Trainee/ Advanced Physiotherapy Practitioner - Pain Management

Detailed job description and main responsibilities

ADVANCED CLINICAL PRACTICE:   

To be a clinical leader in the area of expertise, demonstrating advanced knowledge and skills in pain science, neuroscience education and biopsychosocial interventions with patients and carers.   

Takes professional responsibility as an APP, with high-level decision-making and clinical-reasoning skills to assess, diagnose and triage patients complex 
presentations.   

Manages a complex caseload (including patients with long-term conditions, comorbidities and multi-factorial needs) with supervision/mentoring as required.   

Gather and synthesise information on the nature of the individual’s presenting symptoms taking account of how these relate to relevant past medical history and investigations and psychosocial factors.   

Critically appraise findings – recognising that imaging/ structural changes correlate with pain symptom; distinguish pain arising from tissue injury from pain driven by nerve sensitisation, central mechanisms or psychological factors. Identify features of serious spinal pathology, Cauda Equina Syndrome, systematic disease or red flag conditions and implement appropriate urgent or specialist referral.    

Use interactions as an opportunity to provide pain education and encourage changes in behaviour that can have a positive impact on the health and wellbeing of individuals, communities and populations e.g. increasing physical activity, weight management and smoking cessation applying the principles of MECC.   

Request appropriate investigations based on their level of competence and interpret the findings to facilitate diagnosis and management plans of patients.   

Advise, initiate, evaluate and modify a range of interventions, which may include selfmanagement and lifestyle advice, injection therapy, other therapies, exercise prescription, social and independent prescribing (Prescribing or de-prescribing medications within their scope of practice and competency for patients in their care, following assessment of need and in line with locally agreed guidelines and formularies)  

Advise on the expected benefits and limitations of different rehabilitative 
interventions used in managing specific chronic pain conditions, providing impartial information and advice on the advantages and disadvantages of specific interventions in the context of other management options.   

Promote the importance of physical activity (e.g. continuing work/exercise participation) for physical health and advise on what people with chronic pain conditions can and should do.   

Work in partnership with individuals to explore suitability of pain procedures, interventions or surgical opinion, addressing and seeking to allay individuals’ fears, beliefs, and concerns, seeking guidance when appropriate.   

Refer for surgical opinion when appropriate, taking into consideration patients individual needs and wishes and with regard to patient’s general health status and criteria stipulated in national NICE guidance and local CCG criteria-based access and prior approval policies.   

Record the information gathered through taking individuals’ history concisely and accurately for clinical management, and in compliance with local protocols, legal and professional requirements.   

LEADERSHIP AND MANAGEMENT:   

Develop and implement robust governance systems specifically for pain service delivery assuring safe quality standards of practice for service users.   

Ensure that practice is carried out in accordance with professional rules of conduct, professional standards, departmental and Trust policies, national policies and guidelines and statute.   

Lead new practice and service redesign solutions in response to feedback, evaluation and need.   

Act as a clinical role model, educator, coach and mentor building pain capability across the workforce.    

Develop and initiate systems to collect feedback and involvement from individuals, families, carers, communities and colleagues to assure and improve the quality of care and service delivery.   

Lead on the monitoring of complaints, incidents, and patient/service user outcomes and feedback.   

Demonstrate receptiveness to challenge and preparedness to constructively challenge others, dealing with concerns that affect individual patients, colleagues and overall service safety and quality.   

To lead the development of relevant policies and clinical protocols and be 
responsible for policy implementation and service development for pain 
management services.   

Negotiate a personal and individual scope of practice for staff to operate within legal, ethical, professional and organisational policies, governance and procedures, with a focus on managing risk and upholding safety.   

Demonstrates an awareness of their own limitations and through this, recognise the parameters of their scope of practice.  

Represents the pain service on relevant committees and meetings, as a lead physiotherapy clinician, provide input in relation to specialist issues and clinical matters as required.  

Provide annual individual performance review for staff to critically assess and address learning needs, negotiating a personal development plan that reflects the breadth of ongoing professional development necessary for the role.  

Act as an advocate for and contribute to a culture of organisational learning to inspire and develop future and existing staff.  

EDUCATION, LEARNING AND DEVELOPMENT:   

Lead on the development and delivery of an education programme for primary care staff focusing on the biopsychosocial assessment and appropriate first line management of chronic pain conditions to promote more efficient and effective use of services and resources.   

Develop a strategy for training of the physiotherapy staff building specialist pain knowledge and skills for succession planning, creating a sustainable workforce within the organisation.   

Provide professional clinical leadership through actively engaging in peer review to inform own and other’s practice, formulating and implementing strategies to act on learning and make improvements.   

To maintain own continuing professional development (CPD) by engaging in selfdirected learning, using a process of critical reflection to identify learning needs to maximise clinical skills and knowledge. Specifically in areas including pain science, pharmacology, psychology and advanced clinical practice.   

Maintain a portfolio of evidence or work-based learning showing how you meet all the required capabilities for working in this role e.g. completion of NHSE e learning modules.   

Take a lead role in implementing a competency and capability framework, inspiring the wider team to develop competencies and capabilities through provision of work based and inter-professional learning opportunities.   

As a clinical leader and educator, designs, develops and delivers programmes of specialised learning in line with evidence-based practice to peers, junior staff and the wider MDT. 

As the Pain Management Service sits alongside other Services within an integrated model (MSK, Physiotherapy and Rheumatology Service) you will be expected to acknowledge the importance of close working relationships to assist the optimum patient pathway and provide support to colleagues within these Services for advice and education on the treatment of persistent pain patients.  

The position if full time however we are happy to consider all applications, and would consider flexible working patterns to meet both individual and service needs. Our staff are warm, friendly, supportive and dedicated professionals who will make you 
feel very welcome.  

RESEARCH, AUDIT AND SERVICE EVALUATION:   

To evaluate the quality of service provided by leading an annual programme of clinical audit, service evaluation and research activities, selecting and applying valid, reliable methods, then acting on the findings.  

Critically appraise and synthesise the outcome of relevant research, evaluation and audit, using the results to underpin own practice and to inform that of others.   

To analyse and interpret referral and clinical data related to the service in order to inform and advise managers on future developments.   

To evaluate the local service against national and/or local standards and benchmarks.   

Demonstrates ability to generate evidence suitable for presentation at local level.   

To establish education and research partnerships with higher education institutes as appropriate in relation to identifying gaps in the evidence base and potential research opportunities.