This paper clarifies recommendations of best practice for Long Arm Practice (LAP) placements for physiotherapy learners within the UK. It includes explanations about what a LAP is, roles and responsibilities, including delegation, and guidance about countersigning notes and placement insurance.
Overview of Long Arm Practice placements in pre-registration physiotherapy
Placements are a crucial component of pre-registration physiotherapy courses, offering learners exposure to various healthcare settings. While the Chartered Society of Physiotherapy (CSP) does not mandate specific placements, learners should gain experience across the four pillars of practice: Clinical, Research, Education, and Leadership. Diverse placement opportunities enhance professional growth and interdisciplinary collaboration. The CSP supports the use of LAP if they are well-constructed and follow appropriate guidelines to establish quality, safety and sustainability.
Innovative placement models: Role-emerging and underutilised placements
With increasing demand for placements, innovative models have emerged, such as placements in settings where physiotherapy is not traditionally provided. These are known as role-emerging or underutilised placements. Learners contribute to developing new roles within these settings, promoting integration of physiotherapy services in broader healthcare environments.
Long Arm Practice (LAP) placements
LAP placements involve supervision from a physiotherapist at a distance, with on-site support from a health or social care professional. These placements can take place in various settings and must align with national regulations to ensure quality learning experiences. Universities must establish agreements with placement providers to maintain educational standards and learner safety.
Definition of roles
- DtD supervisor: A registered health or social care professional responsible for daily supervision and ensuring appropriate support for learners.
- LAP supervisor: An HCPC-registered physiotherapist overseeing the learner’s development, usually employed by the university.
- Learner: Engages in patient care under supervision, contributing to service delivery while staying within their scope of practice.
Scope of practice and delegation
Scope of practice varies based on experience, setting, and regulatory guidelines. The HEI, LAP supervisor, and DtD supervisor collaboratively define appropriate tasks. Delegation should be based on learner competency, ensuring patient safety and adherence to professional standards.
Regulatory compliance, record-keeping
Placements must comply with HCPC standards. Record-keeping is a key aspect of placements, with responsibilities shared between the learner, DtD supervisor, and LAP supervisor. Proper documentation, including countersigning notes where necessary, ensures accountability and quality assurance.
Placement insurance
Placement providers are responsible for learner safety and must have Employers' Liability Insurance to cover any injuries due to provider negligence. Medical Malpractice Insurance should also be in place to cover any clinical negligence. If the provider’s insurance does not extend to learners, the learner must obtain their own coverage, such as the CSP Public Liability Insurance (PLI) scheme.
Public Liability Insurance, covering non-treatment-related incidents like slips and falls, must also be ensured by the HEI, placement provider, or the learner’s own policy. The HEI must verify appropriate insurance coverage before placement commencement. More information can be found on our CSP webpages here: Insurance for learner physiotherapy placements
Further information about practice-based learning for clinicians, learners, and universities.