope practitioner roles in physiotherapy field but much of this support lacks quantification. Sarah and Fiona (2011, p. 140) reported that ESP roles were heavily driven by political and organizational; motivated factors; thus the reported evaluations of these initiatives significantly focused on organizational outcomes. Even though benefits may be recorded for the specific extended scope practitioner initiative, they should also be weighed against the costs and needs for particular services. ESP physiotherapists have opportunities for developing and demonstrating their expertise beyond their current recognized scope of practice; thus they play significant roles especially where there are shortages of clinical specialists. The research study review carried out revealed that roles within different allied health professions are increasingly being introduced with over 200 sources of information identified in support of these roles in AHPs (McPherson 2006, p. 241). Professional interest in these roles is reflected in the some of the professional bodies such as the CSP (Chartered Society of Physiotherapists) in the United Kingdom with more than 270 members in the ESP group (McPherson 2006, p. 241). The study also provided a review for the effectiveness of ESP in allied health professions in five key areas of AHP groups. The evidence about effectiveness of such roles in relation to three significant variables including the impact on the outcomes of patients, the impact on other health care professions and the impacts on healthcare delivery services were evaluated. From the research review, it was found that ESP for allied health professionals is imperative especially where there is shortage of health care professionals. The patient demand is the main driver for employing ESP role because this will enable health professional to improve the quality life of patients. This is in case there is shortage of trained Physiotherapists and the patient demand is high; thus ESP will play significant roles in this case. Additionally, although the research study indicated that ESP is crucial because it improves timely service delivery, reduces waiting lists in the health care and it is also the main driver for professional enhancement. The study review highlighted that despite the significant roles that ESP plays in improving the quality of patients, the strongest evidence is that health professionals can indeed learn particular advanced skills outside their routines scope of practice (McPherson 2006, p. 245). Therefore, health care professionals can apply these advanced skills outside their professional work; thus enhancing health care provision for all people. However, the main problem and unanswered question is about the financial and opportunist costs regarding such services; thus these aspects remain unclear. For example, it is unclear about the consequences that the junior psychotherapists or patients under care experience when the most experienced psychotherapists move away from his or her routine work to ESP roles. The Impact of Extended Scope Practitioners on a Range of Stakeholders and Other Health Professionals Any task of extended scope practice even though it is designated by workforce or service delivery gap will impact on the tasks or roles carried out by healthcare professionals (Sarah and Fiona, 2011, p. 138). In this case, consultations may be required and this would be welcomed in case there are sufficient workforces in the healthcare sector. Extended scope can impact severely the tasks of health professions because varied things should be taken into considerations in order to avoid these impacts. One of them is wide-ranging evaluation and transparent should be carried out by an autonomous body to describe things that has been completed in a different place. Another aspect is the need for discussions with the key stakeholders in order to facilitate better understandings of the outline clearly and the required steps necessary for ensuring a smooth passage of the extended scope initiative. Moreover there should be open or clear communication and the outcomes from a new role extension should be clearly defined with all stakeholders before extending the scope of practices (Higgs and Titchen, 2001, p. 94). Another impact of AHP extended scope practice is experienced on the health outcomes because there would be a reduction in the quality of life of patients. Health workforce meet varied and unique challenges including the changing demographics of patients, changing work patterns and the need to underpin health care service delivery with safety and among other aspects. However, the challenges are too much when extending the scope of practices in a health care sector especially when the health professionals have poor experience or skills to perform a certain task. This may contribute to poor service provisions and poor quality services, which might contribute to the reduction of life quality. Moreover, extending the scope of practice can offer a career path for health professions but it is unlikely to be successful because it may impact not only the patient outcomes but also other health professional within the scope roles. The cost effectiveness of training on extensive scope practitioner for AHPs to carry out comprehensive roles is high (Chartered Society of Physiotherapy, n.d, p. 77). This is because ESP includes the concealed costs of diverting senior practitioners from more conventional tasks; thus, the superior role would need extra training costs. This is also because ESP in physiotherapy is a role, which is outside the currently documented range of practice in health care field. ESP needs some credentialing technique following a proficiency expansion and substantial clinical experience. Therefore, ESP role should be underpinned by comprehensible patient needs and widespread waiting lists that cannot be addressed using the conventional labour force. Recommendations Providing future clinical training programmes and this could be obtained in a structured internship programs to assess the capabilities of physiotherapy entry students. The structured internship after three to four years of study would require a considerable bureaucracy in case it was to be administered effectively and to ensure compliance by all parties (Chartered Society of Physiotherapy, n.d, p. 67). Training programs are vital because it can increase the skills necessary for improving the professional skills in physiotherapy. Some AHPs are more specialized than others; thus there must be effective training programs and provision of