2. Job Purpose The post holder is an advanced musculoskeletal practitioner with a self-generated caseload

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1 1. Job Identification Job Title: Advanced Practitioner Physiotherapy for Crosshouse /Ayr Hospitals/Orthopaedic Triage Responsible to: AHP Manager East, Orthopaedic Consultants Department: Physiotherapy Department, Orthopaedic Department. Directorate: South Health and Social Care Partnership Operating Division: Job Reference: S/058/18 No of Job Holders: 5 Last Update: 04/05/16 2. Job Purpose The post holder is an advanced musculoskeletal practitioner with a self-generated caseload incorporating patient diagnosis, assessment and treatment. The post holder will be able to carry out or call on investigations and examinations by other disciplines, which would be out with normal scope of physiotherapy practice in order to complete their assessment. They will also provide a highly specialist resource to other healthcare staff/patients/carers and have an active involvement in Clinical Governance, Clinical Effectiveness, and research. They will lead in the development of own specialist service, e.g. orthopaedic triage and are the key contributor to development of new specialist multi-disciplinary services within own area of practice.

2 3. Dimensions As a highly skilled practitioner, provide expert assessment and ordering of radiological and haematological investigations in a specific clinical area. On behalf of the Consultant in a specialist area they will act independently to assess and diagnose patients referred to the orthopaedic service. They will facilitate optimal management of the patient using investigations, clinical reasoning and evidence based practice and discharge when required. Has sole lead responsibility for developing and implementing evidence based protocols, which may impact on other professions Decides the priorities of own work area and is responsible for balancing the varied demands of the post (essentially self directed) Has sole responsibility for systematic evaluation of clinical outcomes and standards of care, initiating changes accordingly. Works as an autonomous clinician taking full responsibility for own workload. Monitors and evaluates and audits the service provision in conjunction with orthopaedic consultants Provides highly specialist advice to other specialist areas. 4. Organisational Position See last page 5. Role of Department Provision of Orthopaedic care across Ayrshire and Arran, both surgical and non-surgical management, to a diverse range of musculoskeletal conditions and patient types. The department provides physiotherapy care to a diverse range of patients with a variety of clinical conditions across Ayrshire and Arran. This includes a 24-hour, year round emergency respiratory service, and weekend cover for agreed patients who have urgent rehabilitation needs in order to facilitate their discharge. Physiotherapy is a health care profession concerned with human function and movement and maximising individuals potential within these. The Physiotherapist will consider all aspects of the patients life roles and will co-ordinate with other health disciplines, Community services and carers in ensuring a seamless service.

3 Physiotherapists use physical approaches to promote, maintain and restore physical, psychological and social well being, taking account of variations in health status. Physiotherapy is science based and is committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery. The exercise of clinical judgement and information interpretation is at its core. 6. Key Result Areas To be professionally and legally accountable for all aspects of own work includes direct and indirect patient care including work outside the normal scope of practice of a Physiotherapist. To assess capacity, gain valid consent and have the ability to work within a legal framework with patients who lack capacity to consent. Act independently to assess, analyse, clinical and non-clinical information, and provide specialist and comprehensive clinical diagnosis for individual patients. This would include patients with complex presentations. To determine the necessity for additional investigations, Physiotherapy interventions or the need for referral to other disciplines including assessment / treatment by rheumatologists or orthopaedic surgeon. This would include advising patients on surgical intervention and treating patients with complex presentations. To carry out soft tissue injections, joint aspiration or responsibly request haematological and radiological examination where necessary. Act independently to plan, implement, evaluate, treat and progress patient care to maximise their rehabilitation potential including decision making regarding discharge from care, or onward referral to other services. To attend and manage clinics, working independently to determine appropriate pathway of care for each patient. Manages an identifiable caseload of patients effectively and efficiently, utilising current literature and research. To provide highly specialist advice, teaching and training to other members of the multidisciplinary team regarding patient management to ensure a consistent approach to patient care. This will include advice on complex treatment issues. Uses additional expert skills and knowledge gained from CPD and systematic review of the literature and disseminates to others in order to continuously improve the Service. This may necessitate implementing change and negotiating changes in service provision. Works within a multi-professional, multi-agency context to ensure effective communication and collaborative working, making recommendations to maximise patient care, e.g. case conferences, reviews and discharge planning. Maintain accurate, comprehensive and up to date patient documentation, records and accurate mandatory statistical information to reflect care provided and meet professional and local

