An audit of the utilization of physiotherapy assistants in the musculoskeletal outpatients setting within a primary care physiotherapy service

• Published in: Musculoskeletal care 2018-09, Vol.16 (3), p.405-408
• Main Authors: Sarigiovannis, Panos, Cropper, Steve
• Format: Article
• Language: English
• Subjects: Adult; Ambulatory Care - organization & administration; Chiropractic medicine; Community health care; delegation; Female; Humans; Job Description; Job descriptions; Job satisfaction; Male; Medical Audit; Musculoskeletal Diseases - physiopathology; Musculoskeletal Diseases - rehabilitation; Needs Assessment; Outpatients - statistics & numerical data; Physical Therapist Assistants - statistics & numerical data; physiotherapy assistants; Primary Health Care - organization & administration; Professional Competence; Professional Role; skill mix; United Kingdom; Workforce - organization & administration
• ISSN: 1478-2189; 1557-0681
• DOI: 10.1002/msc.1238

Background Physiotherapy assistants account for approximately 20% of the physiotherapy workforce across a community health service in North Staffordshire. Although their job descriptions state that the post is primarily clinical, their role depends heavily on the qualified physiotherapists and how they utilize their clinical skills. Methods An audit of the physiotherapy assistants’ tasks was carried out to reveal whether the physiotherapy assistants’ time spent on clinical tasks complied with their job descriptions. Using the audit improvement cycle, pathway mapping of specific anatomical areas was performed to identify which parts of treatment can be carried out by physiotherapy assistants, clarify the physiotherapy assistants’ clinical role and standardize treatments. A competences and training needs analysis was completed and physiotherapy assistants were trained before the pathways were implemented. Finally, the physiotherapy assistants’ practice was re‐audited and job satisfaction questionnaires were redistributed after the pathways were implemented. Results The results showed that, following the implementation of the pathways, the amount of working time that physiotherapy assistants spent treating patients increased from 9% to 16%. Their job satisfaction changed from 11% prior to the implementation of the pathways to 100% post‐implementation. Conclusions Using defined pathways in the treatment of musculoskeletal conditions of the peripheral joints provides the framework to standardize delegation of clinical tasks from qualified physiotherapists to physiotherapy assistants. However, the utilization of such pathways needs to be examined further, to clarify the clinical and cost effectiveness of delegating clinical work to physiotherapy assistants, and also the perceptions of qualified physiotherapists.