Job summary This is an excellent opportunity to join our Musculoskeletal (MSK) Advanced Physiotherapy team at Lewisham and Greenwich NHS Trust (LGT), where we are looking for a highly skilled Specialist MSK Physiotherapists to join our senior team. We are expanding our team and re-developing our musculoskeletal services in Lewisham so this is an exciting time and an opportunity to shape our services for the future. You will need to be an experienced, enthusiastic, and dedicated individual with excellent communication and interpersonal skills. You must have relevant clinical experience, teaching and organisational skills, with evidence of CPD. The post holder(s) will work autonomously within MCATS clinics. As such you should have previous experience of working as an Advanced Practice Physiotherapist in an MSK Triage and Treat Service or be ready to make this step with our support. Main duties of the job You will also work in the MSK Physiotherapy Outpatient department, providing expert patient assessment and treatment and senior clinical support to the team. The post holder(s) will assist the MSK Team Lead in developing physiotherapy services within the MSK pathway, where they will hold a clinical caseload comprising of patients referred to the MSK Outpatient Physiotherapy department. You should be a dynamic and motivated physiotherapist, who can provide decisive and effective Physiotherapy input and can demonstrate leadership qualities, effective communication skills, a flexible approach and an ability to work under pressure, both as part of a team and independently. In LGT you will join a friendly and dedicated Physiotherapy and Therapies team, driven to provide a quality, innovative and person-centred service. We will support you with a supervision, training and appraisal structure to enhance your professional development. The post holder will input into clinical governance activity, supervision and the development of Band 7, 6 and 5 physiotherapists, physiotherapy students and assistant staff working within the MSK outpatients setting and will assist in coordinating a rolling programme of audit and training within the pathway. About us Our people are our greatest asset. When we feel supported and happy at work, this positivity reaches those very people we are here for, the patients. Engaged employees perform at their best and our Equality, Diversity & Inclusion (EDI) initiatives contribute to cultivate a culture of engagement. We have four staff networks, a corporate EDI Team and a suite of programmes and events which aim to insert the 5 aspirations: Improving representation at senior levels of staff with disabilities, from black, Asian, and ethnic minorities background, identify as LGBTQ and women, through improved recruitment and leadership development Widening access (anchor institution) and employability Improving the experience of staff with disability Improving the EDI literacy and confidence of trust staff through training and development Making equalities mainstream Date posted 30 December 2024 Pay scheme Agenda for change Band Band 8a Salary £53,755 to £60,504 a year per annum plus HCAS Contract Permanent Working pattern Full-time, Part-time, Flexible working Reference number 197-UT6210 Job locations University Hospital Lewisham Lewisham High Street London SE13 6LH Job description Job responsibilities JOB PURPOSE The post holders key responsibility is to work autonomously as an Advanced Physiotherapy Practitioner (APP) and Physiotherapist on behalf of LGT. The APP is a highly experienced clinician who independently manages a significant and highly specialised clinical caseload. Areas of work might include the Musculoskeletal Community Assessment, Triage and Treat Service (MCATS) based at UHL, the MSK physiotherapy departments based at Queen Elizabeth or Lewisham hospital, or other areas as required. APP staff provide clinical leadership to physiotherapy staff working in the musculoskeletal outpatient team. To achieve this, the post holder works in close collaboration with the Physiotherapy Outpatient Team Lead (as applicable), and APP colleagues. The post holder assists in leading a rolling programme of education, clinical evaluation, audit and research across the speciality. 7-day working for Therapies is under development within the Trust and the post holder may be required to undertake a different working pattern, including weekends, in the future. Staff working in UCC will be required to work weekends. KEY RELATIONSHIPS Physiotherapy B7 Outpatient pathway Leads, Rheumatology consultants, A&E Clinical Lead Consultants, Trauma & Orthopaedic Consultants, Patient Management Centres in all Boroughs, Local Commissioners, L&G Information Department, Senior Therapists in Occupational Therapy / Speech and Language Therapy / Dietetics, All Physiotherapy Staff Working in Musculoskeletal Pathway, ESP staff working in MCATS services in Community, Nursing Leads in associated specialities, Referring Hospitals, Social Services, Community Services, GPs, Voluntary Services, Academic Institutions, Musculoskeletal Specialists external to L&G. DUTIES AND RESPONSIBILITIES CLINICAL 1 To be responsible for the delivery of advanced physiotherapy clinics, working autonomously. 