4 standards. To comply with all Health & Safety regulations To examine orthopaedic waiting list and advise on appropriateness of physiotherapy, surgical or other multi-disciplinary management e.g. Podiatry. Exercise the freedom to manage a self-generated caseload self selected from orthopaedic waiting list, as required by the musculoskeletal and orthopaedic services. Managerial Participate in, and lead, within the specialist area, the departmental Personal Development and Planning Review process to promote personal and service development Identify inadequacies and needs in the service and implement plans in order to maximise patient care and use of resources in consultation with orthopaedic department eg triage, injection clinics. Take responsibility for the day-to-day management and delivery of service to the specialist area including identifying equipment needs and maintaining and ordering supplies as necessary. This would include future planning and organising of slots in the orthopaedic outpatient clinic. Develop robust systems to monitor evaluate and ensure standards of care and clinical outcomes in conjunction with Orthopaedic services. Develop multi-disciplinary protocols and guidelines to promote effective running of the ESP service and supporting clinical governance agenda. Educational To provide both spontaneous and planned specialist advice, teaching and training to other members of the multi-professional team, educational staff and others (e.g. relatives and carers; voluntary sector) to promote knowledge of physiotherapy, or alternative management options to enhance patient care. Actively develop, implement and participate in the Physiotherapy department and Specialty In Service Training programs to promote own personal development and that of staff. Ensure that a comprehensive In Service Training programme is provided in the specialty and provide expert clinical input to the Specialty. To attend education sessions for Orthopaedic Consultants and doctors. Research Lead, undertake and support clinical research to extend professional practice, devise or test new clinical benchmarks, outcome measures or clinical indicators. Disseminate and facilitate the communication of recent and relevant orthopaedic and

5 musculoskeletal research between the orthopaedic and physiotherapy services. 7a. Equipment and Machinery After an assessment of patient needs, the following the following items of equipment may be provided: Electrical equipment to contribute to treatment programme including ultrasound, short-wave diathermy, lasers, interferential therapy, transcutaneous electrical nerve stimulation machine, biofeedback machine, continuous passive movement machines, and functional electrical stimulation machine. Supports to optimise functional status a range of appliances and orthoses are available from the department or can be ordered from the Appliances Department. Rehabilitation equipment to contribute to treatment programmes including exercise bikes, weights, balance boards, gymnastic balls, theraband, treadmills, steppers, tilt tables, standing frames, and hydrotherapy equipment. Measurement devices for objective assessment including goniometers, dynamometer, inclinometer, tape measure, stop watch, heart rate monitor, blood pressure cuffs, and pulse oximetry. Thermal equipment to assist in pain management and the healing process including heat packs, wax baths, and ice. Acupuncture needles may be used to contribute to treatment programmes if an appropriate, recognised course has been completed. Hypodermic needles, corticosteroid and local anaesthetics. Please note that this is not an exhaustive list. Equipment used will vary depending on clinical caseload and working environment. To understand, prescribe and ensure safe use of Physiotherapy Equipment including electrotherapy, exercise equipment, orthotics/appliances, prosthetics, mobility aids and assisted ventilation To understand and ensure safe use of additional patient care equipment including specialist beds, hoists, stand aids, sliding sheets and wheelchairs local examples Maintain and ensure cleanliness as well as safety of equipment used for patient care in accordance with national and departmental policy To be competent in the use of IT hardware and software utilised within the department including Word Processing, Spreadsheets, Databases, Presentation Software, , Internet, Physio-tools, and Patient Management Systems appropriate to your service. To provide expert advice in the selection, provision and use of all Physiotherapy Patient Care Equipment, e.g. Walking aids, pulpit frames, walking frames, elbow crutches, sticks and

6 specialist walking aids. Keep and maintain stock of diagnostic and therapy equipment relating to ESP e.g. syringes and injectables, Venepuncture equipment, injectable medications. 7b. Systems Document patient records in accordance with professional standards to ensure continuity of care and compliance with current legislation. Records may be shared dependent on patient need (e.g. Other Healthcare Professionals, Social Work, and Lawyers etc). Appraisal, Continuing Professional Development and training systems Use of Information Technology (I.T.) system for communication, source of referrals, retrieval of results etc Use of I.T. system for report writing, collation of data etc. Patient Physiotherapy records maintain up-to-date records of assessment, treatment and outcome for individual patients. Patient Medical Records dictate records of assessment, investigation, treatment and outcomes for individual patients. Ensure dictation is accurate and signed promptly to keep GP informed. Physiotherapy discharge sheet to be sent to General Practitioner/Consultant on completion of treatment summarising course of treatment and outcome. Monthly number sheets to monitor monthly patient treatments and discharges. Referral to other professions or physiotherapy colleagues written and telephone referral where appropriate to share patient information to allow further input as assessed and deemed appropriate. Medical notes access medical notes for patient information, diagnosis, results and investigations. Travel expense forms to be completed monthly as appropriate. Overtime and additional hour s timesheet to be completed monthly as appropriate. Integrated care pathways to note physiotherapy treatment and assessment. Hospital information system to check location of patients and results of investigations. Write medical/legal reports.

