AGENDA FOR CHANGE
                                     NHS JOB EVALUATION SCHEME

                                              JOB DESCRIPTION


Job Title:                     Junior Physiotherapist Band 5

Reports to:                    Senior Physiotherapist in charge of the Unit the
                               postholder is working in

Accountable to:                Team Leader and Professional Advisor Physiotherapy

Department, Ward or Section: Physiotherapy Department

CHP, Directorate or Corporate Department: Mid Highland CHP

Job Reference:                 MDRCWNCOMMPHYS01 MDRCWNHOSPPHYS01

No of Job Holders:
Last Update:                   6 May 2010.


     To provide an efficient and effective Physiotherapy Service, to patients located at County Community Hospital
     Invergordon Ross Memorial Hospital, Dingwall ,Care of the Elderly & Rehabilitation Physiotherapy. OPD, &
     Rheumatology Units in Ross and Cromarty

     To provide a high standard of Physiotherapy, consistent with both local and national standards

     Currently the Physiotherapy service in NHS Highland is undergoing a review, which may result in some
     changes. This may result in the Band 5 post being amended. E.g. Including rotational roles to other areas.

Physiotherapy in the primary care sector of NHS Highland is currently divided into 3 CHP’s and 9
operational units these being, Nairn Ardersier, Badenoch and Strathspey, Ross and Cromarty ,
Lochaber, Skye and Wester Ross, Caithness, Sutherland, and Inverness. Mental health and Children’s
The specialist service unit is based at Raigmore Hospital Inverness

Local population of approximately 59.000 in Ross and Cromarty West Ness area.

The staff include:
 I x Band 8a Professional Advisor Physiotherapy.
2 x Band 7 Clinical Specialist Rheumatology /Orthopaedic Triage ,
1 x Band 7 Team Leader Care of the Elderly /Rehabilitation.
10 x Band 6 Senior physiotherapists working in Diverse areas.
1 x Band 6 Senior physiotherapist (rotational post from SSU),
2 x Band 5 Junior Physiotherapists.
4 xTechnical Instructors,
1 x Assistant
2 x Clerical Assistants.

Physiotherapy services are provided in 2 Community Hospitals and 11 designated
G P practices:

County Community Hospital Invergordon,
32 bedded general ward
Day hospital accommodating 6 patients per day
Out-patient department
Rehabilitation team for the Augmented Care at home service.

Ross Memorial Hospital:
Specialist Highland Rheumatology Unit, 14 bedded unit and physiotherapy department, providing a
Highland wide facility.
General ward with 14 beds
Hydrotherapy Unit, for In-patient rheumatology and Out-patients for Ross and Cromarty/West Ness
Out Patient physiotherapy Department

11 Designated GP practices.
The physiotherapists run clinics at GP practices or health centres as part of the practice based

To provide a comprehensive range of in-patient, out-patient and community physiotherapy services.

Chartered Physiotherapists use their expertise and skills in assessment, movement, exercise, electrotherapy,
facilitation techniques and manipulation to effectively treat, rehabilitate and advise clients with a wide range of
health problems. They work with people of all ages who have lost some degree of movement or ability through
injury, surgery, pathological change or illness. Ultimately, the aim of Physiotherapy is to help patients resume as
active and independent a lifestyle as possible through individual intervention or as part of a multidisciplinary team.
It is the objective of all Physiotherapy staff in Mid Highland CHP to provide the highest quality of patient care
possible. As part of an on-going Physiotherapy departmental quality assurance programme, staff are actively
involved in setting, maintaining and improving standards. This is primarily aimed at:

    1. Improving the range and quality of services available.
    2. Ensuring patient needs are best met.

The Physiotherapy Department also supports undergraduate training and professional development of BSc and
 MSc Physiotherapy students.

The Physiotherapists in this locality work as part of Community Integrated Teams or part of Hospital Teams.


