Permanent Full-Time

                                                                              JOB DESCRIPTION
  
                       Clinical Specialist Physiotherapist – MSK Triage
                                                            Reference No. 11.037 (2022)
 
Details of Service

The “Care Redesign Fund” was made available as part of the National Service Plan 2020 to support the delivery of reform initiatives, identified through the Capacity and Access Joint Action Programme, that aim to move scheduled care closer to home, being more responsive to the needs and wishes of patients. It has been estimated that up to 60% of Orthopaedic and Rheumatology referrals could have been managed through an MSK physiotherapist service. This funding aims to enhance the existing MSK service in order meet this level of demand in the Acute setting and to develop Integrated Musculoskeletal (MSK) services through the establishment of community/primary care-based Musculoskeletal Interface clinics nationally.  This long-term aim will be achieved through service expansion and reconfiguration of the existing MSK services to develop an integrated pathway, predominantly based in the community/primary care setting

These clinics will be an extension of the existing MSK Triage Service, in the form of Outreach MSK Interface Clinics, and will also support physiotherapy services in Community/Primary Care for patients with MSK conditions. The Outreach MSK Interface Clinics will be the interface between Acute and Community/Primary Care service providers. The Clinics will comprise Clinical Specialist Physiotherapists, Orthopaedic and Rheumatology Consultants, and General Practitioners.  These clinics will undertake paper, Virtual and Face to Face triage of referrals to ensure patients are assigned to the optimum pathway of care for their referral. The Clinical Specialist Physiotherapists will work as a first contact practitioner at an advanced level in physiotherapy practice in line with competency level and scope of practice.

This model has proven effective in other countries for delivering safe, cost-effective alternatives and can be achieved in the Irish setting through outreach MSK Interface clinics, which will embed Consultant Governance and patient centred care.

Purpose of the Post

The purpose of this role is:
 
  • To provide advanced triage and physiotherapy services as part of the Sláinte Care Programme (https://assets.gov.ie/22607/31c6f981a4b847219d3d6615fc3e4163.pdf), to support service redesign initiatives aimed at delivering the safe transition of patient care between Acute & Community/Primary Care services, to facilitate the delivery of integrated care for patients with MSK conditions, and to ensure that patients receive appropriate care at the earliest possible time, as close to home as possible.
 
  • To contribute to the mainstreaming of the improved musculoskeletal pathways of care between Community/Primary Care and Acute services, through the establishment of multidisciplinary outreach MSK interface clinics.  
 
  • To work with orthopaedic and rheumatology consultants and GPs undertaking triage of musculoskeletal referrals to improve the pathway of care between Community/Primary Care and Acute services, thereby facilitating efficient access to orthopaedics, rheumatology, physiotherapy or other service as required.


Principal Duties and Responsibilities
The Clinical Specialist Physiotherapist holding this post is required to support the principle that the care of the patient comes first at all times and will approach their work with the flexibility and enthusiasm necessary to make this principle a reality for every patient to the greatest possible degree.

The Clinical Specialist Physiotherapist (Musculoskeletal Triage) will:

Professional Practice

Undertake MSK Triage (Paper, Virtual, Face to Face) with Orthopaedic and Rheumatology Consultant teams, and GPs, as necessary, to ensure that patients are placed on the most appropriate pathway of care at the earliest possible time.
 
  • Duties of Triage will require the Clinical Specialist Physiotherapist to:
    • Identify patients with red flag and/or suspicious symptoms and potential serious life threatening pathologies, and to adhere to relevant pathways of care, as agreed with relevant consultant and/or GP teams.   
    • Identify patients requiring further investigations/intervention and consult with relevant consultant and/or GP teams to arrange onward referral as necessary.
    • Follow up with further investigations and results, in line with the agreed pathway of care, and within Physiotherapy scope of practice.
    • Communicate the clinical decision/patient outcome following all consultations to the relevant referrer. 
    • Record patient clinical outcomes and return service data as required.
    • Review and update Standard Operating Procedures (SOPs) as necessary.
    • Achieve agreed KPIs as necessary to meet evolving National Outpatient Targets (e.g. Current New Patient KPI is 900 patients pa).
 
  • Work with Orthopaedic and Rheumatology Consultant teams, GPs, Acute and Community/Primary Care Physiotherapy Managers, Patients, Patient advocates, Implementation teams and other relevant stakeholders to establish outreach MSK Interface Clinics and develop Integrated Care Pathways for patients with MSK presentations.
 
