Surrey Downs Health & Care
We are looking for a flexible, dynamic and forward thinking FCP to join our team in SDHC working in the ICP PCN Community Hub. You will be part of the MDT (including health and well-being coaches and pharmacists) working closely with the GPs and wider MSK pathway with an aim to fully integrate the service.
You will be the first point of contact for patients with musculoskeletal conditions and will be responsible for triaging them into the most appropriate pathway. This may be to self-care to yourself for further assessment or an Advanced Practitioner colleague to community physiotherapy for appropriate diagnostics or to secondary care.
You will have excellent clinical assessment and triage skills be a great communicator, have good motivational skills and be happy to step out of your comfort zone to drive forward rapid changes.
You must be self-motivated, organised, computer literate and able to demonstrate excellent interpersonal skills with a commitment to continued personal development.
There will be development opportunities in line with the Health Education England recommendations for First Contact Practitioners and Advanced Practitioners in Primary Care.
The post will be based in the Epsom area between GP surgeries and you must be able to meet the travel requirements of this post.
Please ensure that you have completed Stage 1 of the FCP framework and evidence this at the interview.Main duties of the job
Provide clinical expertise, acting as first-contact Musculoskeletal (MSK) practitioner and making decisions about the best course of action for patients' care. This will involve seeing patients, without prior contact with their GP. Practitioners will use their clinical-reasoning skills to undertake an assessment of the presenting problem, interpret findings, develop working and differential diagnoses, and formulate, communicate and implement management plans that take account of individual's needs, goals and wishes, local service availability and local and national guidelines and policies.
Request investigations to facilitate diagnosis and choice of treatment regime, understanding the information limitations derived from these and the relative sensitivity and specificity of particular tests diagnostic services such as x-rays and blood tests, and interpret and act on results to aid diagnosis and the management plans of patients.
Enable individuals to make decisions about their care using the principles of shared decision making:
- helping them to identify the priorities and outcomes that are important to them
- explaining in non-technical language all available options (including doing nothing)
- exploring with them the risks, benefits and consequences of each available option
- supporting them to make a decision on their preferred way forward
Surrey Downs Health and Care (SDHC) is a partnership between local NHS organisations that collaboratively provide adult community health services in Surrey Downs (Epsom, Dorking and East Elmbridge areas). SDHC sits as one of the wider partner organisations within Surrey Downs Health and Care Partnership. Our ambition is to create a health and care system that is built around the people and communities of Dorking, Epsom and East Elmbridge.
SDHC is a dynamic partnership of Primary Care, Community and Acute colleagues at the forefront of delivering services locally to meet our patient needs. There are 6 PCNs within Surrey Downs. We have 7 FCP posts across the patch.Job descriptionJob responsibilitiesExpert Clinical Practice
Communication and Key working relationships
- Take professional responsibility as a first contact practitioner, with high-level decision-making and clinical-reasoning skills to assess, diagnose and triage patients.
- Electronically triage information received directly from patients via digital primary care platforms and determine the optimum pathway for management of that patients condition, including advice and self-care, MSK physiotherapy or and FCP appointment.
- Manage a complex caseload (including patients with long-term conditions, comorbidities and multi-factorial needs) across multiple healthcare settings.
- Gather and synthesise information, both virtually and in a face to face setting, on the nature of the individuals presenting symptoms taking account of how these relate to relevant past medical history and investigations.
- Critically appraise information obtained taking account of the potential for MSK symptoms to be features of non-MSK conditions, frailty, co-morbidities or indicative of potentially serious pathology with implementation of appropriate onwards referral.
- Use interactions as an opportunity to educate 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 make every contact count (MECC).
- Request appropriate investigations based on level of competence and in line with national and local evidence based practice guidelines and interpret the findings to facilitate diagnosis and management plans with patients.
- Advise, initiate, evaluate and modify a range of interventions, which may include self-management and life style advice, injection therapy, other therapies, exercise prescription, social and independent prescribing.
- Advise on the expected benefits and limitations of different rehabilitative interventions used in managing specific MSK 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 MSK health and advise on what people with MSK conditions can and should do.
- Work in partnership with individuals to explore suitability of surgical intervention, 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 patients general health status and criteria stipulated in national NICE guidance and local CCG criteria based access for evidence based interventions and prior approval policies.
- Record the information gathered through taking individuals history concisely and accurately via EMIS (or similar relevant healthcare software) for clinical management, and in compliance with local protocols, legal and professional requirements.
- Adhere to legal, regulatory and ethical requirements, professional codes, and employer protocols.