   To provide effective and efficient Physiotherapy Services for patients located within Ross Cromarty and West
    Ness, OP departments, GP practices, HRU and care of the elderly/rehabilitation service at CCHI and RMH.
    Musculoskeletal Outpatients, Women’s Health including Ante Natal Care classes in conjunction with the

   To organise follow up physiotherapy out patients services on patient discharge/transfer, where appropriate.

   To be able to perform physiotherapeutic assessment to patients with diverse presentations and multi-
    pathologies and use developing clinical reasoning skills and manual assessment techniques to provide an
    accurate diagnosis of their condition, in the majority of cases.

   To interpret and analyse clinical and non-clinical facts to form a diagnosis in a wide variety of conditions e.g.
    musculoskeletal, respiratory, neurological, surgical, cardiovascular problems. To recommend the best course
    of intervention and to develop comprehensive treatment plans. To assist the multidisciplinary team in making
    appropriate decisions regarding appropriate treatment and management of the patients conditions.

   To undertake comprehensive assessment of patients using investigative and analytical skills to formulate
    individualised management and treatment plans, using developing clinical reasoning and utilising a variety of
    treatment skills and options to formulate a specialised programme of care.

   To demonstrate developing palpatory skills for assessment and treatment using manual handling techniques
    and therapeutic handling.

   On a daily basis provide spontaneous and planned advice, teaching and instruction to patients and other
    professionals to promote understanding of the aims of physiotherapy and to ensure a consistent approach to
    patient care.
   To demonstrate developing palpatory skills for assessment and treatment using manual handling techniques
    and therapeutic handling.

   On a daily basis provide spontaneous and planned advice, teaching and instruction to patients and other
    professionals to promote understanding of the aims of physiotherapy and to ensure a consistent approach to
    patient care.

   To be responsible for assessment and management of clinical risk within own caseload and to observe the
    Health and Safety at Work Act at all times by bringing defects of equipment to the notice of the appropriate
    authorities and reporting any accidents to staff or patients appropriately and as soon as possible.

   To be professionally and legally responsible and accountable for all aspects of own work including the
    management of patients. To ensure a high standard of clinical care for patients and to assist colleagues less
    experienced and/or Physiotherapy Assistants to do likewise.

   To maintain accurate, comprehensive and up-to-date documentation in line with legal, Chartered Society of
    Physiotherapy (CSP) and Departmental requirements, and communicate assessment and treatment results to
    the appropriate disciplines in the form of reports and letters and to assist colleagues less experienced and/or
    Physiotherapy Assistants to do likewise.

   To communicate effectively and work collaboratively with medical, nursing, AHPs and other colleagues to
    ensure delivery of a co-ordinated multidisciplinary service and to attend ward rounds, case conferences and/or
    team meetings, as required.

   To be able to communicate effectively with patients to gain valid consent to treatment and to agree expected
    treatment outcomes. Assess patient’s understanding of treatment proposals and have the capacity to work
    within a legal framework with patients who lack capacity to consent to treatment.

   To be able to motivate patients to comply with treatment programmes when they may be reluctant, frightened
    or in pain.

   To be able to demonstrate the ability to communicate sensitively to patients which may include asking about
    confidential domestic or health issues. To communicate information regarding Physiotherapy treatment
    programmes in an understandable form to patients.
   To respond efficiently to unplanned events (e.g. staff shortages), which may require a change to work

   To maintain own clinical professional development (CPD) by keeping abreast of new research evidence and
    developments and incorporate them, as appropriate, into care programmes and maintain a portfolio which
    reflects personal development.

   Maintain and develop current knowledge of evidence-based practice, developing specialist knowledge of
    particular conditions and patient types (relevant to each rotational placement) and to seek advice from Senior
    Physiotherapy colleagues, as required.

   To undertake measurement and evaluation of your work and current practices through the use of Evidence
    Based Practice (EBP) projects, audit and outcome measures either individually or with clinical lead or line

   To be actively involved in the collection of appropriate data and statistics for the use of the department on a
    daily basis.

   To provide support, guidance, clinical education and training to Physiotherapy Assistants, where appropriate.

   To keep up to date with recent developments in clinical practice by attending and presenting at
    departmental/internal training sessions, by attending external post graduate training course and by engaging in
    reflective practice.