7 8. Assignment and Review of Work Patients are referred by GP s and other medical specialities to Orthopaedic Consultants. ESP clinics are generated from this pool of referrals. Consultants and on occasions AP s triage named and un-named referrals from GPs and other Consultants. Caseload is prioritised by you into urgent, soon, routine. Prioritisation must be efficient and effective within waiting time targets. The amount of time spent in Orthopaedic clinics is decided by you, the Consultants and head of physiotherapy. Time is allocated for specific administration, audit and research relevant to your post. Work is generated and progress reviewed through regular discussions with Consultants. Physiotherapy caseload generated by AP/Consultant referrals from Orthopaedic clinic. These referrals are generally deemed too complex or challenging for routine department referral and require highly specialist Physiotherapy treatment. Some Physiotherapy referrals are generated after previous failed Physiotherapy interventions. This includes post-surgical cases and GP referrals. Plan the future development and ensure the progress of the Advanced Practitioner Physiotherapy service with the Orthopaedic Consultants and physiotherapy managers Work in advance schedules of at least 4 weeks in the Orthopaedic Clinics giving sufficient advanced warning to administration staff of clinic cancellation and amendments. At times changes may have to be made at short notice because of patient, professional or workforce demands, e.g. sickness or urgent patient referrals. Decisions regarding the prioritisation of referrals, in your area, have to be made from the often limited information from the referral source. Managerial tasks are generated by the service and staff needs of each area. The Orthopaedic Consultants or physiotherapy manager may delegate additional managerial and / or non-clinical tasks e.g. organising and chairing short term working groups, specialist clinical effectiveness groups, the recruitment of staff, reviewing and implementing policies, protocols and clinical guidelines. Project work and tasks can be self-generated from the range of meetings and groups the post holder attends. This may involve working across multi-agencies. Practice autonomously without direct supervision. Professionally and legally accountable for all aspects of your own work including the management of patients in your care.

8 9. Decisions and Judgements Works independently to scrutinise referrals to Orthopaedic service, within the field of specialty, independently identifying the most efficient treatment pathway, including selection and ordering of investigations e.g. X-Rays, blood tests and advising on surgery. This is out with the normal scope of Physiotherapy practice. Works in parallel with Consultant Orthopaedic surgeon within the clinic setting at an equitable level. Discussions may commence regards best patient management and at times this will involve negotiating different viewpoints. Guided by broad occupational and departmental guidelines/policies, has a wide scope of practice and demonstrates significant independent decision-making and interpretation of policies and guidelines, which will guide future management of the patient and will impact directly on associated services. Following initial consultation, assess, plan and undertake Physiotherapy interventions if required, some of which may be highly complex. Using clinical reasoning (a systematic approach to reaching decisions regarding interventions relating to presenting factors) throughout the day in order to decide how to complete and/or discontinue treatment taking all presenting factors into account regarding the clinical condition and utilising an holistic approach to individual care To work autonomously, making clinical decisions within extended scope of practice To provide highly specialist advice regarding additional patient care to appropriate clinician or service To undertake risk assessments throughout the day regarding patient condition and their environment to ensure staff and patient safety To constantly balance clinical, managerial and professional demands to ensure quality of care to specialist area, including prioritisation of own caseload taking into account competing clinical priorities. Assist and advise more junior staff regarding clinical decision making. To recognise the need to seek advice from other colleagues/peers, often out with the field of Physiotherapy. Troubleshooting and problem solving in the clinical area including patient related problems or more sensitive and complex situations (e.g. conflicting professional opinions). To provide highly developed, specialist advice to Multi Professional/Agency Team colleagues regarding the requirement for intervention, including by telephone and . Provide expert advice to physiotherapy and medical staff regarding:- -appropriateness of referral to orthopaedic service

9 -appropriateness of further investigations -physiotherapy intervention 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB 1. The high level of responsibility that comes with assuming the care/assessment of a patient originally referred to an Orthopaedic Consultant. Establishing and developing your role within 2 departments and thus a multi-disciplinary team. Consistently working to provide an Orthopaedic assessment comparable to an Orthopaedic Consultant s standard. Developing own clinical skills through knowledge gained by working with Consultants whilst meeting expectations of physiotherapy staff in keeping up to date with research in own clinical specialty. Undertake a mentally and physically demanding job, whilst at the same time taking care to safeguard personal health and safety as well as that of colleagues and patients. Dealing with sensitive issues in an understanding and supportive manner relating to:- -patient expectations of investigations and surgery and potential risks of surgery. -explaining reasons for investigations. -explaining complex Orthopaedic diagnosis. -conveying unwelcome news to both patients and staff, e.g. abnormal blood results and implications; patient may be a high surgical risk due to obesity. Working for a number of Consultants who have differing criteria, protocols and personalities. Keeping abreast of the large volume of information pertaining to guidelines (clinical, professional and managerial) and ensuring compliance where appropriate. Lack of office space to work privately and without interruption 11. Communications and Relationships You will communicate with a wide range of people from Consultants and GPs to patients and carers, physiotherapists and multi disciplinary colleagues through to senior physiotherapy management, other hospital / CHP management, local authority, lawyers and other agencies locally or nationally. This can be about any issues pertaining to your own designated service area, specialism, or profession, e.g. patient or staff specific issues, local service delivery, wider service developments, or education. You need to communicate effectively through face-to-face contact, via the telephone, , written correspondence, report writing, meetings and formal and informal presentations. This may be with individuals or groups.

