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1. Communication and relationship skills

• Post holder must be able to communicate, establish and maintain relationships to gain the co-operation of patients, and staff, in order to gain their cooperation and achieving a successful outcome.
• Information will be received in writing, orally or electronically and be between other primary and secondary care health care professionals, patients, carers, other departmental clinicians and administrative staff.
• Negotiating, empathy and motivational skills must be highly developed as there is often a barrier to understanding which may be related to culture, language, past experiences.
• To be able to ensure that highly complex and/or sensitive information is relayed effectively to patients, carers, and other members of the extended multi professional and multi-agency team. Skills of persuasion, diplomacy and negotiation may be required particularly where there may be barriers to understanding or a second opinion is sought. Patient must be able to make an informed decision about their treatment after assessment; this includes declining referral to secondary care or accepting that this is not appropriate.
• To be able to communicate highly complex and sensitive information effectively, at a high level, with colleagues across health as well as in an understandable form to patients, carers and other staff. This will be in the written and verbal form.
• Excellent communication is required when prescribing medication
• To prepare and submit reports for G.P.s, Consultants, solicitors for legal purposes and other agencies as required within Caldicott guidelines.
• To provide training opportunities for local GP population in the form of shadowing CAS clinics, phone advice and 6 monthly training events.

2. Knowledge, training and experience

• Experience in a busy musculoskeletal/orthopaedic department.
• Allied health professional Degree/diploma (Physiotherapy, Occupational Therapy, Podiatry as appropriate)
• Registered with the Health Professions Council
• Highly developed specialist knowledge in field of musculoskeletal medicine/management which is underpinned by master’s level qualification or equivalent.
• IR(ME)R certificate
• Evidence of high organisational and time management skills.
• Ability to communicate effectively with colleagues at all levels, both in writing and verbally
• Experience of participation in service planning and development
• Injection therapy Diploma 20(M) level credits or equivalent & independent prescribing qualification (working towards or achieved)

3. Analytical and judgement skills

• Post holder will have highly developed clinical and non-clinical reasoning skills and evidence based knowledge to formulise a diagnosis, prognosis and treatment plan. A range of options will be available however evidence is often conflicting or even absent so clear judgment is required. Information used will be obtained through 1 or all of these methods: history taking, physical examination, use of imaging, past response to treatment (surgical and conservative), co morbidities which may be MSK or non MSK pathologies.
• To re-evaluate the patient condition which may change as a result of pathological processes, growth, maturation, aging and the effects of treatment.
• Post holder will advise less experience members of staff on best practice and treatment plans to follow.
• Post holder will be involved in the assessment of staff competency
• Deputise for the manager in their absence on operational issues within orthopaedic CAS.

4. Planning and organisational skills

• Plans specialist caseload
• To achieve the effective daily management of a complex caseload of patients including the provision of timely clinical advice to others, prioritising clinical work and balancing other patient related and professional activities in accordance with service standards.
• Plans training programmes for staff in response to service/individual/ organisation/ publication of new evidence in lead and area and physiotherapy advances.
• The post holder will be involved with arranging annual updates for anaphylaxis and injection therapy and quarterly updates with local Consultants.

5. Physical skills

• Post holder processes highly developed dexterity, co-ordination and palpatory sensory skills necessary for assessment and treatment of patients, including complex manual therapeutic techniques, therapeutic handling, and use of specialist equipment.
• Post holder must have standard key board skills
• Responsible for own safe and competent use of all gym and electrical equipment, patient appliances and aids from own caseload.
• To be responsible for equipment used in carrying out duties and to adhere to departmental policy, including competence to use equipment and to ensure the safe use of equipment by others through teaching training and supervision of practice.

6. Responsibility for patient / client care

• Post holder develops specialised physiotherapy treatment plans. This may include recommending a package of care to another member of MCH clinical teams
• The post holder provides specialised knowledge on assessing, diagnosing and treatment modalities to other staff.
• The post holder will be involved in the development of care pathways across all local primary and secondary care providers of musculoskeletal, Orthopaedic and pain management care.
• Following assessment, the post holder will be able to request a wide range of diagnostic tests which are not accessible to other clinicians within MCH.
• Post holder develops specialised care plans, which involves the interpretation of highly complex diagnostic test results and correlation to clinical presentation, in order to determine the patient’s ongoing management.
• Responsibility for the prioritisation & triage of referrals and the identification of serious pathology with appropriate response and management.
• To continually reassess patient progress, adapt treatment plans accordingly, and develop discharge plans to maximise rehabilitation potential, to allow a resumption of normal activities of daily living.
• To assess patient understanding of treatment proposals, gain valid consent and have the capacity to work within a legal framework with patients who lack the capacity to consent to treatment
• As a CAS clinicians to refer to any provider of primary or secondary care including: physiotherapy, podiatry, Orthopaedics, Rheumatology, Pain teams and Vascular surgeons.
• To provide expert prescription and application of injection therapy in a lone working environment, a modality unique to the Clinical Assessment Service. Some injections may be performed under ultrasound guidance.  You will also be responsible for the possible consequences of the injection, including anaphylaxis situations.
• To work closely with providers of “emergency” secondary care when patients present with serious pathology.
• Responsible for identifying aspects of patient client care outside the scope of their own knowledge and skills and referring on to appropriate agency as required.
• Post holder follows trust and professional standards relating to record keeping

7. Responsibility for policy and service development implementation

• Post holder follows evidenced based guidelines and ensures staff are implementing them.
• Would be expected to propose service changes where efficiencies or clinical need presents themselves to the Head of Service. There may be implications for MSK physiotherapy/ outpatient hand therapy division that would need to be communicated and discussed. They are expected to support and work with Manager to achieve aims in efficient and effective way.
• Involved in the researching, development and implementation of Orthopaedic care pathways across primary care that provide best practice, positive outcomes, improve access and the involvement of users in the planning, implementation and evaluation of services. The post holder provides specialised knowledge on assessing, diagnosing and treatment modalities to other staff.
• To work closely with other Orthopaedic Service providers, including Medway Foundation Trust, to ensure seamless care pathways and to ensure the implementation of evidence based practice.

8. Responsibilities for financial and physical resources

• Personal duty of care for equipment used during treatment
• Responsibility for alerting the manager to resource issues regarding Staffing levels & equipment
• Responsible for alerting the manager to potential deficits and or availability of supplies/resources required for patient treatment
• Responsible for ensuring that medication prescribed recommended offers best value if qualified to prescribe
• Authorised Signatory

9. Responsibilities for human resources (HR)

• Responsible for delivering training on lead area to MCH staff.
• Will deliver training on other areas of profession to the therapy departments (Occupational therapy, Physiotherapy, podiatry) on an ad hoc basis
• Post holder will provide professional and clinical supervision to other members of MSK service formally and informally.

10. Responsibilities for information resources

• Post holder follows trust and professional standards relating to record keeping when collecting any patient information
• To ensure the effective collection and timely submission of clinical information and data to support decision making and the management and delivery of care

11. Responsibilities for research and development (R&D)

• Participates in clinical audits within the department and promotes this to other staff. Post holder expected to undertake on going audit work relating to patient outcomes.
• Undertakes all mandatory and statuary audits as identified by clinical governance
• To participate in multi-centre research projects including liaison with the local universities and Medway Foundation Trust.
• To act as research lead including acting as principle investigator where indicated, evaluating research opportunities presented to the department and close liaison with R&D department.