   To be responsible for keeping up to date with mandatory training, i.e. Basic Life Support, Manual Handling, Fire
    Lectures, Hydrotherapy Evacuation, Violence and Aggression and On-call training.

   To participate in the staff appraisal scheme and Personal Development Plan (PDP) and be responsible for
    complying with agreed personal development programmes to meet set knowledge and competencies.

   To work within NHS Highland clinical guidelines and CSP guidelines and to have a developing working
    knowledge of national and local standards and maintain own quality of practice.

   To comply with NHS Highland and Departmental policies and procedures and to maintain the strictest levels of
    confidentiality at all times.


   To be responsible for organising and planning own caseload, to meet patient priorities and service needs.
    Regularly readjust plans as situations change/arise.

   To assist with the supervision of Physiotherapy Assistants, in the absence of Senior colleagues, including the
    delegation of appropriate tasks to Physiotherapy Assistants.

   Ensure that own practice and that of staff under supervision meet the required professional standards of
    physiotherapy practice.

   To be responsible for equipment used in carrying out physiotherapy duties and to adhere to departmental
    policy, including competence to use equipment and, where appropriate, to ensure the safe use of equipment by
    others through teaching, training and supervision of practice.

   To be actively involved in the collection of appropriate data and statistics for the use of the department.

   To be responsible for Health and Safety at Work and its implications for safe practice and environments within
    a designated area, including prompt reporting of accidents to senior staff, and recording on appropriate


    Therapeutic use of the following items of equipment requires a very thorough knowledge of anatomy,
    physiology, pathology, kinesiology, indications and contraindications as well as each individual patient’s
    presenting symptoms, concurrent treatment, previous response to treatment, drug treatment and medical

    Type of equipment used and frequency of use will be dictated by the speciality the postholder is working in and
    patient needs within that specialist area.

    1. Ultrasound treatment units– treatment of soft tissue inflammatory disorders – frequently (HRU,Physio
    2. Shortwave therapy units – treatment of musculoskeletal inflammatory disorders- frequently (HRU,Physio
    3. Interferential therapy units – management of musculoskeletal pain, muscle stimulation/strengthening –
       frequently (HRU,Physio OPD).
    4. Transcutaneous electrical stimulation units – management of musculoskeletal pain – frequently (HRU
       Physio OPD).
    5. Ice therapy – to reduce swelling and inflammation – frequently (HRU, Wards, Physio OPD).
    6. Heat Pack – to reduce muscle spasm and pain – occasionally (HRU,Wards, Physio OPD).
    7. Electromyographic biofeedback units – assessment, monitoring and rehabilitation of muscular
        recruitment/motor unit function in musculoskeletal disorder – frequently (Physio OPD)
    8. Mechanical traction tables – traction treatment of cervical and lumbar spinal pathology – occasionally
        (Physio OPD).
    9. Halter traction kits – traction treatment of cervical and lumbar spinal pathology – occasionally (Physio
    10. Manual therapy belt – application of mobilisation forces/counterforces in the manual mobilisation of
        stiff/painful motion segments – frequently (Physio OPD).
    11. Walking aids (Auxiliary crutches, elbow crutches, gutter crutches, Zimmer walking aids, Arjo walker, K-
        walker, gait trainers, rollator frames, delta frames, uniscan frames, tripod sticks, bariatric walking aid,
        walking sticks, Fischer walking sticks) – selection, adjustment, issue and instruction of appropriate walking
        aid – frequently (Wards & Physio OPD).
    12. Hoists – Standing hoist), tracking hoists, lifting hoists, Hydrotherapy hoists – occasionally (Wards).
    13. Manual Handling Equipment – Slide sheets, pat slides, beds, trolleys, porter chairs – frequently (Wards).
    14. Rehabilitation Standing Aids – Standing frames (various models), tilt table, James hoist – occasionally
    15. Wheelchairs – aware of how to correctly position patient in chair – frequently (Wards).
    16. Wood saw/metal pipe cutter and vice – for sizing of walking aids – frequently (Wards & Physio OPD).
    17. Exercise equipment –
              a. Small Gym Equipment: Theraband, gym balls, wobble boards, sit-fits, pedals,
                  Steps, balls, therapeutic hand equipment, sliding boards, slings, pulleys, force plate - frequently.

            b. Large Gym Equipment: Parallel bars, stairs, static bicycles, moto-med, wallbars
               -rehabilitation/exercise in the management of musculoskeletal pathology – frequently.