10 Managerial: Network and build relationships, on behalf of your service area, to ensure optimal service for patients and to raise the profile of the physiotherapy service. Using negotiation and bargaining skills to secure resources for service development. Communicate, verbally and by presentations and reports, service related information to senior managers, other agencies and service users. Communicate highly complex sensitive information appropriately to gain agreement and cooperation from staff and service users. Liase with a range of individuals, internal and external to the organisation, to ensure effective service delivery. Adapt communication styles to overcome barriers to communication that may be caused, for example, by emotional distress, attitude to change, language or culture. Ensure highly complex or technical information, is conveyed in a manner and language that is easily understood by all. Use good interpersonal skills and be receptive to feedback to seek agreement and gain cooperation. Provide a channel for communication between physiotherapy and medical staff and senior management. Clinical Patients, relatives, carers : Communicates highly complex clinical information effectively and appropriately with patients and their carers using a range of verbal, non-verbal, written and presentation skills. This may involve conveying highly complex terminology into lay terms. e.g. explaining chronic pain mechanisms to patients. Provides and receives information regarding assessment, diagnosis, prognosis, setting agreed goals, and treatment, to encourage compliance. Identifies and modifies the most appropriate communication method depending on the individual requirements e.g. hearing or visual impairments, learning difficulties, language differences or disinterest. Provides support (planned and spontaneous), reassurance and encouragement to patients and their carers as part of the rehabilitation process Provides support and advice on highly emotive issues such as appropriateness or inappropriateness for physiotherapy treatment, joint injection, investigations or surgery. This would involve explaining potential benefits and risks of surgery to patients and relatives to allow them to make a fully informed decision about their future management. Convey comprehensive detail of physiotherapy treatment programs in a manner and at a rate which is appropriate for every individual emphasising and reiterating points as and when required to ensure a full understanding Encourage and motivate patients with complex and multi-factorial problems to maximise

11 outcome recognising those who are in pain of distress, are afraid or reluctant and require reassuring, motivating and persuading to comply with treatment Utilise appropriate methods and aids e.g. audio-visual aids or music when working with patients in groups for either education or exercise purposes Infrequently deal with volatile situations which may involve verbal/physical abuse. Effectively utilise a range of verbal and non-verbal communication techniques at all times in order to gain consent for investigations and treatment and optimise treatment outcomes. This may include patients with communication or cognitive impairments, those who lack the capacity to give consent, those with challenging behaviour and any other patients deemed unsuitable for more junior staff. Reassure, support, encourage, motivate and educate to achieve the best possible outcome from treatment. The pain or apprehension that patients may associate with and/or experience during treatment often complicates this. Deal with difficult situations at the request of senior staff or other professionals to clarify situations and/or diffuse potential complaints. Convey information in a particularly sensitive manner when it is contrary to the expectations or desires of the patient, carer or family. Be aware of cultural and sexual diversity and its impact on treatment altering communication as appropriate. Teach relatives / carers specific techniques to optimise individual rehabilitation potentials as appropriate. Other professionals (this could include physiotherapists, nurses, consultants and other medical staff, general practitioners, pharmacists, social workers, home care organisers, other allied health professionals, and lawyers): Report orthopaedic and physiotherapy assessment findings and treatment outcomes verbally or in writing. Initiate and/or actively participate in formal or informal discussions regarding patient care, progression of treatment and discharge planning. This may involve situations where your specialist opinion is contrary to those of the other professionals. Suggest the input of other professional teams as appropriate. Refer to Local Authority services and the voluntary sector as appropriate. Demonstrate and advise on physiotherapy management strategies to optimise patient care. Where appropriate complete discharge documentation. Explain the role of physiotherapy and clarify the appropriateness and frequency of continued intervention. Physiotherapy staff Provide appropriate details for transfer of patients for on-going care elsewhere.

12 Collaborates with peers e.g. Clinical Effectiveness Groups, Managed Clinical Networks Education of junior staff and students including presentations and the demonstration application and assessment of practical skills. Multi-professional/multi-agency team Provide patient assessment findings, progression of treatment, and discharge information to appropriate agencies. Provide advice regarding additional strategies for patient management e.g. referral to another specialist practitioner Education of other staff in the role of physiotherapy (including presentation skills) Works in parallel with consultant Orthopaedic surgeon within the clinic setting at an equitable level. This will involve discussions about best patient management. At times this will involve negotiating different viewpoints. Other agencies eg. Local authority, voluntary sector Provide information to support on-going management,e.g. Pain Association Make referrals to other agencies, e.g. for social work community care, physical disability teams in keeping with policies and standards May be required to complete legal documentation, e.g. letters/reports for solicitors, criminal injures, and child protection. Education of other relevant agencies in the role of physiotherapy Delegate tasks to other agencies in a clear and comprehensive manner, 12. Physical, Mental, Emotional and Environmental Demands of the Job Working conditions and physical tasks are continually risk-assessed with reasonable preventative steps taken; however, it is recognised that risk cannot be entirely eliminated. PHYSICAL EFFORT/SKILLS: Manual and therapeutic handling of patients occasionally for long periods. This may include very immobile, obese, unwilling or unpredictable patients, often from lying to sitting position, sitting to standing and transfer onto chair and back in one session. Manual physiotherapy techniques several times a day, including facilitation of movement and/or joint manipulation. This requires a high level of accuracy in positioning, dexterity, response to sensory feedback, and co-ordination of movement. Significant element of walking, climbing stairs, standing and working within confined and

