Physiotherapist (Paediatrics) | Chelsea and Westminster Hospital NHS Foundation Trust

This established multidisciplinary team is responsible for providing orthopaedic care for children with a variety of clinical conditions, including neuro-disability. It is a tertiary service caring for children from across North-West London and beyond. Unique to this service, all orthopaedic referrals are assessed in physiotherapy led clinics. The team works in tandem with acute and community therapy, psychology, nursing, medical and surgical colleagues to ensure continuity of care. It is also responsible for supporting and guiding pre-intervention, post-intervention and maintenance rehabilitation programmes.

To provide expert assessment and diagnosis for children with neurological conditions referred to the paediatric orthopaedic service, advising on appropriate and effective treatment with support of the paediatric orthopaedic physiotherapy practitioners and paediatric orthopaedic consultants.

To work as an integral member of a multidisciplinary paediatric orthopaedic team providing a holistic service to the child and their family/carers.

To work alongside orthopaedic colleagues to triage new referrals to the paediatric orthopaedic service.

To provide a comprehensive musculoskeletal assessment of the child with neurological impairment and identify/devise optimal management plans for children requiring surgery or other intervention/monitoring programmes.

To refer patients on to appropriate teams should they require further investigations.

To review CPIP assessments and measure hip radiographs.

To participate in gait analysis reviews, where appropriate.

To ensure management plans are in place for children pre and post-surgery, communicating with the family, acute and local therapy teams to optimise recovery and rehabilitation both pre and post-surgery/intervention.

To coordinate packages of care when intervention has been agreed, ensuring seamless service between orthopaedics, inpatient physiotherapy and local community services.

Chelsea and Westminster Hospital NHS Foundation Trust is proud to be one of the top performing and safest trusts in England. We have two main acute hospital sites-Chelsea and Westminster Hospital and West Middlesex University Hospital, plus our award-winning clinics across North West London and beyond.

CLINICAL

• To be professionally and legally responsible for all aspects of your work, including the management of patients in your care.


• To carry out highly specialised assessments of children with a variety of complex disorders and other physical/neurological conditions including neurological disorders, developmental delay and genetic syndromes referred to the neuro-orthopaedic service. To be highly competent in assessing and treating a wide range of paediatric and orthopaedic conditions based on theoretical knowledge of anatomy, physiology, biomechanics and pathology.


• To interpret and analyse the relevant clinical and non-clinical facts found to formulate accurate diagnoses and prognoses for individual patients and to identify impairments and establish/score levels of functional ability.


• To use advanced clinical reasoning skills, knowledge of evidence based practice and advanced expertise to determine appropriate care plans, refer for appropriate investigations (e.g. radiography, gait analysis), review hip surveillance radiographs and utilise specialist treatment skills and options, including serial casting.


• To identify those children requiring a surgical opinion. Work with the orthopaedic consultants to determine the best intervention options for the child and their families. These may include orthopaedic surgery, Botulinum Toxin injections, serial casting, progressive strength training, and inclusion in sporting activities.


• To be able to carry and prioritise your own clinical caseload to ensure that an efficient and effective service is provided to all.


• To act as an expert opinion for other teams.


• To interpret and analyse relevant clinical and non-clinical facts, which may be conflicting, to formulate accurate diagnoses and prognoses and develop appropriate intervention plans for individual patients.


• Act with the consultants to plan, implement, evaluate, refer for investigation, treat and progress patient care to maximise the patients' rehabilitation potential - including decision making regarding discharge from care, or onward referral to other services.


• To review and interpret CPIP assessments from community teams, including measuring hip surveillance radiographs, for children with cerebral palsy and to devise an orthopaedic plan based upon these assessments.


• To promote understanding of aims of treatment by providing both spontaneous and planned teaching and advice sessions to relatives, carers and other health professionals thus ensuring a consistent approach to patient care.


• To prioritise allocation of referrals to appropriate neuro-orthopaedic clinics.


• To attend and manage clinics to determine appropriate pathway of care for each patient. To identify and present complex case studies to the orthopaedic consultants for advice and MDT management approach.


PROFESSIONAL

• To comply with the physiotherapy codes of professional conduct at all times


• To be professionally and legally responsible and accountable for all aspects of professional activities.


• To be responsible, with the divisional therapy lead and orthopaedic consultants for leadership in maintaining and improving all aspects of clinical governance, evidence based practice and quality assurance in paediatric neuro-orthopaedic service.