high quality education standards in the professional scope of practice. Therefore, their skills should be proved through provision of certified credentials, degrees and masters in order to determine in case practitioners are able to deliver high services. The research study indicates that given sufficient training and education programs, healthcare practitioners can undertake many extended practices (Malloch and Porter-O'Grady, 2006, p. 82). Therefore, training AHPs to undertake varied range of tasks, which traditionally performed by medical practitioners can be of great significant. The physiotherapy professionals need to develop strategies vital for establishing a career structure. This will enable them to formalise changes, which are already taking place in order to enable them deliver effective services in the healthcare sector. Clear strategies and plans for evaluation should be implemented and well advanced in order to enable ESP to achieve their intended objectives successfully. Therefore, key results should be defined in advance and they should be coupled with clear evaluation strategies. The evaluations should incorporate organisational, health professionals and stakeholders outcomes. Moreover, there is a need for cost effectiveness trials considering comprehensive costs such as hidden costs in order to determine the effectiveness of ESP. Strategies should also be employed in order to determine the effectiveness of ESP on patient outcomes such ads improved quality of life and reduced disability. Employing qualified or finding sufficient clinical placements for physiotherapy entry-level students is most relevant in this context. It is recommended that extended scope practitioners for AHPs physiotherapists should have a minimum of five years clinical experience post entry level qualifications of which three years should be relevant to specialist area (NHS Wales and Wales, 2004, p. 56). The completion of further post-graduate study or accredited training programs will also be desirable and this should be of great significant to the clinicians once ESP programs are well established. Therefore, appropriate training methods should be established following consideration of precise nature of proposed ESP roles. The methods of training employed can be formal or informal or employing both methods in establishing the most appropriate training programs. Another prospect is to retain university accountability for clinical education but to lessen the range of practices necessary for certification of entry-level courses. The ESP physiotherapist should expand and exhibit expertise beyond their presently recognized range of practice. This includes some aspect of job expansion or task enhancement, which involves in the areas of extended therapeutics, practice and diagnostics or other range of extended scope. The majority of physiotherapists are trained in hospital based learning institutions outside the mainstream of higher education. It is assumed that the professional standards of clinical competence are maintained through centrally appointed examinations which are based on the central control of the syllabus. However, for the past decades, learning institutions have transferred to polytechnics, which offer internally examined courses; thus, it is crucial that students who successful in this examinations to become members of the chartered society of physiotherapy. Conclusions In conclusion, the project evaluated the research and theoretical issues underpinning on an aspect of the Extended Scope of Physiotherapy (ESP) practice role for Allied Health Professions (AHPs). The projected provided study objectives that covered arrange of aspects including the significant roles and impacts of ESP for AHPs, as well as, offered vital recommendations for expanding or changing roles of healthcare professionals within the current health care environment. Varied literatures were employed were employed to offer justifications on the way previous researchers have attempted to argue on ESP practice role for AHPs. Extended scope practitioners roles within physiotherapy encompass varied tasks, which may have been previously carried out by the medical professions. Literature indicated that the information about psychotherapist in ESP has grown tremendously for the past three decades with some recent studies attempting to assess the impact of new roles on the wellbeing and outcome of patients. However, the research found that ESP plays significant role such as improving the patient outcomes, enhancing professional developments and meeting the patient demands in case there are shortages for trained healthcare professions. Despite these roles, ESP can impact the role of psychotherapists and this includes a reduction in the quality of life of patients, impact on the tasks or roles undertaken by healthcare professionals and the cost of training extended scope practitioners is high. Therefore, it was recommended that offering future clinical training programmes in terms of structured internship programs to assess the capabilities of physiotherapy entry students is vital. Employing adequate clinical professions for physiotherapy entry-level students is most relevant in this context and also developing effective strategies vital for establishing a career structure in necessary. Bibliography Chartered Society of Physiotherapy (CSP). (n.d.). Masters level Programmes Within Post- Qualifying Physiotherapy Education : CSP Criteria And Expectations. (Chartered Society of Physiotherapy (CSP).) Chartered Society of Physiotherapy (CSP. Higgs, J., & Titchen, A. (2001). Practice Knowledge And Expertise In The Health Professions. Oxford: Butterworth-Heinemann. Malloch, K., & Porter-O'Grady, T. (2006). Introduction to Evidence-Based Practice In Nursing And Health Care. Sudbury, Mass: Jones and Bartlett. McPherson, K. et.al (January 01, 2006). A Systematic Review Of Evidence About Extended Roles For Allied Health Professionals. Journal of Health Services Research & Policy, 11, 4, 240-247. NHS Wales., & Wales. (2004). The NHS Knowledge And Skills Framework (NHS KSF) And The Development Review Process. Cardiff: Welsh Assembly Government. Pearson, A., Field, J., & Jordan, Z. (2009). Evidence-based Clinical Practice In Nursing And Health Care: Assimilating Research, Experience And Expertise. John Wiley & Sons Sarah, F., & Fiona, C. (January 01, 2011). Is a Primary Care Orthopaedic Interface Service Sustainable In A Continually Changing Political And Healthcare Environment?. Clinical Governance: an International Journal, 16, 2, 137-147. Read More