13 awkward spaces on a daily basis. May adopt static postures for prolonged periods whilst assessing dependent patients to regain movement patterns. May spend periods using IT equipment (on occasions 3-4 hours) requires awareness of own postures and positioning of equipment/seating etc. Frequent use and moving of hoists, wheelchairs, walking aids, or other physiotherapy equipment throughout the day. The unpredictability of patients can result in a sudden effort being required, for example to prevent a loss of balance/fall. Standing and walking for the majority of the working day. Frequent kneeling, sitting, bending, crouching, and working in confined space at patient s bedside and in treatment areas throughout the day. Frequent time at desk and use of computer to sign clinic notes and access patient results. MENTAL EFFORT/SKILLS: High levels of concentration are required to ensure safe and thorough assessment an management at all times. Reading results, dictating notes and maintaining statistical records als requires this level of concentration. Mental agility and concentration required to deal with an unpredictable pattern of work due to varying clinic throughput and frequent interruptions. Listening and observational skills are required to be aware of needs of staff and patients in order to improve job satisfaction for staff, to try to prevent escalation of problems, and to try to ensure harmony in the workplace. Intense concentration is required during patient contact to ensure correct investigations are instigated and interpreted accurately and advice sought when necessary. This also applies to treatment techniques as incorrectly applied techniques can endanger the patient. Responding to frequent changes in patients conditions. This requires being alert in order to undertake a high standard of clinical reasoning involving constant reassessment regarding clinical management. Frequent use of computers. Very high levels of alertness and vigilance are required when leading a group-based treatment, or treating more than one patient at a time. Training and facilitating the development of physiotherapy staff. Daily requirement to maintain treatment records to required legal standards. Throughout the day responding to frequent and unpredictable changes in patients condition this requires being alert in order to undertake a high standard of clinical reasoning involving

14 continual reassessment regarding clinical management for periods of minutes. Prioritising workload continuously throughout the day. Frequent periods of particular concentration with new and complex patients and/or those with communication difficulties for periods of minutes per patient. Clinics last 3-5 hours and require sustained clinical concentration for this time. Dealing with abusive patients or carers (frequently) Dealing with frequent interruptions and distractions which require attention and distraction throughout the working day, e.g. Phone Calls. Dealing with complaints in line with NHSL policy and procedures Able to clinically reason conflicting diagnosis at the highest level with all patients throughout the day. Concentration sufficient to read patient results, dictate notes and maintain statistical records of work. EMOTIONAL DEMANDS Dealing with death and bereavement occasionally. Dealing with patients who have long-term chronic illness daily. Dealing with terminally ill patients rarely. Dealing with patients who may have severe injury frequently. Undertaking distressing treatment modalities with consideration of their associated risks e.g. joint injection and /or aspiration/anaphylaxis. Undertaking treatment modalities that may increase pain or distress levels Dealing with additional responsibilities for staff and students e.g. managing poor performance Frequently dealing with patients and relatives unrealistic expectations of treatment outcomes and service provision, including those who will be advised they wouldn t benefit from scans or surgery or appointment with orthopaedic consultant. Daily delivering unwelcome news to patients who are likely to have a poor outcome from surgery or rehabilitation and that may leave them with long-term disability. Liaising with Heads of Departments within a number of specialties to progress the role and dealing with resistance to change. Adapting to differing and strong personalities amongst Heads of Departments and Consultants Supporting staff through periods of personal/professional difficulty is a part of the role and can be emotionally demanding.

15 The job involves working with critically or terminally ill patients, those with chronic degenerative disorders, those who exhibit challenging behaviour, and/or those who are angry or depressed. These patients can be from any age group. Dealing with complaints and conflict situations require a high level of interpersonal skills. As a clinician having to deliver negative feedback on performance relating to patient treatment. Skill is required to make this a constructive learning process. Negotiation and persuasive skills are required to be used frequently on behalf of patients /staff and the service. WORKING CONDITIONS Daily exposure to body odours. Exposure to infectious diseases occasionally Dealing with body fluids from aspirated joints or surgical wounds frequently. Frequent exposure to unpleasant working conditions, which involves direct contact with bodily fluids and occasionally parasites. Occasional subjection to verbal and/or physical abuse. Daily exposure to transmittable diseases and infections. Having to manage and work within the constraints of limited resources e.g. staff, equipment, accommodation can be frustrating and add to stress. 13. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB 2. Take sole responsibility for the assessment, triage and management of complex medical and musculoskeletal conditions often with no peer support. Continually maintain and extend clinical role out with the boundaries of routine physiotherapy practice. This may challenge other professional roles. Establishing close working relationships with Consultants. Assuming the clinical risk of working out with normal physiotherapy scope in patients being referred to the orthopaedic clinic. Undertake a physically and mentally demanding job whilst taking care to safeguard own health an safety as well as that of patients and colleagues with issues arising, for example competence or poor performance Participating in multi-disciplinary teams, ensuring a professional opinion is expressed, which