• To be responsible for maintenance of accurate and evaluative written records using the POMR system; to include comprehensive and timely progress and discharge reports to medical referrers, legal and disability reports.


• To be responsible for own personal professional development and keep abreast of new clinical practice in the area of paediatric orthopaedic and neurodisability. To support and oversee any junior staff with CPD.


• To participate in the appraisal system as both appraisee and appraiser to more junior staff using trust appraisal documentation.


• To have key responsibility for clinical teaching and development of peers, medical colleagues and other health professionals within the paediatric orthopaedic area, to include community based colleagues and those based in other trusts.


• To provide clinical placements according to the standards of the universities for undergraduate and post graduate physiotherapy students.


• To understand and apply clinical governance and clinical risk management principles to the service. To effectively manage, alongside the consultants any associated clinical risk.


ORGANISATIONAL

• To be responsible for providing an efficient and effective physiotherapy service, by demonstrating good leadership, organisational, time management and prioritisation skills.


• To manage and prioritise own workload by appropriately balancing clinical and other demands to ensure all service needs are met.


• To formulate flexible strategies for clinical education and service development within area of physiotherapy expertise.


• To effectively plan and manage the paediatric neuro-orthopaedic service including patient care, training, supervision, various meetings including management and strategy planning and meetings with other health professionals.


• To use excellent prioritisation and time management skills to meet the unpredictable and conflicting needs of the service.


• To work closely with consultants, GPs, therapists and other health professionals to provide a seamless service.


• To maintain accurate and up-to-date patient records in line with departmental, professional and legal standards, and ensure that all members of yourteam do likewise.


• To be aware of and implement all organisational, departmental and trust policies and to be involved in updating any as appropriate.


• To ensure timely communication of assessment and treatment findings to other involved disciplines such as discharge and referral letters and ensure that all members of yourteam do likewise.


• To provide statistics and analysis reports regarding the designated service using databases in an accurate and timely manner and to gather and collate information from the paediatric neuro-orthopaedic team to identify service improvements.


• To develop robust systems to monitor evaluate and ensure standards of care and clinical outcomes., To use specialist knowledge of current evidence to drive clinical audit, alongside the orthopaedic consultants.


• To evaluate and refine the paediatric neuro-orthopaedic service through research and audit with the consultants.


• To identify areas of need and develop clinical guidance within the paediatric neuro-orthopaedic service.


• To disseminate the results of audit/research/expert practice at local level.


• To present service development occasionally at local and national level.


• To keep abreast of evidence based practice in paediatric orthopaedics and neurodisability by use of relevant reading, attendance at in-service training, external courses and database searches.


EFFORT

• To carry out assessment and treatment using manual and therapeutic handling techniques which require moderate to high physical effort and concentration frequently during each working day.


• To comply with the trust health and safety policies including manual handling and infection control at all times.


• To work in an environment where the work patterns may be disrupted by frequent demands from patients, clinical staff, students and administrative support staff and any emergency situations arising.


• To deal sensitively with distressing or emotional circumstances regarding patient care, e.g. imparting news of poor prognoses.


• To support staff when indicated in the management of challenging patients, families or situations.


• To deal sensitively with patients and families who have a high level of anxiety or aggression due to, for example, fear or unrealistic expectations.


• To be able to convey sympathetically unwelcome news regarding functional progress and diagnosis to patients and carers.


• To work in an environment that may include frequent exposure to unpleasant working conditions.
  
  To be able to motivate, persuade and explain to others (staff, patients and their families) through advanced communication skills, utilising verbal and non-verbal skills, and using written and electronic information where necessary.


• To demonstrate expert ability to communicate complex and sensitive information to patients, carers and other staff, where there may be barriers to effective communication


• To maintain good communication and liaison between all staff and MDT members regarding service provision and development and to promote a strong working relationship at all times.


• To clearly convey detailed knowledge of techniques, biomechanics, anatomy and physiology to patients and staff where appropriate.


• To represent the physiotherapy and neuro-orthopaedic departments within the trust and to external agencies e.g. community and other tertiary teams, orthotics services, wheelchair services, GPs.


• To be able to diffuse potentially hostile and antagonistic situations with staff, patients and relatives, using highly developed negotiation and interpersonal skills.


• To give and receive complex and sensitive information about staff and patients where significant education and counselling skills are required. This may include information about long term/permanent disabilities or chronic pain.