  • Support the Physiotherapy managers in the Acute and Community/Primary Care settings to develop and deliver physiotherapy care pathway for patients with complex MSK complaints, in partnership with Community/Primary care colleagues.
 
  • Comply with the Physiotherapist Registration Board (PRB) at CORU, Code of Professional Conduct and Ethics, regarding all professional standards, including relevant Continuous Professional Development.
 
  • Observe confidentiality requirements: In the course of their employment the post holder will have access to information regarding the personal affairs of patients or staff. Such information is strictly confidential. Unless acting on the instruction of an authorised officer, on no account must information concerning patients, staff or health service business be divulged or discussed except in the performance of normal duty. In addition, records must never be left in such a manner that unauthorised persons can obtain access to them.  Records must be stored in safe custody when no longer in use.

Quality, Safety and Risk Management
 
  • Comply with the delivery of standards in the assessment, treatment and management of patients within his/her assigned area in line with international best practice guidelines.
  • Contribute to the development of, and comply with health and safety policies and procedures in the relevant clinical areas in Acute and Community/Primary Care Settings.
  • Lead, promote and ensure clinical effectiveness of musculoskeletal physiotherapy through performance management, education, audit and research.
  • Undertake Service Development activities regarding Service Evaluation and Quality Improvement Initiatives as required.
  • Develop service in line with requirements for advanced physiotherapy practitioner role.
  • Provide Advice and support regarding changes in work practices and procedures in the light of best practice developments in the field of musculoskeletal physiotherapy.
  • Advise the Physiotherapy Managers/Consultants in Orthopaedics and Rheumatology/GPs on the needs of the service.
  • Contribute to forward planning and development of Orthopaedic and Rheumatology MSK Clinical Pathways.
  • Work in line with agreed competency level in terms of triage and advanced practice role.
  • Be familiar with and uphold the policies and principles of the Safety Statement, HSE Risk Management and professional guidelines, across all relevant work settings.
  • Identify, assess and report any risk and contribute to the management and review of all risks.
  • Participate as required in Occupational Health and Safety training.
  • Document all accidents, incidents and potential hazards to patients or staff immediately and report them to the Physiotherapy Manager and Consultants in Orthopaedics and Rheumatology.
  • Have a working knowledge of the Health Information and Quality Authority (HIQA) Standards as they apply to the role for example, Standards for Healthcare, National Standards for the Prevention and Control of Healthcare Associated Infections, Hygiene Standards etc. and comply with associated HSE protocols for implementing and maintaining these standards.
  • Support, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.

Planning, Organisation and Risk Management
 
  • Work as part of the multidisciplinary team in the design, planning, organisation and delivery of triage musculoskeletal services, including the establishment of outreach MSK Interface Clinics.
  • Advise on waiting list validation in each organisation to determine the appropriate patients for triage clinics.
  • Deliver on key performance indicators in line with evolving KPIs and work targets.
  • Provide performance statistics and communicate these in line with deadlines for performance review.
  • Keep accurate written and/or electronic records on the assessment, treatment, outcome and other information relevant to patients.
  • Record, collate and submit statistics including key performance indicators for the programme within agreed timeframes.
  • Participate in relevant service and professional meetings.
  • Participate in relevant recruitment and selection, induction, staff development, and performance and review within the musculoskeletal service.
  • Develop and Attend outreach clinics in line with orthopaedic and rheumatology service provision to the HSE Network and Region.

Communication, Leadership and Team Work
  • Work as part of the multidisciplinary team.
  • Attend and contribute to multi-disciplinary meetings.
  • Lead and develop strong links with Orthopaedic and Rheumatology Consultants, GPs and Community/Primary Care physiotherapy colleagues, and liaise as necessary to support the safe transition of patient care across Acute & Community/Primary Care services, to facilitate the delivery of integrated care for patients with MSK conditions.
  • Ensure timely communication and collaboration with the Multi-disciplinary Team, and Physiotherapy Manager.
  • Build and maintain good relationships with relevant stakeholders.
  • Work collaboratively within the designated region with other MSK Physiotherapist Clinical Specialists.
  • Serve on and advise such committees as appropriate.

Education and Development
  • Initiate and participate in own continuous professional development and performance management with the Physiotherapy Manager and Consultants in Orthopaedics and Rheumatology.
  • Serve as a resource to contribute to the continuing professional development activities and education programmes of the physiotherapy, GP, Orthopaedic and Rheumatology services at Acute, community and regional levels, as appropriate.
  • Attend where possible relevant post graduate courses and lectures.
  • Co-operate in the provision of safe and productive clinical placements in accordance with the department’s commitment to clinical training programmes.
  • Agree and undertake appropriate training to provide advanced practice physiotherapy activities within the musculoskeletal pathway based on local service need, cognisant of Physiotherapy scope of practice and Legislation frameworks (eg injection therapy, real-time ultrasound etc).