16 other experienced members of the team may not agree with. Development and maintenance of high-level skills. Communication with patients of varying ages, abilities and cultures. Constantly balancing clinical and managerial duties, including training junior staff. Time management: dealing with increasing demands both in terms of service delivery and patient expectations, e.g. waiting list initiatives. 14. KNOWLEDGE, TRAINING AND/OR EXPERIENCE REQUIRED TO DO THE JOB Degree or diploma leading to Physiotherapy HPC registration Current HPC registration Significant level of clinical experience within speciality. Possessing relevant master s qualification or equivalent. Post-graduate diploma to qualify to do injections and request investigations. Previous experience of research and audit Updates in statutory training as required by the organisation and department, e.g. Moving & Handling Relevant post graduate training regular in-service training and post graduate courses and evidence of application of acquired skills as evidenced in CPD portfolio Comprehensive knowledge of clinical guidelines and standards within the speciality. Highly specialist knowledge and experience of relevant conditions, pathology, policies and procedures associated with the specialty. Working knowledge of basic IT e.g. word processing, use of Internet, database management Excellent communicator with advanced interpersonal skills. Car driver. Annual Mandatory Training Cardiopulmonary resuscitation. Anaphylactic training Manual Handling. Violence and Aggression Awareness or Breakaway training as appropriate. Fire Safety. Health and Safety awareness.

17 Person Specification Qualifications & Training Essential Criteria Diploma/BSc/MSc Physiotherapy HCPC Post graduate diploma to qualify to do injections and request investigations or working towards this qualification Qualifications & Training Desirable Criteria Relevant MSc qualification Experience Essential Criteria Significant clinical experience within MSK Significant leadership experience Previous experience of research and audit Evidence of teaching various healthcare settings Experience Desirable Criteria Managerial experience Knowledge Essential Criteria Relevant post registration CPD Knowledge of health and safety issues and policies Comprehensive knowledge of clinical guidelines and standards Highly specialist knowledge and experience of relevant conditions, pathology, policies and procedures associated with the specialty Knowledge Desirable Criteria Member of special interest group Knowledge of local and national strategic direction. Competencies & Skills Essential Criteria Excellent communication skills with advanced interpersonal skills Ability to be innovative and use own initiative Good Information Technology skills Competencies & Skills Desirable Criteria

18 Personal Characteristics and Other Essential Criteria Good communicator Good organisational skills Ability to work as part of a team Car owner/driver Personal Characteristics and Other Desirable Criteria

19 ORGANISATIONAL CHART AHP Associate Director AHP Manager East Physiotherapy Consultant Physiotherapy Manager East Ortho ESPS x 5

20 Working together to achieve the healthiest life possible for everyone in Ayrshire and Arran Candidate information pack Post title: Advanced Practitioner Physiotherapist-Orthopaedics Job reference number: Closing date: S/058/18 1 May 2018 Process for submitting application: Follow us on Find us on Facebook at Visit our website: All our publications are available in other formats

21 Welcome from the Chief Executive Thank you for the interest you have shown in this post. I hope that the information in this pack will help you to decide and encourage you to apply for this post. In recent years we have re-defined the purpose and values that are the foundation for our approach to health and social care delivery. You will find more information on our purpose and values in this pack. As with other health and social care providers, we are delivering our services in challenging times. Demographic changes, increasing demand and wider socio-economic factors all impact on service delivery. We are committed to working together with our teams and communities to re-design services to meet these challenges and fulfil our purpose. Delivering high quality, safe, person-centred care to every person every time is our clear aim. This can only be achieved when our staff feel valued and fully engaged. NHS Ayrshire & Arran has a clear commitment to the health, safety and wellbeing of our staff. I am sure that you will have many questions and we would be delighted to hear from you in order to further your knowledge of this post and of NHS Ayrshire & Arran. Kind regards, John G Burns Chief Executive 2

22 Section one: About NHS Ayrshire & Arran NHS Ayrshire & Arran is one of 14 territorial NHS Boards within NHSScotland. Ayrshire and Arran NHS Board is responsible for the protection and improvement of the local population s health and for the delivery of frontline healthcare services. The NHS Board membership consists of executive and non-executive members, and is accountable to the Cabinet Secretary for Health, Wellbeing and Sport. Our operational frontline services are provided through four distinct operational units Acute Services and the Health and Social Care Partnerships in East, North and South Ayrshire. You can find further detail on the role of the NHS Board, and our organisational structure on our website NHS Ayrshire & Arran serves a mixed rural and urban population of 376,000. We have a full range of primary and secondary clinical services, covering the mainland of Ayrshire and the islands of Arran and Cumbrae. NHS Ayrshire & Arran covers three local authority areas: East, North and South Ayrshire. There are major areas of widespread deprivation and social exclusion in both rural and urban areas. The healthcare challenge within the area is considerable: our population suffers higher than average rates of coronary heart disease, lung cancer, respiratory illnesses and premature death among males. Ongoing lifestyle issues, such as the prevalence of smoking, poor diet and lack of exercise, are key factors, as is the steadily ageing profile of the population. Here in NHS Ayrshire & Arran, we want the best for our staff and the best for local people. We pride ourselves on improving health and providing a comprehensive range of high quality, safe, effective and person-centred health services. Our strategic direction is based on continuous improvement and services that are centred on patients and service underpinned by our organisational commitments. 3