    18. Transfer equipment – Sam Hall turner, transfer boards, turning disks, transfer blocks – increase patients
        independence during transfers and activities of daily living – frequently (Rehabilitation and General Wards).
    19. Hydrotherapy Pool and associated equipment – to encourage weight bearing, reduce swelling, increase
        mobility, increase joint range of movement, increase muscle power, reduce pain, increase function and
        increase patient independence – occasionally (Wards), frequently (HRU Physio OPD).
    20. Adjustable Shoe raise – to measure leg length discrepancy and assess for need of a shoe raise and
        thereby improve gait – occasionally (Rehabilitation Wards, HRU, Physio OPD).
    21. Pneumatic Post Amputee Mobility (PPAM) Aid – to re-educate gait following lower limb amputation and
        thereby increase patient independence. – frequently (Surgical).
    22. Orthotics & taping – Splints, AFO (ankle-foot orthosis), Fem Braces, Prafos (pressure relieving ankle foot
        orthosis), spinal braces, knee braces, collar & cuff, neck collars, arm slings, strapping, tape, tubigrip – to
        reduce swelling, pain and pressure and to facilitate movement – frequently (Wards, Physio OPD).


    1.   Desktop personal computer – Microsoft Word, PowerPoint, Excel, Access, GPASS – very frequently,
    2.   Data projector – delivery of in-service training, demonstrations – occasionally.
    3.   Overhead projector – delivery of in-service training, demonstrations – occasionally.
    4.   Scanner – for CPD activities – occasionally.
    5.   Digital Camera – for CDP activities – occasionally.
    6.   Telephone – regularly.
    7.   Photocopier – occasionally.
Manual Treatment Records – written records of treatments/attendances with patients/interaction with medical staff
in relation to patient care in accordance with CSP and Departmental standards – daily.

Patient Activity Statistics – written record of patient contacts including number of new patients, total patients,
attendances and treatments for use in Departmental auditing of Physiotherapy activity and for ISD purposes – daily.
Appraisal – Annual review with line manager (Superintendent/Senior I) – 4 monthly review

PDP – Regular review and updating – 4 monthly basis, as required.

Training Needs Analysis – in conjunction with senior staff/professional advisor – annually.

Staff induction/orientation – as required.
Production of Exercise/Information Leaflets – using Physiotools software - regularly and Medical Illustrations
Department – occasionally.
Expenses Claims forms – on call, travel & subsistence expenses – complete on a monthly basis.
Annual leave/study leave – complete and forward onto Line Manager/Head of Department – as required.


    The Senior Physiotherapists responsible for the provision of clinical Physiotherapy Services within the Unit the
    postholder is working, is the postholders immediate clnical line manager.

    The Senior Physiotherapist will delegate duties and approve planned leave in the first instance. However, the
    postholder is ultimately responsible to the Professional Advisor Physiotherapy and Hospital/Community Team
    Leader, who will authorise leave, post graduate training requirements and record sickness absence.

    Clinical caseload/workload is assigned and reviewed by the postholders immediate clnical line manager in the
    Unit the postholder is working in.

    The postholder is expected to organise and plan his/her own clinical workload/caseload effectively and
    efficiently. Guidance and support will be provided by their immediate clinical line manager or senior
    colleagues as appropriate, if and when required.

    The postholder will, in the absence of their immediate clinical line manager or senior colleagues, organise and
    plan; and where appropriate supervise the workload/caseload of Physiotherapy Assistants and/or
    Physiotherapy students in his/her work location.

