Developing a best practice framework for musculoskeletal outpatient physiotherapy delegation: the MOPeD mixed-methods...

Area of Science:

• Healthcare workforce development
• Clinical delegation practices
• Musculoskeletal (MSK) physiotherapy services

Background:

• Physiotherapy assistants/support workers are integral to UK National Health Service (NHS) physiotherapy outpatient services, particularly for musculoskeletal (MSK) conditions.
• Their roles are often undefined, leading to variations in duties and tasks performed under supervision.
• This variability impacts the standardization of care and patient treatment by the most appropriate healthcare professional.

Purpose of the Study:

• To design a 'best practice' framework for delegation in NHS physiotherapy MSK services.
• To guide clinicians in standardizing delegation practices.
• To ensure safe and effective patient treatment by the most appropriate healthcare provider.

Main Methods:

• A mixed-methods study involving focused ethnography to explore current delegation practices and stakeholder views.
• Nominal group technique to achieve consensus on framework components.
• Discrete choice experiment to understand patient preferences for care provider.
• Triangulation of findings to develop the best practice delegation framework.

Main Results:

• The study will generate a consensus-based framework for delegation in physiotherapy.
• It will identify patient preferences regarding care from physiotherapists versus physiotherapy assistants/support workers.
• The findings will inform the development of standardized delegation protocols.

Conclusions:

• A standardized best practice delegation framework is needed for physiotherapy assistants/support workers in NHS MSK services.
• This framework will enhance the quality, safety, and efficiency of patient care.
• Further testing and implementation of the framework are recommended for widespread adoption.