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A brave new multi-skilled future

Dr Pippa Collins and Belinda Twissell ask why some physiotherapists feel their professional identity is compromised by broadening their skill range?

Dr Pippa Collins and Belinda Twissell
Right Dr Pippa Collins is an advanced clinical practitioner in frailty and research fellow. Left Belinda Twissell is a physiotherapist and clinical education improvement fellow

Our patient caseloads have changed dramatically over the last decade and with this comes the need to widen our skillsets.

We now work with people who are acutely unwell or highly complex.  Take for example a person who has had a cluster of falls, is less mobile and has sustained a skin tear.

By enhancing a physio assessment with an assessment of their chest, urinary symptoms, abdominal symptoms; take lying and standing blood pressures; take an ECG to rule in/out cardiac causes; dress the skin tears; take bloods to look for other medical reasons for falling; review medication and discuss changes with a prescriber and assess cognition, a comprehensive picture is gained. Perhaps the person is constipated, dehydrated or is starting a chest infection and this is the cause of their falling. It is rare to meet a patient who says ‘please get other people involved with my care, I look forward to waiting and explaining everything again’! 

Why then are some therapists reluctant to take on a wider range of skills?

A range of skills that can make our roles both satisfying, and of course, more challenging.

Conversations with colleagues suggest a fear of taking on new skills; of becoming de-skilled; of losing professional identity; a lack of role models; entrenched working methods and inadequate training due to provision or time constraints and clinical pressures. By acknowledging these barriers we can find ways to overcome them.

Learning from existing successful models of multi-skilled working is helpful. Many teams, especially our intermediate and urgent care teams, have embraced multi-skilled working. Teams around the country have embedded sharing and learning from across professional groups and found effective and safe ways to do this. 

The iCSP platform is another valuable way that members can share information around team development and new practices. 

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