The above Job Specification is not intended to be a comprehensive list of all duties involved and consequently, the post holder may be required to perform other duties as appropriate to the post which may be assigned to him/her from time to time and to contribute to the development of the post while in office.


ESSENTIAL CRITERIA:

Candidates must have at the latest date of application: 

Statutory Registration, Professional Qualifications, Experience, etc.
 
(a) Candidates for appointment must:
 
 
  (i) Hold a Physiotherapy qualification recognised by the Physiotherapists Registration Board at CORU.  Please see list of acceptable Physiotherapy qualifications:

https://coru.ie/files-registration/hse-list-of-physiotherapist-qualifications.pdf
 
 
    AND
 
 
  (ii) Be registered on the Physiotherapists Register maintained by the Physiotherapists Registration Board at CORU.   
    OR  
  (iii) Applicants who satisfy the conditions set out in Section 91 of the Health and Social Care Professionals Act 2005, (see note 1 below*), must submit proof of application for registration with the Physiotherapists Registration Board at CORU. The acceptable proof is correspondence from the Physiotherapists Registration Board at CORU confirming their application for registration as a Section 91 applicant.  
    AND  
  (iv) All candidates must have 5 years full time (or equivalent) years post qualification clinical experience of which 3 years full time (or equivalent) must be consecutive in specialism of musculoskeletal physiotherapy # (see details below).  
    AND  
  (v) All candidates must demonstrate a proven record of clinical excellence in the specialism.  
    AND
 
 
(b) Professional Development and Practice

All candidates must demonstrate evidence of continuing professional development relevant to the required area of specialism, in the form of post-graduate qualifications or relevant courses.
AND
All candidates must demonstrate achievement in the areas of clinical audit, quality improvement initiatives, practice development, teaching and research.
 
  AND
(c ) All candidates must have the requisite knowledge and ability (including a high standard of suitability, management, leadership and professional ability) for the proper discharge of the duties of the office.
 
 

Annual Registration
(i) On appointment practitioners must maintain annual registration on Physiotherapists Register maintained by the Physiotherapists Registration Board at CORU.
And
 
(ii) Practitioners must confirm annual registration with CORU to the HSE by way of the annual Patient Safety Assurance Certificate (PSAC).

Health
Candidates for and any person holding the office must be fully competent and capable of undertaking the duties attached to the office and be in a state of health such as would indicate a reasonable prospect of ability to render regular and efficient service.

Character
Candidates for and any person holding the office must be of good character.

*Note 1
Section 91 candidates are individuals who qualified before 30 September 2016 and have been engaged in the practice of the profession in the Republic of Ireland for a minimum of 2 years fulltime (or an aggregate of 2 years fulltime), between 30th September 2011 and 30th September 2016 are considered to be Section 91 applicants under the Health and Social Care Professionals Act 2005.

# Musculoskeletal physiotherapy experience can be acquired in orthopaedics rheumatology, plastics, hand therapy, occupational health, emergency department, Community/Primary Care or general musculoskeletal physiotherapy.  Experience in hospital in-patient, out patients, Community/Primary Care, secondary care and private practice settings are also reckonable.

DESIRABLE CRITERIA:
A completed post graduate MSc, specialised in the area of Musculoskeletal Physiotherapy
Previous experience in musculoskeletal triage
First contact experience in an acute hospital setting
Advanced Practice Physiotherapy training (e.g. radiology, bloods, ultrasound, APP specific courses)

Post Specific Requirements
Demonstrate depth and breadth of experience in musculoskeletal physiotherapy as relevant to the role.

Demonstrate depth and breadth of experience in the areas of clinical audit, quality improvement initiatives, practice development, teaching and research.

Demonstrate depth and breadth of experience in continuous professional development relevant to the required area of specialism.

Other requirements specific to the post
Access to appropriate transport to fulfil the requirements of the role, as the post will involve travel.

