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== Clinical Specialist ==
== Clinical Specialist ==
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== Advanced Practitioner
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== Advanced Practitioner ==
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It was during the Vietnam War that advanced practise roles for physiotherapists first emerged in the United States, and for around 20 years have been part of the national health framework for allied health professionals in the United Kingdom.
== Extended Scope Practitioner ==
== Extended Scope Practitioner ==
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Consultant Physiotherapists go beyond the boundaries of the profession, providing leadership and strategic vision through four main domains<ref name="Vits 2010">VITS, K.M., 2010. Consultant Physiotherapist: a career goal achieved. ACPWH Conference 2009. Journal of the Association of Chartered Physiotherapists in Women’s Health [online]. vol. 106, pp. 25-29 [viewed 01 October 2015]. Available from: http://pogp.csp.org.uk/group-journal/acpwh-journal-106-spring-2010/consultant-physiotherapist-career-goal-achieved</ref>: expert and clinical practice, education and clinical development, professional leadership and consultancy, and research evaluation of practice and service development. These areas were envisaged as being fundamental in the development of an allround professional, providing post-holders with opportunities to develop their career pathways, impacting clinical protocols and service provision. It was viewed that these consultants could operate as primary practitioners, shifting care from hospitals into the primary care setting helping to cut waiting times<ref name="Clews 2007">CLEWS, G., 2007. View from THE TOP. The Chartered Society of Physiotherapy [online]. September, vol. 15, no.16 [viewed 01 October 2015]. Available from: http://www.csp.org.uk/frontline/article/view-top</ref>.
Consultant Physiotherapists go beyond the boundaries of the profession, providing leadership and strategic vision through four main domains<ref name="Vits 2010">VITS, K.M., 2010. Consultant Physiotherapist: a career goal achieved. ACPWH Conference 2009. Journal of the Association of Chartered Physiotherapists in Women’s Health [online]. vol. 106, pp. 25-29 [viewed 01 October 2015]. Available from: http://pogp.csp.org.uk/group-journal/acpwh-journal-106-spring-2010/consultant-physiotherapist-career-goal-achieved</ref>: expert and clinical practice, education and clinical development, professional leadership and consultancy, and research evaluation of practice and service development. These areas were envisaged as being fundamental in the development of an allround professional, providing post-holders with opportunities to develop their career pathways, impacting clinical protocols and service provision. It was viewed that these consultants could operate as primary practitioners, shifting care from hospitals into the primary care setting helping to cut waiting times<ref name="Clews 2007">CLEWS, G., 2007. View from THE TOP. The Chartered Society of Physiotherapy [online]. September, vol. 15, no.16 [viewed 01 October 2015]. Available from: http://www.csp.org.uk/frontline/article/view-top</ref>.
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Challenging The Department of Health’s 2001 target of 250 new consultant allied health professional (AHP) posts by 2004 was the lack of allocation of appropriate funding to support these new posts. In 2009 it was calculated that approximately 123 consultant AHP posts were occupied nationwide, 64 of which were thought to be registered consultant physiotherapists, the largest of all AHPs<ref name="Vits 2010" />. The distribution of consultant physiotherapists to this point is dominated by the musculoskeletal speciality with 29 consultants in this area registered in 2009<ref name="Vits 2010" />. Consultant physiotherapists are usually salaried equivalent to a grade 8a-d on approximately £35,232 to £73, 281 (2006 rates).
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Challenging The Department of Health’s 2001 target of 250 new consultant allied health professional (AHP) posts by 2004 was the lack of allocation of appropriate funding to support these new posts. In 2009 it was calculated that approximately 123 consultant AHP posts were occupied nationwide, 64 of which were thought to be registered consultant physiotherapists, the largest of all AHPs<ref name="Vits 2010" />. The distribution of consultant physiotherapists to this point is dominated by the musculoskeletal speciality with 29 consultants in this area registered in 2009<ref name="Vits 2010" />. Consultant physiotherapists are usually salaried equivalent to a grade 8a-d on approximately £35,232 to £73, 281 (2006 rates).
