Ward-based therapists

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A case study describing action by Gateshead Health NHS Foundation Trust to use ward-based therapists to overcome staffing shortages.

What was the problem?

With nurses in short supply throughout the NHS in England, the trust had more than 50 posts persistently vacant. 

What was the solution?

A new clinical role of Band 5 ward-based therapist. Physiotherapists and occupational therapists at the Queen Elizabeth Hospital were trained in basic nursing competencies and recruited to vacant nursing posts. They work a combination of early shifts, late shifts and long days, seven days a week, in the same way as staff nurses. This increases the number of registered health professionals on the ward and the qualified to non-qualified staffing ratio. The ward-based therapists have expertise in patient assessment, manual handling, rehabilitation and discharge planning. 

What were the challenges?

Staff anxiety – from all professions – about the blurring of professional boundaries. Relieving this anxiety required support from senior therapy and nursing leaders and a robust competency framework to provide clinical assurance of safety and quality. 

What were the results?

Five whole-time equivalent ward-based therapists (three occupational therapists and two physiotherapists) were recruited in December 2017. They were assigned to these clinical areas:

  • orthopaedic trauma – occupational therapist
  • dual care (elderly mental health and acute elderly medicine) – occupational therapist
  • hospital to home unit – occupational therapist
  •  acute elderly medicine – two physiotherapists
  • acute elderly medicine – occupational therapist.

The role is in its infancy and the trust is evaluating it.

What were the learning points?

  • As a Band 5 post, the role mainly attracted new graduates or therapists with little NHS experience.
  • Significant support is required from senior therapy and nursing clinicians to relieve anxiety about blurring professional boundaries.
  • As ward-based therapists work early and late shifts outside traditional therapy teams’ working hours, they were able to assess patients’ function at different times of day, adding value to their treatment plans and discharge planning.
  • Ward-based therapists help to enhance a culture of rehabilitation and enablement on acute hospital wards.
  • As ward-based therapy is not the traditional route for therapists to enter the NHS, further work is needed to develop opportunities for career progression.

Want to know more?

Tracy Webb, Service Line Manager, Tracy.Webb5@nhs.net

Hilary Lloyd, Director of Nursing, Hilary.Lloyd1@nhs.net

Dawn Duncan, Head of Physiotherapy, Dawn.Duncan4@nhs.net

Andrew Hall, Physio Team Leader, Andrew.Hall23@nhs.net

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