Upskilling and redeployment FAQs

We answer some of your frequently asked questions about redeployment of the physiotherapy workforce during the COVID-19 pandemic

As healthcare staff across the UK continue to work differently in order to support patients recovering from COVID-19, the needs of the physiotherapy workforce response and that of the profession’s close partners across all settings and sectors in this crisis continue to emerge.  

Efforts to support increased demand on health and care services are being managed through temporary changes to working practices and through staff redeployment. Significant redeployment of staff occurred during the early stages of the pandemic into acute sector in-patient multi-disciplinary teams, particularly to support in critical care. 

As the focus of the pandemic response now moves to the rehabilitation of those recovering from COVID, attention to the complex needs of these patients and the needs of non-COVID patients across the whole system pathway must be considered in ongoing workforce redeployment plans. 

Read what we think should be happening about rehabilitation during the COVID-19 pandemic and beyond.

Recommendations and guidance from across the four countries on safe and appropriate AHP redeployment continue to be relevant. 

This guidance, along with the CSP’s briefing on COVID rehabilitation, should be used along with local risk assessments to support appropriate ongoing deployment of the physiotherapy workforce to meet local demands.

How might my knowledge and skills be used?

With some upskilling and support, every member of the physiotherapy workforce has the capability to apply their underpinning knowledge and experience in a range of settings with a variety of patients. If, following a risk assessment, it is not appropriate or viable for a member of staff to work in a clinical capacity either face to face or remotely, consideration should be given to alternative use of their capability i.e. in operational management or staff support capacities.   

Staff in acute hospital outpatient services have been reasonably expected to redeploy to the wards or to community services. We now expect to see these staff move back to their usual service areas as paused healthcare pathways resume, and demand for community rehabilitation rises. Where the need arises any staff will be reasonably expected to continue to undertake tasks and responsibilities that cross professional boundaries.

Measures continue to be in place to enable staff to work in different ways and increase staffing capacity to meet local need wherever that arises. This continues to be supported by new emergency government legislation, the healthcare regulators and others.

(Last reviewed 15 Oct 2020)


What is the HCPC position on how we are being asked to work?

The Health and Care Professions Council, as the regulator for physiotherapists, has produced a resource: 'How we will continue to regulate in the light of the novel coronavirus (COVID-19)'. This sets out a Joint Statement with other statutory regulators in healthcare. This includes the recognition that registrants may feel anxious about any concerns raised about the care they provide in particular contexts. It also gives the reassurance that the environment in which the professional is working is always taken into consideration, including resources, guidelines, and protocols in place at the time.

(Last reviewed 15 Oct 2020)


What can I do to prepare myself to work in different areas?

  • Ensuring you are as informed as possible about COVID-19. There are numerous resources from the NHS to support staff education and the National Institute for Health and Care Excellence has produced a series of rapid guidelines and evidence reviews.
  • Health Education England has developed a programme of COVID-19 eLearning courses. Following registration to the portal, these are free to access for all healthcare staff across the UK regardless of Country, setting or sector

  • Proactively approaching your manager or clinical lead to undertake a review of your individual circumstances e.g. any health issues, pregnancy, carer commitments or travel difficulties.  
  • Ensuring you attend or read all briefings from your employers in order to keep informed of your organisation’s planning. This is a rapidly moving and evolving situation and plans may change daily.
  • Identifying your transferrable knowledge and skills and previous experience in a range of clinical areas and identify where you could be redeployed with no additional training.

    If you are required to support with respiratory physiotherapy for COVID-19 patients there are resources to support your learning developed by the Association of Chartered Physiotherapists in Respiratory Care (ACPRC) and include eLearning content
  • Identifying additional knowledge, skills and training needs for clinical areas into which you are likely to be deployed and begin some self-directed learning. The CSP professional networks have numerous learning resources, many dedicated to upskilling staff as part of the COVID-19 response.
  • Make sure your personal support networks are aware of how you are being required to work during the ongoing pandemic response and put measures in place to ensure you can access practical and emotional support if you need it. 