- Be accountable for their decisions and actions and the outcomes of their interventions via HCPC registration, supported by a professional culture of peer networking/review, reflective practice and engagement in evidence-based practice
Leadership and Management
- Demonstrate effective person-centred communication skills, supporting people in making decisions, planning care or seeking to make positive changes, using a person-centred approach.
- Adapt how they engage with others (including those with cognitive and sensory impairments) through using different verbal and non-verbal communication styles, and in ways that are responsive to individuals communication and language needs and preferences.
- Convey information and discussing issues in ways that avoid jargon, negative descriptors and assumptions.
- Ability to communicate complex clinical information both written and verbal, in an easily understood form, to patients, carers, and all members of the multi-disciplinary team.
- Ability to deal with difficult or distressed patients and carers, conveying difficult and sometimes unwelcome information relating to clinical issues.
- Work collaboratively with an appropriate range of multi-agency and inter-professional resources, developing, maintaining and evaluating links to manage risk and issues across organisations and settings.
- Advise on local non-clinical services that individuals and their carers may benefit from accessing to help manage an MSK condition and its impact, including those relating to employment, voluntary activities, counselling services and leisure facilities.
- Make appropriate referrals using appropriate documentation to other health and care professionals and agencies when this is in individuals best interests.
- Respect and draw on colleagues knowledge and expertise within the multi-disciplinary team and across the MSK pathway.
- Communicate with colleagues in ways that build and sustain relationships, seeking, gathering and sharing information appropriately, efficiently and effectively to expedite and integrate individuals care.
- Participate as an effective primary care team member and understand the importance of effective team dynamics. Contributing effectively to multi-disciplinary team activity (including service delivery processes and learning and development).
- Maintain close working relationships with all services engaged in delivery of the MSK pathway including secondary care, physiotherapy teams, primary care and third sector / voluntary organisations
Education, Learning and Development
- Demonstrate an understanding of and active engagement with governance agendas through strategies such as clinical supervision, mentorship, good record-keeping, ongoing self-assessment and reflective practice.
- Demonstrate understanding of, and contribute to new practice and service redesign solutions in response to feedback, evaluation and need.
- Act as a clinical role model demonstrating a person-centred approach to service delivery and development.
- Actively seek feedback and involvement from individuals, families, carers, communities and colleagues to assure and improve the quality of care and service delivery.
- Demonstrate receptiveness to challenge and preparedness to constructively challenge others, escalating concerns that affect individual patients, colleagues and overall service safety and quality.
- Negotiate an individual scope of practice within legal, ethical, professional and organisational policies, governance and procedures, with a focus on managing risk and upholding safety.
- Demonstrate an awareness of their own limitations and through this, recognise the parameters of their scope of practice.
- Represent the physiotherapy service on relevant committees and meetings, as a lead clinician provide input in relation to specialist issues and clinical matters as required.
- Assist Team Leaders in the efficient day to day management of the FCP and general musculoskeletal service.
- Actively engage in the appraisal process to critically assess and address learning needs, negotiating a personal development plan that reflects the breadth of ongoing professional development necessary for the FCP role.
- Act as an advocate for and contribute to a culture of organisational learning to inspire and develop future and existing staff
Research, audit and service evaluation
- Actively engage in peer review to inform own and others practice, formulating and implementing strategies to act on learning and make improvements.
- Engage in self-directed learning, using a process of critical reflection to identify learning needs to maximise clinical skills and knowledge.
- Maintain a portfolio of evidence or work based learning showing how you meet all the required capabilities for working in an FCP role e.g. completion of NHSE e-learning modules.
- Support the wider team to develop competencies and capabilities through work-based and inter-professional learning.
- Demonstrate an understanding of competency and capability frameworks relevant to working areas of practice and keep up to date with relevant clinical practice
- As clinical supervisor and educator, to design, develop and deliver programmes of specialised learning in line with evidence based practice to peers, junior staff and the wider primary care MDT.
Person SpecificationQualifications and TrainingEssential
- Engage in the distinct activities of clinical audit, service evaluation and research, adhering to the national and local requirements, and regulatory frameworks that relate to each.
- Evaluate and audit own and others clinic practice, 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.
- Demonstrate ability to generate evidence suitable for presentation at local level
- Degree/diploma level education leading to State Registration by HCPC as a physiotherapist
- Evidence of relevant MSK post - graduate qualification /training at Masters Level.
- Completion of Stage 1 signed off before commencement of role in Primary Care (contract requirement)
- Member of Chartered Society of Physiotherapy
- Relevant Master's Degree
- Diploma in Injection Therapy
- Non-Medical Prescriber
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