The overall aim of this research is to develop a best practice framework of delegation to physiotherapy assistants in NHS musculoskeletal outpatient physiotherapy services.
The study will use different research designs across three stages.
Stage 1:
I will explore how the culture in physiotherapy services may influence how tasks are delegated to physiotherapy assistants by doing detailed observations in two NHS musculoskeletal outpatient physiotherapy services. One of them will be in Staffordshire (Midlands Partnership NHS Foundation Trust, MPFT) and the second one in Cambridgeshire (Cambridge Community Services). I will also conduct interviews with physiotherapists, physiotherapy assistants, managers and patients to find out about their experiences of and attitudes about delegation. The findings will inform the design of the next stages of the study.
Stage 2a:
I will use a discussion method called Nominal Group Technique to reach agreement about what a best practice delegation framework should include. I will work with three separate groups of physiotherapists, physiotherapy assistants and physiotherapy service managers. This involves having a meeting with each group. The meeting will last approximately 3 hours. Participants will be recruited through advertising in professional websites and social media.
Stage 2b:
I will also use findings from the patient interviews in stage one to design a survey to better understand patients preferences for receiving physiotherapy treatment from physiotherapy assistants. Specifically, I will use a technique called Discrete Choice Experiment to describe, explain and predict patients preferences between care from physiotherapists and physiotherapy assistants. We will recruit patients from the patients who are attending physiotherapy appointments from one of the musculoskeletal physiotherapy departments within MPFT.
Stage 3:
I will bring together all findings to develop a best practice framework to guide physiotherapists in delegating clinical work to physiotherapy assistants.