(Last reviewed 15 Oct 2020)


What is my personal responsibility as a registered physiotherapist at this time?

These are very challenging times, and while staff want to do everything they can to support patients, it is important to adhere to the expectations of the Chief Allied Health Professions Officers, who in a statement on 19 March 2020 stipulated:

‘We need to keep to the basic principles of AHP best practice. As registered AHPs, you are expected to follow Health and Care Professions Council (HCPC)…guidance and use judgement in applying the principles to situations that you may face. However, these also take account of the realities of a very abnormal emergency situation. We want AHPs, in partnership with patients and individuals we care for, to use their professional judgement to assess risk and to make sure people receive safe care, informed by the values and principles in our professional standards of conduct, performance and ethics. A rational approach to varying practice in an emergency is part of that professional response’.

(Last reviewed 15 Oct 2020)


When undertaking tasks and activities outside of my normal role and job description at this time, am I working within my scope of practice?

Yes, as long as you working within the limits of your competence, i.e. you have been sufficiently trained to undertake the tasks and responsibilities that are being asked of you.

(Last reviewed 15 Oct 2020)


When undertaking tasks and activities outside my normal role and job description at this time, am I insured?

Yes, if you are employed, your employer's vicarious liability will cover you for any tasks and activities you are required to do as part of your role, including those that you are being required to do temporarily.

In addition, emergency legislation will ensure NHS staff are covered by a state-backed insurance scheme in order that they can care for their patients if, for example, they are moving outside of their day-to-day duties while making use of their clinical skills and training. This will also apply to those staff brought into the NHS from other sectors.

(Last reviewed 15 Oct 2020)


What support should I expect if redeployed or asked to work differently?

However you are asked to contribute, you should be inducted to a new area and be given the necessary training and support to be competent with the tasks and responsibilities you are asked to undertake.

This expectation on employers is also outlined by the Chief Allied Health Profession Officers in their statement.   

‘It is the responsibility of the organisations in which you work to ensure you are supported…They must bear in mind that clinicians may need to depart, possibly significantly, from established procedures to care for people in the unique and highly challenging but time-bound circumstances of the peak of an epidemic…Healthcare professional regulators, including the HCPC…have already committed to take into account factors relevant to the environment in which the professional is working.’

The formal training you have completed to support you to work in new ways and the additional tasks this enables you to undertake should be documented in local training logs. You should be mindful that in this emergency situation self-directed learning and joint treatment sessions will also be essential to meet upskilling needs.

(Last reviewed 15 Oct 2020)


What if after training I still do not feel competent to undertake what I’m being asked?

Youshould raise this immediately with your line manager and discuss your additional training and support needs. You can also contact your CSP steward for support.  

(Last reviewed 15 Oct 2020)


I am being asked to contribute to the on-call rota but I haven’t worked on-call for years. Is this safe?

Even in these unprecedented challenging times, members must continue to adhere to their HCPC regulatory standards of conduct performance and ethics and CSP professional code – in that they should not practice beyond the limits of their knowledge, skills and competence.

It is not unreasonable for staff to be asked to undertake on-call duties at this time exceptfor individuals who are currently exempt due to temporary or permanent amendments to their role.

However,it is incumbent on the employer to provide the training and support to ensure everyone allocated to on-call duties can practice safely, competently and provide a reasonable standard of care. No one will be expected to be an ‘expert’.

In practice, though, this is a big ask and we would encourage employers to think innovatively and pragmatically about on-call at this time. It may not make sense to spend precious time and resources to train up all staff.

We would encourage alternative options e.g. closing services that are considered non-essential at this time; training and redeploying staff to support in other clinical specialities in order to release those who do have on-call competencies to contribute to the rota more regularly. This could be developing a core cohort who only work in urgent respiratory care with a shift pattern approach. This approach would also ensure staff are afforded the appropriate amount of compensatory rest.

(Last reviewed 15 Oct 2020)


I have been a static MSK physiotherapist. Can I be expected to work anywhere else at this time other than in my virtual clinics?