=== How to get there and some examples ===
=== How to get there and some examples ===
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=== The effectiveness of the role ===
=== The effectiveness of the role ===
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The effectiveness of consultant posts in clinical practice and patient care was studied by Guest et al. in 2004<ref name="Guest et al. 2004">GUEST, D.E., PECCEI, R., ROSENTHAL, P., ET AL., 2004. An evaluation of the impact of nurse, midwife and health visitor consultants.[online] [viewed 02 October 2015]. Available from: http://www.kcl.ac.uk/contents/1/c6/o1/69/94/NCFFullReport.pdf</ref>. They explored leadership and how current consultants modify and craft the role in order to remain motivated and committed. It was found that consultant practitioners tend to adjust how they spend their time, with evidence of least time being spent in actual clinical practice. Reasons for these differences are likely to be because prior to taking up the consultant post, clinical practice had been their main priority. Most of the consultants analysed by Guest et al.<ref name="Guest et al. 2004" /> described their jobs as busy but satisfying and believed they were having a positive impact on patient care. Despite this, budgets inclusive of this post are being reduced across NHS boards and without succession planning; it is likely that the consultant post will disappear as the NHS evolves to accommodate changing patient needs<ref name="Vits 2010" />.
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The effectiveness of consultant posts in clinical practice and patient care was studied by Guest et al. in 2004<ref name="Guest et al. 2004">GUEST, D.E., PECCEI, R., ROSENTHAL, P., ET AL., 2004. An evaluation of the impact of nurse, midwife and health visitor consultants.[online] [viewed 02 October 2015]. Available from: http://www.kcl.ac.uk/contents/1/c6/o1/69/94/NCFFullReport.pdf</ref>. They explored leadership and how current consultants modify and craft the role in order to remain motivated and committed. It was found that consultant practitioners tend to adjust how they spend their time, with evidence of least time being spent in actual clinical practice. Reasons for these differences are likely to be because prior to taking up the consultant post, clinical practice had been their main priority. Most of the consultants analysed by Guest et al.<ref name="Guest et al. 2004" /> described their jobs as busy but satisfying and believed they were having a positive impact on patient care. Despite this, budgets inclusive of this post are being reduced across NHS boards and without succession planning; it is likely that the consultant post will disappear as the NHS evolves to accommodate changing patient needs<ref name="Vits 2010" />.
= [[Image:Development.jpg|left|230x87px]]Workforce Development[[Image:Development.jpg|right|230x87px]] =
= [[Image:Development.jpg|left|230x87px]]Workforce Development[[Image:Development.jpg|right|230x87px]] =
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Youtube Video – NHS Wales – advanced MSK physiotherapists <ref name="WALES YOUTUBE">LIVING HEALTHIER - STAYING WELL., 2015. Advanced MSK physiotherapists. [Online]. Accessed 12 November 2015]. Available from: https://www.youtube.com/watch?v=lOT59BgW0oo</ref>
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Youtube Video – NHS Wales – advanced MSK physiotherapists <ref name="WALES YOUTUBE">LIVING HEALTHIER - STAYING WELL., 2015. Advanced MSK physiotherapists. [Online]. Accessed 12 November 2015]. Available from: https://www.youtube.com/watch?v=lOT59BgW0oo</ref>
=== Training/ Qualifications ===
=== Training/ Qualifications ===
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= Prescribing =
= Prescribing =
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== Description ==
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After campaigning for ten years the bill was passed in favour of the chartered society of physiotherapy
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allow for independently prescribe medicine in the United Kingdom (UK) in August 2013
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<a href="http://www.bbc.co.uk/news/health-18955680">BBC News Article: Prescription Powers</a>
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== Cost Effectiveness ==
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== Training/ Qualifications ==
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== Evidence
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== Challenges ==
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== [[Image:Assessment
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A significant amount of research funded by the department of health was conducted by the Universities of Surrey and Brighton to examine the practicality of independent prescribing for physiotherapists before the bill was passed. Professor Ann Moore, professor and director of clinical research at the University of Brighton and who was a study team member makes this a comparison to the scenario where physiotherapists were pushing to allow self referral to the service.
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The legislation was passed at different times around the United Kingdom with England being the first in August 2013, Scotland next in May 2014, next Northern Ireland in 2014 and Wales to Follow in September 2014.
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This landmark decision ‘will hugely improve the care we can provide to our patients’ said CSP chair Dr Helena Johnson.
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Currently statistics from the HCPC illustrate that there are 94 physiotherapists across the UK who are registered as independent prescribers.
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Physiotherapists as part of the multidisciplinary team, play a key role in ensuring holistic care in the management of illnesses to ensure a high standard of care. ‘By introducing these changes, we aim to make the best use of their skills and allow patients to benefit from a faster and more effective service’ says Earl Howe, Department of Health’s under secretary for quality.
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{{#ev:youtube|f42j46PD35Y}}
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== Description ==
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<a href="http://www.bbc.co.uk/news/health-18955680">BBC News Article: Prescription Powers</a>
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== Cost Effectiveness ==
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== Training/ Qualifications ==
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== Evidence to support ==
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== Challenges ==
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== [[Image:Assessment.jpg|left|200x200px]]Self assessment questions ==
= Injection Therapy =
= Injection Therapy =