23 Our commitments to you Our service users and communities We will work with you and your family to: Promote and improve your health Improve your safety, outcomes and quality of experience while in our care Live up to our customer care commitments Our workforce We will work together to create an open, fair and just culture where: We are all valued, respected and developed to be our best We are all informed, involved, listened to and treated fairly and consistently We are all safe and are supported to improve our health and wellbeing Our partners We will work together with partners to: Improve health, prevent disease and reduce inequalities Join up our service delivery to improve outcomes Make best use of our resources Our values Caring I will show concern for others and care about the health, safety, and wellbeing of everyone I come into contact with. Safe I will do my job well, striving to learn and do things better, while taking responsibility for the quality, safety, and effectiveness of my actions. Respectful I will see everyone as an individual, be open, approachable, and treat everyone with dignity and respect. 4

24 2020 vision In September 2011, the Scottish Government set out the strategic vision for the delivery of healthcare services in Scotland. Our vision is that by 2020, everyone is able to live longer healthier lives at home, or in a homely setting. We will have a healthcare system where: we have integrated health and social care; there is a focus upon prevention, anticipation and supported self management; if hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm; whatever the setting, care will be provided to the highest standards of safety and quality with the person at the centre of all decisions; and there will be a focus on ensuring that people get back into their home or community environment as soon as possible with minimal risk of readmission. In February 2014, Ayrshire and Arran NHS Board approved Our Health 2020 as NHS Ayrshire & Arran s health and wellbeing framework. The framework described how we would fulfil the national 2020 vision for health services locally. Our corporate objectives, as illustrated below, reflect the aims of the 2020 vision: 5

25 For more information on how we make decisions, how we perform and our key publications detailing our strategic intent and plans for delivery of healthcare services within Ayrshire, visit the NHS Ayrshire & Arran website Section two: NHS Ayrshire & Arran as an employer NHS Ayrshire & Arran recognises that our staff are vital to delivering our purpose, values and commitments and to achieving our strategic objectives. Our aim is to create an organisation where people want to work and strive to deliver excellence each day; where staff wellbeing and personal resilience are supported; where careers are interesting and developed; where staff are encouraged to reach their full potential; and where staff feel their contribution is recognised and valued. To do this, we need to attract, develop, support and retain our staff and enhance their work experience. This will directly contribute to our aspiration to deliver excellent high quality services to every person every time. Our employees have told us the unique factors that help to define us as an employer are: our friendly and supportive environment; our commitment to staff engagement and effective team working; our track record in creativity and innovation and our ability to successfully implement change and redesign; our track record in supporting our staff s learning, development and career aspirations, from an initial comprehensive three-day corporate induction programme to the availability of a wide range of internal training programmes; our commitment to supporting flexible working through a wide range of family friendly policies; and our commitment to support and improve our staff s health, safety, wellbeing and resilience. We do this by implementing our Staff Health, Safety and Wellbeing Strategy, and in our work towards achieving and maintaining the Healthy Working Lives Gold Award. In addition, our Staff Care and Occupational Health Service provide a range of support and interventions to our staff. 6

26 The Staff Governance Standard is embedded and adhered to as part of the governance framework staff, financial, information and clinical governance - in which NHS Boards operate. The Staff Governance Standard requires all NHS Boards to demonstrate that staff are: well informed; appropriately trained and developed; involved in decisions; treated fairly and consistently, with dignity and respect in an environment where diversity is valued; and provided with a continuously improving and safe working environment, promoting the health and wellbeing of staff, patients and the wider community. Section three: Delivering our services The map below illustrates the key hospital sites throughout Ayrshire and Arran. Lady Margaret Hospital H ISLE OF CUMBRAE Millport Largs NORTH AYRSHIRE Population of Ayrshire and Arran - 367,160 East Ayrshire - 120, per cent of total population North Ayrshire - 135, per cent of total population South Ayrshire - 111, per cent of total population Arran War Memorial Hospital H ISLE OF ARRAN Brodick H Ayrshire Central Hospital Irvine Kilmarnock H University Hospital Firth of Clyde Crosshouse Biggart Hospital H EAST AYRSHIRE Ayr Ailsa Hospital H H University Hospital Ayr SOUTH AYRSHIRE Girvan H Girvan Community Hospital H East Ayrshire Community Hospital Cumnock Key H H Acute Hospital with accident and emergency department Community Hospital 7

27 Acute services Emergency and elective hospital services are provided by our acute services, which includes inpatient, outpatient and day case care. There are two district general hospitals within Ayrshire: University Hospital Ayr and University Hospital Crosshouse. These hospitals provide a wide range of acute services: University Hospital Ayr University Hospital Ayr provides medical and surgical services on an inpatient, day case and outpatient basis. It is the main Accident and Emergency service for South Ayrshire. It provides a number of Ayrshire-wide services including Vascular Surgery, Ophthalmology and Urology. There are approximately 330 inpatient beds at Ayr. University Hospital Crosshouse University Hospital Crosshouse provides medical and surgical services on an inpatient, day case and outpatient basis. It is the main Accident and Emergency service for East and North Ayrshire. Inpatient paediatrics, the Ayrshire Maternity Unit and the main Laboratories for Ayrshire are on the Crosshouse site. There are approximately 600 inpatient beds at Crosshouse Community, mental health and learning disabilities services Following the introduction of Health and Social Integration, the operational delivery for the range of community healthcare services and mental health and learning disabilities services is through the three Partnerships in Ayrshire: East Ayrshire Health and Social Care Partnership North Ayrshire Health and Social Care Partnership South Ayrshire Health and Social Care Partnership 8