2 To use advanced clinical reasoning skills and skills beyond the scope of Physiotherapy ie requesting x-rays, MRI, US scans and blood tests, to aid diagnosis and plan management of patients. 3 To act as a source of expertise in the management of musculoskeletal conditions and provide an advisory service to patients, other ESPs, senior Physiotherapists, other healthcare professionals, GPs and consultants. 4 To be involved in triaging of referrals as required. 5 To be an autonomous practitioner and an expert clinician in the assessment, diagnosis, treatment and management of patients. 6 To develop and maintain skills required to work at a level beyond the scope of practice of Physiotherapy. This includes referring patients for x-rays, blood tests, MRI scans, ultrasound scans blood tests etc. Where applicable, to be skilled and competent in injection therapy and independent prescribing. 7 To be aware of the boundaries of own extended scope of practice and to manage the associated clinical risk effectively at all times. 8 To follow up the results of clinical investigations, discuss these with the Consultants and communicate results to the patient when appropriate, arranging further management as necessary. 9 To work with medical staff and the service manager in developing the strategic and operational management of the MSK physiotherapy service. 10 To use a highly advanced theoretical and evidence based knowledge of anatomy, physiology and pathology and clinical reasoning to assess and diagnose patients, often in situations where conflicting evidence is present. 11 To accept clinical responsibility for a designated caseload of patients, in the MSK outpatient Physiotherapy service, and to organise this efficiently and effectively with regard to clinical priorities and use of time, ensuring a high standard of clinical care for the patients under your management and under the management of the staff for whom you are clinically responsible. 12 To demonstrate physical ability to carry out highly skilled physiotherapy assessments and interventions including a wide range of therapy techniques and therapeutic handling. 13 To co-ordinate intervention which may include other disciplines, including advising and educating patients, carers and relatives. 14 To provide specialist advice and guidance regarding MSK conditions to other health care professionals, both within and outside the Trust. 15 To be responsible for ensuring that quality standards and effectiveness of patient care are continually improved by self and designated team through formal and informal facilitation / staff development. 16 To propose policy changes concerning the management of patients with MSK conditions in conjunction with the Outpatient physiotherapy team leads and hospital Consultants. 17 To work with the Lead Musculoskeletal Physiotherapist in developing the strategic and operational management of the musculoskeletal physiotherapy service. 18 To assess patients capacity, gain valid informed consent to treatment and where such capacity is lacking/absent to work within a legal framework in the management of the patient. 19 To ensure accurate, comprehensive and up to date clinical records are maintained in accordance with Trust guidance and professionally agreed criteria. 20 To use recognised outcome measures to evaluate the effect of physiotherapy interventions and ensure that treatment programmes are progressing appropriately. 21 To ensure that individual practice and that of the team is user focused and patient views are incorporated into treatment planning. 22 To produce comprehensive patient related reports for other disciplines or agencies relating to assessment findings and/or treatment outcomes. 23 To undertake the measurement and evaluation of own work through audit, outcome measurement, the application of evidence based practice and research where appropriate. To identify and initiate audit projects to review current clinical practice within the pathway. WORKFORCE To provide expert advice, guidance and support, both spontaneous and planned, to other physiotherapists in the physiotherapeutic management of patients with more complex musculoskeletal problems. To be responsible for the daily management, supervision and co-ordination of designated team, including staff appraisal, performance management, informal grievance management. To assist with shortlisting and act as a panel member in staff recruitment. To assist the Lead Musculoskeletal Physiotherapist, in conjunction with other senior staff, in the efficient day to day management of the physiotherapy service. To use prioritising and time management skills to meet the unpredictable and conflicting needs of the service. To ensure clear and open channels of communication exist within the physiotherapy pathway team. To ensure the cascade of ideas and information to all pathway staff. To initiate and maintain communication links, collaborative working patterns with other nationally recognised experts and networks in the speciality. In the absence of the physiotherapy lead to organise, plan and lead physiotherapy pathway meetings and to attend staff and managerial meetings as requested. To contribute to the clinical induction of physiotherapy staff. To maintain and provide accurate and timely activity information both as