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DEVELOPING PHYSIOTHERAPY LED SHOULDER CLINICS: A PROPOSAL TO ADJUST SCOPE OF PRACTICE BY TENDAYI MUTSOPOTSI Bsc. HPT (Hons) MSc. ORTHO-MED

DEVELOPING PHYSIOTHERAPY LED SHOULDER CLINICS: A PROPOSAL TO ADJUST SCOPE OF PRACTICE BY TENDAYI MUTSOPOTSI Bsc. HPT (Hons) MSc. ORTHO-MED

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This document outlines proposal for the set up of a physiotherapy led post-operative shoulder rehabilitation clinic. Shoulder Orthopaedic Rehabilitation Clinic is a combined Orthopaedic assessment and rehabilitation advice clinic for post operative elective shoulder surgery patients. It is run by an Orthopaedic Physiotherapy Practitioner (OPP) and operates alongside one of the shoulder unit clinics. The clinic is a follow-up clinic where patients are reviewed and their postoperative rehabilitation is introduced and/ or progressed. Occasionally patients need to be referred to physiotherapy, but this is infrequent rather than routine. For those physiotherapist, nurses or other allied health professionals wishing to develop similar services and need further advice can contact me via LinkdIn
This document outlines proposal for the set up of a physiotherapy led post-operative shoulder rehabilitation clinic. Shoulder Orthopaedic Rehabilitation Clinic is a combined Orthopaedic assessment and rehabilitation advice clinic for post operative elective shoulder surgery patients. It is run by an Orthopaedic Physiotherapy Practitioner (OPP) and operates alongside one of the shoulder unit clinics. The clinic is a follow-up clinic where patients are reviewed and their postoperative rehabilitation is introduced and/ or progressed. Occasionally patients need to be referred to physiotherapy, but this is infrequent rather than routine. For those physiotherapist, nurses or other allied health professionals wishing to develop similar services and need further advice can contact me via LinkdIn

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Published by: Physiotherapy Care Specialists on Nov 07, 2012
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12/04/2012

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Adjustment To Scope Of Practice: Post Operative Shoulder Clinic
Author: Tendayi Mutsopotsi Msc Ortho-Med MCSP 01/07/2008 Page 1 
NOTIFICATION OF PROPOSED ADJUSTMENT TO THE SCOPE OF PRACTICEPROPOSAL FOR THE SET UP OF A PHYSIOTHERAPY LED POST OPERATIVESHOULDER CLINICBYTENDAYI MUTSOPOTSI BSc. (HPT) MSc. ORTHO-MED MCSP MSOM
 
Adjustment To Scope Of Practice: Post Operative Shoulder Clinic
Author: Tendayi Mutsopotsi Msc Ortho-Med MCSP 01/07/2008 Page 2  NOTIFICATION OF PROPOSED ADJUSTMENT TO THE SCOPE OF PRACTICEIntroductionThis document outlines proposal for the set up of a physiotherapy led post-operative shoulder rehabilitation clinic. Shoulder Orthopaedic Rehabilitation Clinic is a combined Orthopaedicassessment and rehabilitation advice clinic for post operative elective shoulder surgery patients. It is run by an Orthopaedic Physiotherapy Practitioner (OPP) and operates alongsideone of the shoulder unit clinics. The clinic is a follow-up clinic where patients are reviewedand their postoperative rehabilitation is introduced and/ or progressed. Occasionally patientsneed to be referred to physiotherapy, but this is infrequent rather than routine. Any concernsabout a patient’s post-operative recovery can immediately be discussed with the OrthopaedicConsultant or his SPR, but most patients attend the Rehabilation clinic until discharge withoutthe need for more specialist Orthopaedic review.Principles of the proposal are based on lessons learnt from shoulder units at St Mary’s (PraedStreet), Reading, Basildon and Royal National Orthopaedic hospitals which have in the longterm optimised patient outcomes, freed Consultants time, reduced waiting times, and costscombined with high levels of patient satisfaction.The proposed model of care will be underpinned by relevant education, audit and research tofacilitate continuous improvement and success.Benefits1. Optimises use of Consultant timeIncrease Consultant ability to see new patients and reduce pressure on ConsultantReduce financial pressure2. Post –op complications can be picked quickly e.g. avascular necrosis, frozen shoulder,infection3. Facilitates skills escalation in line with NHS Plan4. Improves performance in relation to care access targets i.e. Supporting the 18week  pathwayReducing referrals to physiotherapy departmentReducing amount of follow up appointments so that they can see additional referralsReducing patient over treatment5. Underpinning audit and research
 
Adjustment To Scope Of Practice: Post Operative Shoulder Clinic
Author: Tendayi Mutsopotsi Msc Ortho-Med MCSP 01/07/2008 Page 3 6. MDT approach improves team working and morale7. Increase opportunities for physiotherapy roles e.g. Senior 1 development into specialistrole8. Facilitates and improves a fluent patient pathwayPatients seen appropriately, timely and cost-effectively9. Improves communication and saves time regarding communication within the multi- professional teamCurrent Service ModelGP
Orthopaedics (Shoulder clinic)
Investigation
Shoulder Clinic
Surgery
Shoulder Clinic review (2 weeks)
Physiotherapy
Shoulder Clinic review (5-6wks)
Physiotherapy(continue total sessions
6 sessions
≥→
? Shoulder Clinic final reviewProposed Service ModelGP
Orthopaedics (Shoulder clinic)
Investigation
Shoulder Clinic
Surgery
Physio-led post-op clinic (Consultant/Registrar consulted? complications/difficult cases 3-4 sessions.Clinic set-up eight 20minute slots and build up to ten 20 minutes slots.Proposed adjustment to practice:To provide an Orthopaedic Physiotherapy Practitioner led shoulder rehabilitation clinic in theOutpatient Orthopaedic service at Chelsea & Westminster Foundation Hospital.Clinical area applicable to: Orthopaedic outpatients at Chelsea & Westminster FoundationHospital.Applicable to: Physiotherapists who fulfil the following criteria:
 
A minimum of five years post graduate physiotherapy experience
 
A minimum of three years experience in the management of musculoskeletalconditions.
 
Can demonstrate competence to work in the OPP role following a comprehensivetraining programme.
 
Has a special interest and knowledge in the management of complex and post operativeshoulder conditions

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