A study in the United Kingdom has explored the creation of a delegation framework for use with physiotherapy support workers in musculoskeletal outpatient physiotherapy services.

Physiotherapy support workers, also known as physiotherapy assistants, rehabilitation assistants, technical instructors or physiotherapy technicians, are non-registered staff who often work alongside physiotherapists, with delegated interventions and responsibilities.

However, they do not need to hold a qualification accredited by a professional association, they are not formally regulated by a statutory body and training is not standardised, which can affect levels of competency.

The consensus groups study surveyed seven physiotherapists, 10 physiotherapy support workers and 10 physiotherapy operational/clinical leads from 13 musculoskeletal physiotherapy services within the United Kingdom’s National Health Service.

The aim was to reach a consensus on what components should be included in a future framework to guide effective and safe delegation of clinical tasks to physiotherapy support workers.

Using the nominal group technique, participants engaged in highly structured face-to-face group interactions to generate ideas on items for inclusion in the framework.

Participants then voted anonymously on each item with a seven-point Likert scale, with those items achieving a consensus greater than 70 per cent (or 4.9 on the Likert scale) advancing to a second round of voting.

Items were grouped according to five category titles:

• competencies (that is, managing patients’ expectations)
• training/ CPD for physiotherapists and support workers
• clear delegation processes, including reporting and handover mechanisms; defining the role of support workers
• and safety net (that is, identifying when patients need to be referred back to the physiotherapist and having a clear escalation process).

The researchers identified possible limitations of the study, such as the inclusion only of physiotherapists and support workers operating within the National Health Service, rather than in private practice, and therefore the results may not be representative of all UK physiotherapists.

Nevertheless, the results offer clear guidance about the delegation of clinical tasks and clinical scope of physiotherapy support workers, as well as the need for CPD opportunities.

Access the research paper here.