an individual and for the designated pathway. To do this in accordance with local and national requirements to help inform service delivery and evaluation. To adhere to the policies and procedures of the Trust and Physiotherapy service. To ensure that staff are aware of and comply with Trust policies and procedures undertaking action as necessary. To be responsible for the clinical standards of the physiotherapy staff reporting to the post holder within the designated pathway. To facilitate effective team working within the pathway, leading, assisting and supporting other team members. To ensure all incidents, accidents and complaints within the pathway are reported and documented in the appropriate timeframe and in line with Trust policy. To ensure senior physiotherapy managers are made aware of all incidents, accidents and complaints. Job description Job responsibilities JOB PURPOSE The post holders key responsibility is to work autonomously as an Advanced Physiotherapy Practitioner (APP) and Physiotherapist on behalf of LGT. The APP is a highly experienced clinician who independently manages a significant and highly specialised clinical caseload. Areas of work might include the Musculoskeletal Community Assessment, Triage and Treat Service (MCATS) based at UHL, the MSK physiotherapy departments based at Queen Elizabeth or Lewisham hospital, or other areas as required. APP staff provide clinical leadership to physiotherapy staff working in the musculoskeletal outpatient team. To achieve this, the post holder works in close collaboration with the Physiotherapy Outpatient Team Lead (as applicable), and APP colleagues. The post holder assists in leading a rolling programme of education, clinical evaluation, audit and research across the speciality. 7-day working for Therapies is under development within the Trust and the post holder may be required to undertake a different working pattern, including weekends, in the future. Staff working in UCC will be required to work weekends. KEY RELATIONSHIPS Physiotherapy B7 Outpatient pathway Leads, Rheumatology consultants, A&E Clinical Lead Consultants, Trauma & Orthopaedic Consultants, Patient Management Centres in all Boroughs, Local Commissioners, L&G Information Department, Senior Therapists in Occupational Therapy / Speech and Language Therapy / Dietetics, All Physiotherapy Staff Working in Musculoskeletal Pathway, ESP staff working in MCATS services in Community, Nursing Leads in associated specialities, Referring Hospitals, Social Services, Community Services, GPs, Voluntary Services, Academic Institutions, Musculoskeletal Specialists external to L&G. DUTIES AND RESPONSIBILITIES CLINICAL 1 To be responsible for the delivery of advanced physiotherapy clinics, working autonomously. 2 To use advanced clinical reasoning skills and skills beyond the scope of Physiotherapy ie requesting x-rays, MRI, US scans and blood tests, to aid diagnosis and plan management of patients. 3 To act as a source of expertise in the management of musculoskeletal conditions and provide an advisory service to patients, other ESPs, senior Physiotherapists, other healthcare professionals, GPs and consultants. 4 To be involved in triaging of referrals as required. 5 To be an autonomous practitioner and an expert clinician in the assessment, diagnosis, treatment and management of patients. 6 To develop and maintain skills required to work at a level beyond the scope of practice of Physiotherapy. This includes referring patients for x-rays, blood tests, MRI scans, ultrasound scans blood tests etc. Where applicable, to be skilled and competent in injection therapy and independent prescribing. 7 To be aware of the boundaries of own extended scope of practice and to manage the associated clinical risk effectively at all times. 8 To follow up the results of clinical investigations, discuss these with the Consultants and communicate results to the patient when appropriate, arranging further management as necessary. 9 To work with medical staff and the service manager in developing the strategic and operational management of the MSK physiotherapy service. 10 To use a highly advanced theoretical and evidence based knowledge of anatomy, physiology and pathology and clinical reasoning to assess and diagnose patients, often in situations where conflicting evidence is present. 11 To accept clinical responsibility for a designated caseload of patients, in the MSK outpatient Physiotherapy service, and to organise this efficiently and effectively with regard to clinical priorities and use of time, ensuring a high standard of clinical care for the patients under your management and under the management of the staff for whom you are clinically responsible. 12 To demonstrate physical ability to carry out highly skilled physiotherapy assessments and interventions including a wide range of therapy techniques and therapeutic handling. 13 To co-ordinate intervention which may include other disciplines, including advising and educating patients, carers and relatives. 14 To provide specialist advice and guidance regarding MSK conditions to other health care professionals, both within and outside the Trust. 15 To be responsible for ensuring that quality standards and effectiveness of patient care are continually improved by self and designated team through formal and informal facilitation / staff development. 