Unlocking the door to the top

Physiotherapists have a career structure which builds the skills to be successful in senior leadership roles. Developing the confidence to reach for them is now more crucial than ever. CSP professional adviser Pip White finds out more

Hot topic

We still hear from members who are angry and frustrated that senior roles leading, for example, combined allied health professional (AHP) and nursing teams are open only to Nursing and Midwifery Council registrants. 

Much has been said about the loss of physiotherapy professional leadership roles at service lead level in some areas. These discrete professional physiotherapy-lead posts may have been removed as a layer of management and have been replaced with posts which have combined responsibility managing allied health professional groups. As a profession, we are comfortable with successfully leading AHP teams, and indeed many of the emerging chief AHP roles, within both systems and providers are held by physiotherapists. But what, if any, impact is this change having on our ability to access senior leadership positions?

Pillars of practice

Leadership is one of the fundamental career pillars of practice for physiotherapy. Embedding all four pillars – clinical, education, leadership and research – firmly within our profession is central to creating a flexible and sustainable workforce. Recognising the nature and extent of leadership at all career levels is also a critical part of a robust career framework.

There is no doubt that physiotherapists have the capabilities to move into roles that include elements of work beyond the scope of registration as a physiotherapist – this is clearly illustrated and accepted within the clinical pillar with advanced clinical practitioner roles.

But what about senior leadership roles, which utilise the core professional skill of leadership, yet may require the oversight of services as diverse as nursing or quality or theatre services which may not be directly related to physiotherapy?

Leadership capabilities

If leadership is an accepted pillar of physiotherapy practice that is established at the point of registration and developed throughout our careers, then why are physiotherapists still excluded from applying for senior leadership roles because we lack registration with a particular health professional regulator? 

Leadership is a professional activity that demands more than clinical knowledge and skills. An accountable leader may not be involved in the day-to-day clinical delivery of services and instead may be focussing on oversight of operations and strategic service development – something that transcends any particular primary registration.

It is critical to establish the leadership pillar within our practice during early-stage careers in order for physiotherapists to develop the skills needed to be in the best place to be ready for middle and senior leadership roles. 

Within our pathways of care and models of service delivery we need to make sure we can influence the future creation of leadership roles – for example, roles such as rehabilitation leads – by making clear the capabilities that physiotherapists possess and our abilities to lead at senior level within systems and services.

Where barriers to accessing senior roles persist, we need to challenge this. We need to individually and collectively challenge where multi- professional leadership roles are restricted to those from only one registered group. 

Challenging the boundaries 

So what should we do to try and change things?

  • Don’t be put off applying for a role if you believe you have the capabilities that match those required in the person specification, even if HCPC registration isn’t listed as a relevant regulator.
  • Call the HR department and ask if there is a specific reason why a role is not open to physiotherapists.
  • Talk with the recruiter to gain a detailed understanding of the role and its requirements and what capabilities you could bring.
  • Apply for the role making sure you set out how your individual education, skills and experience mean you otherwise fit the person specification. 
  • If you are not shortlisted, try and seek feedback if your registration status was the primary reason. 

Useful guides for NHS leaders/leadership

NHS England 
NHS Scotland 
NHS Wales 
NHS Northern Ireland 

Professional Advice team

The CSP’s Professional Advice Service gives advice and support to members on complex and specialist enquiries about physiotherapy practice, including professional practice issues, standards, values and behaviours, international working, service design and commissioning, and policy in practice.


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