Clinical Specialist Physiotherapist - Royal Brompton Hospital

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• Communication

To maintain an advanced level of communication skills enabling dialogue between all levels of the MDT and external agencies,  providing and receiving sensitive and/or complex information to other senior members of the MDT.

• Have the ability to develop good working relationships, facilitating respect and support of the MDT
• Ensure a patients’ understanding of their therapy intervention in order to gain valid, informed consent and to be able to work within a legal framework with patients / children who lack the ability to consent to treatment.
• To use a range of verbal and non-verbal communication tools when communicating with patients /carers. 

• To communicate highly sensitive information regarding diagnosis / life threatening pathologies to patients and carers using negotiating, reassurance and motivational skills to persuade patients and their families to undertake procedures where co-operation is required or procedure may cause discomfort.

• To provide expert advice to therapy services colleagues working in other clinical areas

• To provide advice to other health care professionals from other trusts.
• To represent the trust externally (locally, regionally, nationally and internationally) regarding therapy services provided to patients within the adult CF service.

• To deal with complaints in accordance with Trust Policy
• Patient/customer care (both direct and indirect)
• To provide a pivotal team leader role for physiotherapy services working in adult respiratory medicine.

• To undertake all aspects of clinical duties as an autonomous practitioner. To be professionally and legally responsible and accountable for all aspects of clinical work.

• To practice autonomously within the specialty of adult respiratory medicine as an expert clinician without direct clinical supervision, using expert knowledge and skills to determine the management indicated to  ensure the highest standard of clinical care.

• To demonstrate highly developed dexterity, co-ordination and palpatory senses for assessment and manual treatment of patients.

• To interpret and analyse clinical and non-clinical facts to form accurate diagnosis and prognoses in a wide range of highly complex conditions, and recommend the best course of intervention.

• To undertake the comprehensive assessment of patients, using investigative and analytical skills, and to form individualised management plans utilising a wide range or treatment skills and options to formulate a specialised programme of care. This may be in a variety of clinical areas including critical care and other high dependency areas, wards, outpatients, and clinics.

• To accept clinical responsibility for a caseload of patients, and to organise this effectively and efficiently with regard to clinical priorities and use of time. To designate appropriate caseloads to the physiotherapists within the Lung/Cystic Fibrosis team.

• To represent the Trust externally (locally, regionally, nationally and internationally) regarding therapy services provided to Respiratory Medicine patients.

• To be responsible for the evaluation of new equipment used by therapies for patients within the respiratory medicine care groups.

• To be involved, within the multi-disciplinary team, in the development of new techniques and approaches to patient management.

• To provide spontaneous and planned advice, teaching and instruction to relatives, carers, patients and other professionals to promote understanding of the aims of therapy, and to ensure a consistent approach to patient care.

• To make recommendations to medical staff regarding modifications/optimisations of non-invasive ventilator settings and oxygen therapy.

• To advise medical staff on medications required for selected patient groups and administer test doses and regular prescriptions of inhaled medication using the correct delivery system.

• To provide expert advice and teaching to colleagues working in other clinical areas regarding cardio-respiratory management.

• To communicate effectively and work collaboratively with medical, nursing, allied health professionals and other colleagues to ensure delivery of a coordinated multi-disciplinary service. This will include case conferences, ward rounds, discharge planning and joint working.
• To train, supervise performance and manage physiotherapy staff working within adult lung/ respiratory medicine services. This will include the use of formal appraisal documentation.
• To assess capacity, gain valid informed consent and have the ability to work within a legal framework with patients who lack capacity to consent to treatment.
• To carry a bleep and respond to emergency situations 
• To be actively involved in advance care planning with our patients
• To provide support for appropriate service delivery throughout the whole of respiratory medicine (for PT, OT and N&D) as demands require.

• To be able to work in a variety of locations including patients homes, out patients and clinics at the Royal Brompton. On occasions to work independently entering patients homes as a lone professional.

• To extend the role of physiotherapy within professional boundaries for example to be registered as an independent non-medical prescriber at the Trust.

Policy & Service development

• To regularly participate in working parties, as a specialty lead 

• To be involved in the development of relevant clinical guidelines, both locally and nationally for best practice.

• To ensure that designated staff implement policy and service development changes.

• Freedom to take action based on own interpretation of broad clinical/professional/ administrative policies.

• To demonstrate a good understanding of clinical governance and risk management and apply to work situations

• To be aware of Health and Safety aspects of your work and implement any policies which may be required to improve the safety of your work area; including prompt recording and reporting of incidents to senior staff and ensuring that equipment is safe.

Resource management

• To provide adequate staffing levels to the adult respiratory service including wards, clinics, day-case annual reviews, homecare and outpatients so patient needs can be met.

• To be responsible for providing profession specific information into any relevant documentation regarding adult CF/ lung patients.

People management

• To actively participate in the recruitment, retention and induction of staff to the Rehabilitation and Therapies Directorate, specifically to the adult CF and Lung therapy teams.

• To ensure all team members have a real voice in the development of the service to patients/customers.

• To maximise the potential of all team members.
• To ensure that all physiotherapy team members have a meaningful appraisal/personal development plan that includes feedback to the individual 

• To provide a safe and attractive working environment for team members within available resources.

• To attend and play a major role in clinical care groups e.g. adult CF services as a representative of the Rehabilitation & Therapies Directorate to provide communication links to those involved.

• To ensure appropriate competencies are completed by all physiotherapy staff working within the adult CF and lung teams.

• To abide by the Trust’s core behaviours for staff and all other Trust policies including standing financial instructions, research governance, clinical governance, patient and public involvement, codes and practices, and health and safety policies

Information management

• Maintain accurate and up to date documentation in line with legal and departmental requirements, and communicate assessment and treatment results to the appropriate disciplines in the form of reports and letters.

• Be actively involved in the collection of appropriate data and statistics including analysis to inform service development.

• Ensure the timely and accurate collection of therapy data on the RATAR computer activity system, ensuring all members of the physiotherapy team do so. 

• Research and development

To provide professional leadership and be involved in service developments and to carry out service review (e.g. audit) acting on findings to improve quality and care and produce new service initiatives.

• To publish own clinical research in peer reviewed papers

• To progress the adult respiratory medicine physiotherapy service by leading service developments and business planning in this area, liaising closely with the Lung/CF therapy lead, Associate Director and Director.

• To undertake and facilitate therapy staff in clinical research projects – to include study design, protocol formulation, data collection and analysis, writing up for presentation and publication, presentation at clinical meetings, and contributing to multidisciplinary research.

• Give research presentations at national and international meetings and ensure other members of the team are involved in research and audit and also have the opportunity to present.

• To assist in the organisation of the respiratory medicine (lung) therapy service in the absence of the Therapy Lead for adult services. 

• Together with the other senior physiotherapists, to assist in the organisation of the physiotherapy service in the absence of the Trust lead