    Formal performance appraisal will be undertaken by the Senior Physiotherapist within the Unit/area the
    postholder is working. Objectives will be set and agreed at the start and will be formally assessed at the end
    of each rotation. The Professional Advisor of Physiotherapy will also be involved in the review process.

    The postholder will have responsibility for assessing, diagnosing/verifying diagnosis and implementing
    appropriate treatment programmes for patients under his/her care. He/she will work autonomously, making
    clinical decisions within their scope of practice. Guidance and support will be readily available from senior
    colleagues, as required.

    The post-holder for the majority of duties will be expected to work unsupervised. He/she is expected to set
    treatment goals, to devise and implement individual treatment programmes; and to decide on continuation,
    review or discharge of the patient. Guidance and support will be readily available from senior colleagues, as

    The postholder can delegate tasks to Physiotherapy Assistants. Clinical tasks delegated to the Physiotherapy
    Assistants will be under supervision until such time that the Senior I Physiotherapist deems that the Assistant
    can undertake such tasks competently, without supervision.

    The postholder advises relevant personnel regarding on-going treatment and progress throughout the episode
    of care and discharge.

            Undertaking a physically and mentally demanding job whilst taking care to safeguard own emotional
             and physical health and safety, as well as that of patients and colleagues.
            Participating in multi-professional teams, ensuring a professional opinion is expressed which may not
             be agreed by other members of the team, some of whom may be more experienced.

            Adjusting to the transition from Student Physiotherapist to qualified Physiotherapist.

            Awareness that one’s role and effectiveness affects the functional outcome for patients.


The postholder will:

Patients and relatives/carers
 Communicate highly complex clinical information effectively and appropriately with patients and their relatives
    or carers using a range of verbal, non-verbal, written and presentation skills. This may involve conveying
    complex terminology into lay terms. The communication skills of persuasion, motivation, explanation and
    gaining valid consent will be used on a wide variety of patients.
    Barriers to effective communication will regularly be evident including: anxiety, pain, embarrassment, fear and
    in some cases cognitive impairment, expressive and receptive communication difficulties and visual/hearing

   Identify and implement the most appropriate communication method depending on the individual requirements
    e.g. hearing or visual impairments, learning difficulties, language differences or disinterest.

   Interact with patients, relatives and carers and multidisciplinary team to provide specialist advice and receive
    information regarding assessment, diagnosis, prognosis and treatment to encourage compliance and maximise
    patient care.

   Provide support, reassurance and encouragement to patients and their partners/carers as part of the
    Physiotherapy treatment programme.

   Convey comprehensive detail of physiotherapy treatment programmes in a manner and at a rate which is
    appropriate for every individual, emphasising and reiterating points to ensure a full understanding, if required.

   Encourage and motivate patients to maximise outcome, recognising those who are in pain, are afraid or
    reluctant and require reassurance, motivation and persuasion to comply with treatment.

   Convey information in a particularly sensitive manner when it is contradictory to patient and partner/carers
    expectations and desires.

   Utilise appropriate methods and aids e.g. audio visual aids or music, when working with patient’s in groups for
    either education or exercise purposes.

   Deal with verbal complaints.

Physiotherapy Staff (internal/external to Hospital)

   Consult more experienced staff for advice.

   Advise Senior Physiotherapist on continuous professional development needs and agree performance
   Arrange follow-up Physiotherapy and provide appropriate details for transfer of patients for on-going care
   Delegate tasks clearly to Physiotherapy Assistants.

   Attend and actively participate in Physiotherapy department meetings, in-service training sessions etc.

   Network with appropriate physiotherapy colleagues, national & local clinical interest groups, clinical
    effectiveness forums and research groups in undertaking development work to ensure delivery of clinically
    effective care.

Multi disciplinary Team (Medical, Nursing, AHP staff, Social Work, Porters etc.)

   Provide/receive information on patient assessment findings; progress with treatment and discharge information
    in written or verbal form. This can be highly complex and/or sensitive information.

   Provide/receive advice regarding additional strategies for patient management e.g. referral to another specialist

   Attend Ward rounds/Team meetings and input into Multidisciplinary Team (MTD) discussions and decision
    making processes regarding patient progress, discharge or transfer.