16 To propose policy changes concerning the management of patients with MSK conditions in conjunction with the Outpatient physiotherapy team leads and hospital Consultants. 17 To work with the Lead Musculoskeletal Physiotherapist in developing the strategic and operational management of the musculoskeletal physiotherapy service. 18 To assess patients capacity, gain valid informed consent to treatment and where such capacity is lacking/absent to work within a legal framework in the management of the patient. 19 To ensure accurate, comprehensive and up to date clinical records are maintained in accordance with Trust guidance and professionally agreed criteria. 20 To use recognised outcome measures to evaluate the effect of physiotherapy interventions and ensure that treatment programmes are progressing appropriately. 21 To ensure that individual practice and that of the team is user focused and patient views are incorporated into treatment planning. 22 To produce comprehensive patient related reports for other disciplines or agencies relating to assessment findings and/or treatment outcomes. 23 To undertake the measurement and evaluation of own work through audit, outcome measurement, the application of evidence based practice and research where appropriate. To identify and initiate audit projects to review current clinical practice within the pathway. WORKFORCE To provide expert advice, guidance and support, both spontaneous and planned, to other physiotherapists in the physiotherapeutic management of patients with more complex musculoskeletal problems. To be responsible for the daily management, supervision and co-ordination of designated team, including staff appraisal, performance management, informal grievance management. To assist with shortlisting and act as a panel member in staff recruitment. To assist the Lead Musculoskeletal Physiotherapist, in conjunction with other senior staff, in the efficient day to day management of the physiotherapy service. To use prioritising and time management skills to meet the unpredictable and conflicting needs of the service. To ensure clear and open channels of communication exist within the physiotherapy pathway team. To ensure the cascade of ideas and information to all pathway staff. To initiate and maintain communication links, collaborative working patterns with other nationally recognised experts and networks in the speciality. In the absence of the physiotherapy lead to organise, plan and lead physiotherapy pathway meetings and to attend staff and managerial meetings as requested. To contribute to the clinical induction of physiotherapy staff. To maintain and provide accurate and timely activity information both as an individual and for the designated pathway. To do this in accordance with local and national requirements to help inform service delivery and evaluation. To adhere to the policies and procedures of the Trust and Physiotherapy service. To ensure that staff are aware of and comply with Trust policies and procedures undertaking action as necessary. To be responsible for the clinical standards of the physiotherapy staff reporting to the post holder within the designated pathway. To facilitate effective team working within the pathway, leading, assisting and supporting other team members. To ensure all incidents, accidents and complaints within the pathway are reported and documented in the appropriate timeframe and in line with Trust policy. To ensure senior physiotherapy managers are made aware of all incidents, accidents and complaints. Person Specification Qualifications & Training Essential Diploma / Degree in Physiotherapy HCPC registration Working at MSc level (e.g. module) or equivalent experience/qualification Undertaken a range of relevant postgraduate courses Undertaken appropriate managerial training Undertaken clinical educators training Desirable MCSP Member of Special interest Group MSC in related subject Injection Therapy Independent Prescribing Experience Essential Wide ranging post graduate physiotherapy experience including having held senior position in relevant speciality Significant experience of relevant specialist pathway Experience of working autonomously and unsupervised Experience in managing limited resources and high workloads Experience in leading and completing audit and evidence based projects Experience of supervision and appraisal of physiotherapy staff and students with ability to give constructive feedback and performance management when necessary Evidence of actively participating in in-service training and presenting to large MDT groups, undergraduate and postgraduate staff and evaluating effectiveness of training Experience and ability to work collaboratively within MDT Evidence of leading change management and innovation in clinical practice Desirable Previous experience at band 8 level/as an ESP Research experience including publication in recognised journal. Presented at national level or external courses relevant to subject area Actively involved in developing research links with other academic institutions Knowledge Essential Extensive specialist knowledge of evidenced based physiotherapy for designated