28 Community services General medical and dental services are provided throughout Ayrshire and Arran by general practitioners, dentists, community pharmacies and optometry practices. Community nurses, health visitors and Allied Health Professionals are all involved in providing care within our local communities. Out-of-hours general medical services are provided by Ayrshire Doctors on Call (ADOC) within the community. Mental health and learning disability services The majority of our inpatient mental health services, including the Intensive Psychiatric Care Unit, are provided at the newly built Woodland View facility in Irvine. Learning disability services are provided from Arrol Park in Ayr. Elderly mental health inpatient services are provided from Ayrshire Central Hospital in Irvine, and East Ayrshire Community Hospital in Cumnock. Community based services are provided throughout Ayrshire for a range of clinical groups: adults, child and adolescent, elderly and addiction services. For more information on the full range of clinical services provided by NHS Ayrshire & Arran, visit our website Section four: Investing for the future Building for better care We have invested 27.5 million to provide fit for purpose front door services for University Hospitals Ayr and Crosshouse, in order to improve emergency and urgent care for patients who come to hospital for anything other than a scheduled appointment. 9

29 University Hospital Ayr: new emergency department with resuscitation bays, high care areas and cubicles and fully integrated with the minor injury unit and NHS Ayrshire Doctors on Call (ADOC). University Hospital Crosshouse: Combined Assessment Unit being built alongside the existing emergency department which will include 35 en-suite bedrooms, as well as new patient assessment and ambulatory care areas. The unit will provide the physical environment needed to allow patients to be rapidly assessed and either discharged safely or admitted to a specialty ward for further care and treatment. Woodland View We have invested 47million providing a 206 en-suite bedroom integrated mental health and community facility, including older people s long term care and rehabilitation. This development brings together a full range of outpatient and inpatient facilities including: an outpatient consultation area to support a full range of mental health and psychology related outpatient activity; tribunal suite; therapy areas with treatment and recovery spaces that will also be used as flexible clinical accommodation for Allied Health Professions; an inpatient clinical pharmacy and dispensary service to all wards; and a staff library. 10

30 Section five: Key facts and figures Our spending... Our typical annual revenue spend is approximately 750+million of which approximately 50% is expenditure on staffing. Staffing The population we serve... Total population of 367,000 which is projected to change by

31 Primary care services GPs across 56 GP practices 22 dentists within community and salaried dental service 15 orthodontists across four orthodontic practices Primary care services community pharmacies 171 optometrists across 63 practices 164 general dental practitioners across 59 practices 12

32 Our staff... 13

33 Our typical annual activity Section six: Why work in Ayrshire? Ayrshire is situated in South-west of Scotland on the Firth of Clyde, and is characterised by 80 miles of varied coastline, picturesque beaches, rolling green hills and islands. Just a 30-minute drive from Glasgow city centre, Ayrshire is an ideal location for those who want to enjoy city life, with all the benefits of living in a semirural area. Ayr, Irvine and Kilmarnock are the largest towns. However, there are many rural towns, villages and communities throughout the area should you wish to relocate to Ayrshire. Whether you decide to locate to Ayrshire or a neighbouring area, you will find that property prices are more affordable than in other parts of the UK. Local educational standards are very high at primary and secondary level. However, private education is also available in the area. 14

34 See below for more information on local authority services: East Ayrshire Council North Ayrshire Council South Ayrshire Council Working in Ayrshire provides an easy commute from both Glasgow and the wider central belt. There is an excellent network of both rail and bus links throughout Ayrshire to Glasgow and beyond. There are UK and international flights available from Glasgow Airport, as well as a range of services from Glasgow Prestwick Airport. Ayrshire provides a wide range of excellent recreational activities: whether you are interested in history and heritage, outdoor pursuits, events and festivals, or simply food and drink, there is something for everyone. Ayrshire boasts more than 40 quality golf courses, including two Open Championship courses at Turnberry and Royal Troon. For more information on the range of recreational activities in Ayrshire, visit 15

35 All of our publications are available in different languages, larger print, braille (English only), audio tape or another format of your choice. Tha gach sgrìobhainn againn rim faotainn ann an diofar chànanan, clò nas motha, Braille (Beurla a-mhàin), teip claistinn no riochd eile a tha sibh airson a thaghadh Tell us what you think... If you would like to comment on any issues raised by this document, please complete this form and return it to: Communications Department, 28 Lister Street, Crosshouse Hospital, Crosshouse KA2 0BB. You can also us at: comms@aaaht.scot.nhs.uk. If you provide your contact details, we will acknowledge your comments and pass them to the appropriate departments for a response. Name Address Comment Last reviewed: May 2016 Leaflet reference: MIS GD