Other Agencies (local Authority, Voluntary Sector)

   Liase with other agencies to optimise patient care and ensure efficient service delivery, as required.

The postholder will also be expected to:

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

   Work with Senior colleagues to influence and implement the use of evidence based practice.

   Achieve and maintain a level of information technology relevant to all areas of work.


    Physical demands:

           Manual handling of patients on a daily basis. This may include assisting patients with significant
            physical, cognitive or behavioural impairment. Patients may be very immobile, obese or unwilling to
            move, e.g. patients who require support for lengthy periods – often from lying to sitting position, sitting
            to standing and back in one session, or positioning of unconscious patients, e.g. in Intensive Therapy

           Assisting patients with walking and stair practice – this may include sudden and unpredictable changes
            in direction of movement, or faints/falls which require physical support and/or safe lowering to the floor
            to avoid injury to patient and staff. This may include the higher risk areas of walking outdoors or using
            public stairways.

           Manual physiotherapy techniques, several times a day, including facilitation of movement and/or
            joint/limb manipulation. This requires a level of dexterity gained through supervised experience and
        post-graduate training. It requires response to sensory feedback, and co-ordination of movement to
        maximise rehabilitation potential and reduce risk of injury.

       Frequent use of equipment such as hoists, walking aids, tilt tables which require manipulation and
        dexterity, often manoeuvring within confined spaces.

       A significant element of walking, climbing stairs, standing and working within confined and awkward
        spaces for the majority of the working day.

       May need to adopt static postures for lengthy periods whilst assisting dependent patients, e.g. following
        stroke or spinal injury, to regain movement patterns, providing physical support using own body weight.
        This requires a significant degree of physical strength and endurance.

       May spend short periods using IT equipment – requires awareness of own postures and correct
        positioning of equipment/seating etc.

Mental demands:

On a regular basis:

       Responding to frequent changes in patients’ condition – this requires being alert in order to undertake
        high standard of clinical reasoning, involving constant assessment and decisions regarding patient

       Managing and prioritising workload/caseload.

       Prolonged and frequent periods of concentration especially with new and complex patients with
        communication difficulties.

       Dealing with acutely ill patients requiring urgent treatment while remaining calm, e.g. acute respiratory
        infection, respiratory failure, aspiration pneumonia.

       Dealing with abusive patients or carer – this may be physical and/or verbal abuse.

       Responding to group dynamics during exercise classes.

       Dealing with lone working and sole responsibility for the emergency service when on-call.

Emotional demands:

On a regular basis dealing with:

       Death and bereavement.

       Patients who have long term chronic illness or progressive conditions.

       Patients who are in pain.

       Breaking news about poor outcome or prognosis.

       Patients who may not be able to return to their home and require long term care.
           Emotionally labile and/or depressed patients.

           Patients with severe injury and loss of function.

           Terminally ill patients.

           Undertaking distressing treatment modalities, e.g. naso-pharyngeal suction.

           The transition from student to qualified member of staff.

   Environmental demands:

           Undertakes lone working when on-call covering the hospital site at night and driving to the hospital at
            night following a call out – sometimes in hazardous, adverse weather/road conditions.

           Frequent exposure to

                1. bodily fluids, e.g. urine, faeces, blood, vomit, sputum,

                2. transmittable diseases and infections, i.e. Hepatitis B, TB, MRSA,

                3. body odours.

           Occasional exposure to fleas and lice.

           Occasional exposure to potentially dangerous and unpleasant conditions during home visits.

           Occasional exposure to violence and aggression.


    State registered Physiotherapist, with either a Diploma or BSc/MSc Degree in Physiotherapy.
    Good verbal and written communication skills.
    Competent IT skills.
    Driving license and own transport is desirable.

I agree that the above Job Description is an accurate reflection of my duties and
responsibilities at the date of signing.

Job Holder’s Signature:                                                                    Date:

Professional Advisor :                                                                     Date:

Community Team Leader :

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