specialist pathway In depth knowledge of national guidelines and standards pertaining to specialist pathway and physiotherapy Robust understanding of clinical governance and its implication for physiotherapy Awareness and understanding of NHS structure, current issues and developments Understanding of the legal responsibilities of the profession Skills Essential The ability to discuss advanced clinical reasoning in the management of highly complex cases The ability to identify and act upon adverse clinical signs Ability to carry out advanced manual therapy skills The ability to formulate and carry out an expert assessment and treatment programme specific to the patients' needs Able to communicate at advanced level including complex information to patients, carers, team and other health professionals Excellent ability to work effectively in a team environment Excellent time management skills with ability to organise, prioritise and delegate. Ability to self direct learning, be critical and evaluate own learning needs, demonstrated in a CPD portfolio. Ability to collect and present data for service performance information Excellent teaching and presentation skills IT skills, including using hospital databases, word processing, excel, email and power point Desirable IT skills - Ability to create and/or format data and/or complex spreadsheets using computerised systems Person Specification Qualifications & Training Essential Diploma / Degree in Physiotherapy HCPC registration Working at MSc level (e.g. module) or equivalent experience/qualification Undertaken a range of relevant postgraduate courses Undertaken appropriate managerial training Undertaken clinical educators training Desirable MCSP Member of Special interest Group MSC in related subject Injection Therapy Independent Prescribing Experience Essential Wide ranging post graduate physiotherapy experience including having held senior position in relevant speciality Significant experience of relevant specialist pathway Experience of working autonomously and unsupervised Experience in managing limited resources and high workloads Experience in leading and completing audit and evidence based projects Experience of supervision and appraisal of physiotherapy staff and students with ability to give constructive feedback and performance management when necessary Evidence of actively participating in in-service training and presenting to large MDT groups, undergraduate and postgraduate staff and evaluating effectiveness of training Experience and ability to work collaboratively within MDT Evidence of leading change management and innovation in clinical practice Desirable Previous experience at band 8 level/as an ESP Research experience including publication in recognised journal. Presented at national level or external courses relevant to subject area Actively involved in developing research links with other academic institutions Knowledge Essential Extensive specialist knowledge of evidenced based physiotherapy for designated specialist pathway In depth knowledge of national guidelines and standards pertaining to specialist pathway and physiotherapy Robust understanding of clinical governance and its implication for physiotherapy Awareness and understanding of NHS structure, current issues and developments Understanding of the legal responsibilities of the profession Skills Essential The ability to discuss advanced clinical reasoning in the management of highly complex cases The ability to identify and act upon adverse clinical signs Ability to carry out advanced manual therapy skills The ability to formulate and carry out an expert assessment and treatment programme specific to the patients' needs Able to communicate at advanced level including complex information to patients, carers, team and other health professionals Excellent ability to work effectively in a team environment Excellent time management skills with ability to organise, prioritise and delegate. Ability to self direct learning, be critical and evaluate own learning needs, demonstrated in a CPD portfolio. Ability to collect and present data for service performance information Excellent teaching and presentation skills IT skills, including using hospital databases, word processing, excel, email and power point Desirable IT skills - Ability to create and/or format data and/or complex spreadsheets using computerised systems Disclosure and Barring Service Check This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions. Certificate of Sponsorship Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab). From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab). UK Registration Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window). Additional information Disclosure and Barring Service Check This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions. Certificate of Sponsorship Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab). From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab). UK Registration Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window). Employer details Employer name Lewisham and Greenwich NHS Trust Address University Hospital Lewisham Lewisham High Street London SE13 6LH Employer's website https://www.lewishamandgreenwich.nhs.uk/ (Opens in a new tab)