Physiotherapists who choose to go into private practice do so for a wide variety of reasons. Maybe because they feel they have gained sufficient experience, are competent and confident in their clinical skills, or that they wish to maintain autonomy over their decision-making and time. Once the decision is made, the following years will be spent developing a business and undertaking continuing professional development (CPD) possibly through external courses and self-directed reading, etc. As far as formal career development goes, however, there is very little structure available to demonstrate progression. To find out how to start in private practice, click here for our joint CSP and Physio First booklet.

First contact practitioners

The role of first contact practitioners (FCPs) in settings such as general practice (GP) surgeries is on the rise, and it is great for our profession that the public are now seeing physios as the “go-to” professionals for their musculoskeletal (MSK) problems. Initial studies indicate that the FCP acts as a filter, giving patients good self-management advice in the first instance and, where appropriate, signposting to further investigation or a medical opinion. Approximately 20% of patients are referred for a course of physiotherapy treatment. The development of FCPs is fully supported by our Physio First executive, and our members would say that in private practice we are all FCPs, the only difference being that we deliver the course of treatment following first assessment if we, and the patient, deem it to be appropriate. The findings from our Physio First Data for Impact (DfI) project demonstrate that more than 85% of our members’ patients are either self-referred or recommended by others, and more than 75% are self-paying.

In the course of developing the FCP role, Health Education England (HEE) and NHS England commissioned the development of a MSK core capabilities framework as a tool for supporting the improvement of services. The framework outlines the core skills expected of any FCP and “provides clarity both on the standards expected of first point of access MSK service delivery, and the knowledge, skills and behaviours that practitioners need to develop and demonstrate”. More information about the framework specific to FCPs can be accessed here.

It is expected that physios working towards FCP roles will use this framework to guide their CPD and, in order to support this, HEE have created eight e-learning sessions that each take around 20-30 minutes to complete. These are now widely accessible to all practitioners and can be accessed here.

This learning module is self-managed and self-declared and the framework can be used as guidance for benchmarking yourself in private practice, as a reference in any portfolio of evidence required for registration purposes, and for providing evidence of self-learning and development for private practitioners wishing to compete for FCP contracts.

Advanced clinical practice

The HEE multi-professional framework for advanced clinical practice (ACP) in England was developed and agreed by all stakeholders and is designed for consistent understanding of the ACP title, furthering work carried out previously across England, Scotland, Wales and Northern Ireland. The core capabilities for health and care professionals at the level of ACP are articulated and will apply across all ACP roles, regardless of the health and care professional’s setting, subject area and job role.

While there is no UK-wide definition or standard for ACP, there are multiple national Allied Healthcare Professions (AHP) frameworks which describe the level and range of capabilities needed in the workplace. The four pillars of advanced practice comprise of:

  • Clinical Practice
  • Leadership
  • Education
  • Research

These may be demonstrated in different ways depending on the profession, role, population group, setting and sector in which an individual is practising. An ACP will be expected to demonstrate capabilities pertaining to each of these pillars. The framework has been written with the NHS in mind, however the fundamental principles and opportunities are relevant across all sectors.

The frameworks can be accessed here in full:

https://www.health-ni.gov.uk/sites/default/files/publications/health/AHP-Framework.pdf

https://www.wales.nhs.uk/sitesplus/documents/829/NLIAH%20Advanced%20Practice%20Framework.pdf

https://www.hee.nhs.uk/sites/default/files/documents/Multi-professional%20framework%20for%20advanced%20clinical%20practice%20in%20England.pdf


Why might a private physiotherapy practitioner be interested in ACP? 

The multi-professional ACP frameworks are broad enough to be tailored to any applicable professional working in any clinical setting. By using them to recognise the required level of ACP, you can benchmark your capabilities in relation to an NHS employed physiotherapist to enable you to compete on a level playing field for any FCP contract.

Being aware of the requirements of this advanced status will also give you something to work towards in terms of formal career development, which is something private physios really haven’t had available to us before.

The multi-professional ACP frameworks are measured at master’s level and require external assessment of evidence of capability for each pillar. This process is currently under development and Physio First is working with the CSP to ensure that the system is accessible for private practitioners.

Where do our Physio First Quality schemes fit in?

By collecting and inputting sufficient data through our free-for-members data collection scheme, you will have received your individualised report and been measured for our Quality Assured Practitioner (QAP) kite mark. With this invaluable range of evidence and insight into your own practice, you can demonstrate competencies for both the MSK core capabilities required for becoming a FCP, and work towards completing the ACP Framework.

Through our collaboration with the CSP, Physio First is committed to learning more about the ACP Framework and how it will be measured in practice and we will continue to update you on this, so look out for our communications. For now, if you are interested in this career development, then being part of our Physio First DfI and aiming for QAP or QAC status will certainly help to get you a long way towards producing cogent evidence.

Students are the future

As supporting students through practice-based learning may fulfil some of the criteria in the pillars for the ACP framework, we are also working with the CSP to create a business case and make it easier for private practitioners to take students who wish to complete their practice-based learning in a private practice setting. While there are perceived barriers to this, both on the part of the higher education institutions and from some practitioners, the CSP are in the early stages of developing a common placement assessment form (CPAF) that Physio First have offered to pilot when it is ready, to help ensure that it is quick to complete and suitable for private practice.

We are also discussing the skills required to be practice-based educators and how training programmes to develop these skills can be accessible for private practitioners.

So, do private physios have a career pathway? We certainly believe that the development of a career structure is possible for private physiotherapy practitioners, and especially for Physio First members who are collecting data and working towards QAP and QAC. As we learn more about how to advise you towards this goal, we will let you know, so keep looking out for updates in our Physio First communications.

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