Yes, experienced MSK colleagues are extremely skilled in core rehabilitation practices and while it may not be operationally viable (in terms of the extent of training and support required) for them to be redeployed to care for acute respiratory patients, with the right induction and support they will be able to make a significant contribution to urgent rehabilitation pathways in both acute and community settings. This is in addition to operational management and staff health and wellbeing support that they may be able to provide.   

(Last reviewed 15 Oct 2020)


What is reasonable for support workers to undertake in these circumstances?

The CSP has a progressive approach to support worker practice. We believe the support workforce, particularly at Band 4 or equivalent, could do much more to free up the registered workforce to undertake the tasks and responsibilities that only they can provide.

Working within the scope of their role and under the delegated authority of a registered healthcare professional appropriately competent Band 4 support workers can:

  • Contribute to the assessment of patients 
  • Manage a whole episode of care for certain patient cohorts
  • Provide routine respiratory care interventions
  • Lead discharge planning processes 

(Last reviewed 15 Oct 2020)


What if because of redeployment of staff we find patients recovering from COVID-19 or other patients are not being offered suitable rehabilitation locally? 

Rehabilitation for COVID-19 patients at all stages – including in the community – is critical to keeping the flow of patients moving, freeing up beds and capacity to treat more critically ill patients. 

Physiotherapy managers should be trying to ensure that their expertise is being fully used by local health system leaders so that rehabilitation needs for COVID-19 and non-COVID-19 patients are maintained as much as possible. 

If too many physiotherapists and support workers are redeployed away from rehabilitation as part of the urgent response effort, or for too long, then there will be bottlenecks in hospitals. This will cost lives and must be prevented. 

Community rehabilitation for patients who are not recovering from COVID-19 will still be needed throughout the pandemic, with face-to-face and/or remote consultations and support options, based on need. 

The temporary NHS workforce, including physiotherapy staff from private practice, returning to practice and students may be very well suited to providing physiotherapy in the community if you have gaps in your team.

If you are concerned about patients' rehabilitation needs not being met, including COVID-19 patients, you should work with your management locally and propose solutions. 

You should also do this if you believe this is because of how the physiotherapy workforce is being redeployed in your area. 

If you are not happy, you should speak to your CSP rep or let the CSP know at enquiries@csp.org.uk 

(Last reviewed 15 Oct 2020)

 

I am a physio manager and have been told that my staff need to continue to be redeployed into an acute ward or ICU to treat COVID-19 patients. What do I do if I am concerned about this? 

The focus on workforce redeployment has been saving lives and in some situations, this has meant physiotherapy staff being redeployed to deliver non-physiotherapy-related care. 

This might be the right thing to do in some situations to ease pressures, but it should not be at the expense of people with COVID-19 having the rehabilitation they need. 

Rehabilitation for people with and recovering from COVID-19 starts in intensive care and continues in the community 

Rehabilitation for COVID-19 patients at all stages – including in the community – is critical to keeping the flow of patients moving, freeing up beds and capacity to treat more critically ill patients. 

If too many physiotherapists and support workers are redeployed away from rehabilitation as part of the urgent response effort, or for too long, then there will be bottlenecks in hospitals. This will cost lives and must be prevented. 

Community rehabilitation for patients who are not recovering from COVID-19 will still be needed throughout the pandemic, with face-to-face and/or remote consultations and support options, based on need and local risk assessment. 

(Last reviewed 15 Oct 2020)


If having considered the information here you are concerned about what you are being asked to do, please contact enquiries@csp.org.uk

The NHS Staff Council statement provides further advice on the importance of agreeing any changes with individual staff, taking into account their own health and wellbeing. If changes are agreed and put in place, it is then essential that staff receive adequate training – for example, on the use of equipment – and are paid appropriately for any shift work. Although the statement has been produced for the NHS, the good practice principles it outlines would be relevant in any similar environment.

If you are concerned you are being asked to undertake a role that is not reasonable, please discuss with your local CSP steward in the first instance.

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