As a fellowship-trained upper limb advanced practitioner, Jo Winton is keen to promote a research-based culture in the NHS.
Tell us about the fellowship
The upper limb physiotherapy fellowship is an innovative new post that has been pioneered to reflect recent NHS reforms and the wider skill set demanded of advanced practitioners. Central to the purpose of the new role is engendering a culture of research; establishing routine collection of patient reported outcome measures alongside clinical practice; and to coordinate research activity within the unit. It is a three-year appointment that has resulted from the working partnership and shared vision of specialist physiotherapists, orthopaedic surgeons and industry sponsors. Through supporting the development of a physiotherapist as an advanced practitioner and clinical researcher, it emphasises the symbiosis between research and clinical practice that is essential for modern healthcare delivery.
What have you achieved personally?
This has been the most amazing opportunity of my career! I have been personally mentored by Jo Gibson, an internationally renowned upper limb clinical physiotherapy specialist, and a team of specialist orthopaedic consultants at the Liverpool upper limb unit. In addition, the role has enabled me to underpin clinical and research competency by completion of the MSc in advanced practice at the University of Liverpool. It has been a challenging and rewarding opportunity that has enabled me to develop both my clinical and research skills to a high level.
Has the team and trust benefited?
The Royal Liverpool and Broadgreen University Hospitals NHS trust has a wealth of clinician expertise and patient-rich resources that were not being utilised to their full potential due to the usual constraints of pressurised service delivery. The fellowship has been successful in creating a culture of research and establishing the infrastructure to make it possible. There has been a commensurate increase in research activity and ultimately the vision of clinician led research has become a reality. I am now the allied health professional representative in the north west surgical trials centre orthopaedic specialist group, ensuring that both the trust and the physiotherapy profession are at the forefront of research delivery.
And the patients?
My clinical role involves me treating a caseload of patients with complex shoulder and elbow pathologies. Many of them have undergone multiple courses of unsuccessful physio and have associated psychosocial issues compounding their recovery. The role has given me the time to develop my clinical reasoning skills and critically reflect on my practice. Mentorship from Jo and support from other specialist clinicians in the team, together with opportunities to network with regional and national specialist interest groups, has widened my treatment repertoire. It has been exciting to see positive outcomes in complex patient groups resulting from modern evidence-based approaches to treatment. I endeavour to share this knowledge and skills with others.
Should more fellowships be created?
The development of this inaugural fellowship post has not been without its challenges. Its emergent nature has necessitated considerable dedication from the whole team here in the Liverpool upper limb unit to facilitate its success and we are learning from our mistakes as it evolves. We have developed a competency assessment framework for the post to provide an explicit structure for clinician development with measurable outcomes. The industry sponsors have been overwhelmed by its achievements and as a result have committed to continued funding and are keen to roll the model out in other trusts.
What’s next for you?
I need to find a job! This is a three-year post with development at its core. The fellowship has opened up new avenues. In my heart of hearts I am a clinician, but through the fellowship I have developed a skill set that enables me to ensure that research is embedded into the core of clinical practice. I endeavour to help drive forward the physiotherapy research agenda and contribute to the expanding evidence base that the profession so desperately deserves. fl
Jo Winton is an upper limb advanced physiotherapy pracititioner
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