Skills, competencies and/or knowledge

The successful candidate will be required to demonstrate competency in line with the Therapy Projects Office Competency Framework for Clinical Specialist 2008, and including:

Professional Knowledge
  • Demonstrate evidence of advanced clinical experience, knowledge reasoning and skills in the assessment, planning, implementation, evaluation and modification of treatment programmes for service users in musculoskeletal physiotherapy.
  • Demonstrate evidence of experience in differential diagnosis and in keeping with current evidence based practice.
  • Demonstrate evidence of dissemination of advanced ethical awareness and responsibilities in the areas of extended scope physiotherapy.
  • Demonstrate evidence of a critical understanding of the context in which practice occurs for example social, political and inter-professional collaboration.
  • Demonstrate evidence of knowledge and application of risk management processes.
  • Demonstrate evidence of application of clinical standards, guidelines and procedures.
  • Demonstrate evidence of IT skills to enable service and statistical analysis, health care records documentation, report writing and email communication.
  • Demonstrate evidence of appropriate documentation in line with HSE standards for Health Care Records.
  • Demonstrate evidence of identifying and availing of formal and informal learning opportunities including:
  • Evidence of education in advanced clinical reasoning in musculoskeletal conditions.
  • Evidence of delivering an educational role.
  • Demonstrate a commitment to continuing professional development.
  • Demonstrate a willingness to develop IT skills and provide innovative and blended methods of care delivery (eg Telehealth) as appropriate to service and patient needs.

Evaluating Information & Judging Situations
  • Demonstrate evidence of appropriate referral of decisions to a higher level of authority or inclusion of colleagues in the decision making process
  • Demonstrate evidence of collecting, evaluation and reporting data on therapy outcomes for service users.
  • Demonstrate evidence of use of evidence based practice through clinical reasoning and decision making, applying evidence based outcome measures to evaluate efficacy of treatment and quality of care.

Commitment to Providing a Quality Service
  • Demonstrate evidence of clinical leadership in the development of new service initiatives in collaboration with line manager and other appropriate stakeholders
  • Demonstrate evidence of application of research, audit and resulting change and/or quality initiatives
  • Demonstrate a commitment to assuring high standards and strive for a user centred service.
  • Display evidence of knowledge and application of risk management processes
  • Display awareness and appreciation of the service users and the ability to empathise with and treat others with dignity and respect.
  • Demonstrate initiative, flexibility and openness to change.

Planning and Managing Resources
  • Demonstrate evidence of appropriate planning and balancing of clinical demands with other responsibilities through effective time management and organisation skills
  • Demonstrate evidence of appropriate delegation of tasks within the clinical area

Communication & Interpersonal Skills
  • Demonstrate evidence of experience in communication skills, oral and written in clear, concise and well-structured manner in multidisciplinary team working appropriate to the content and target audience
  • Demonstrate evidence of negotiating clearly and constructively with relevant stakeholders.
  • Managing and Developing (Self & Others)
  • Demonstrate evidence of team skills and leadership of clinical practice within the multidisciplinary team.
  • Demonstrate evidence of multidisciplinary working in the designated clinical area
  • Demonstrate an ability to manage and develop self and others in a busy working environment.
  • Demonstrate ability to utilise supervision effectively

Particulars of Office:
The initial vacancy for this posts is permanent and whole-time.   The post is pensionable.
A panel may be created from which permanent and specified purpose vacancies of full or part time duration may be filled.

Remuneration
Remuneration is in accordance with the Department of Health Consolidated Salary Scales, grade code 3707.

Hours of work
Normal working hours are 35 hours per week worked over 5 days spread.
You will be required to work the agreed roster/on-call arrangements advised to you by your line manager.  Your rostered hours of work are liable to change between the hours of 8 am to 8 pm over 5 days to meet the requirements for the extended day.

Annual Leave
The annual leave entitlement is 29 working days per year. The leave year runs from 1st April to the 31st of March each year.

GENERAL
Applications can be submitted ‘on-line’ at www.tuh.ie/careers by completing the application form and attaching your CV.

Candidates should be aware that, when applying for a post through the 'On-Line' Application System (Candidate Manager) they will receive an automated replying acknowledging receipt of their application.  Should you for any reason, not receive this automated acknowledgement, you should notify the Human Resources Department, before the closing date, otherwise your application will not be considered

Closing Date: Before close of business on: Friday 2nd December 2022

Informal enquiries to
Elaine Barker, Physiotherapist Manager-in-Charge III
Tallaght University Hospital, Tallaght, Dublin 24.
Email: Elaine.Barker@tuh.ie
Phone: (01) 4142756

All candidates should note that, in order to maintain a timely process, the closing date and time for receipt of applications will be strictly adhered to

Please note that you must also complete a Work History Form which must be submitted online as one document with your CV. Please request the Work History Form by e-mailing elaine.barker@tuh.ie

For a full copy of the job description, please contact elaine.barker@tuh.ie