Establishing your scope of practice

The following questions are designed to justify your own thinking and evidence your decision making. You can download a print version from the bottom of the page.

It is important to understand that even if you answer ‘no’ to a question, you should still consider the other questions and answers. Reflect on the answers and your own personal justification, before making a decision regarding your scope of practice.

If you are still unsure whether the activities/areas of practise that you are proposing are within or out of scope, then please contact the Professional Advice Service who can support you through the decision-making process.

Question 1: Scope of the profession

Consider whether the activity or area of practice meets the basic aims of Physiotherapy: to enable individual/populations (citizens) to restore and maintain function, maximising quality of life and/or promoting and protecting mental, physical, emotional health and well-being.

Whilst making this decision you must also consider the following;

1) The four pillars of practice

  • Ensure activity fits within at least one of the pillars i.e. massage, exercise, electrotherapy, kindred methods of treatment

2) Context of practice

  • Consider whether you are working as a Physiotherapist.  This does not necessarily mean that you have physiotherapist in the titlebut that you are still Practising your profession i.e. using the knowledge, skills and competencies that you have gained as physiotherapist, and whether any of these contribute to you being able to deliver this area of practice.
  • It may state in the job description or advert, that you are required to be a physiotherapist or HCPC registered healthcare professional.   If it does not state either of these requirements, it is still possible that you will be using your skills, knowledge and competencies developed as a physiotherapist, and therefore still practicing within the profession and individual scope.
  • Would your colleagues recognise what you are doing as physiotherapy?  It is important to gain peer understanding.  This can be useful in helping you to critically think about the area of practice/role.

3) Responsibility & Accountability

  • Will you be retaining ultimate responsibility and accountability for the proposed area of practice and the care you deliver to your patients?

4) Autonomy

  • Consider how you are working autonomously i.e. are you able to make decisions without the permission of another healthcare professional. It is worth considering that there are different levels of autonomy.

Question 2: evidence-base

Consider whether there is any evidence to support this area of practice? The CSP has expectations of its members’ engagement with evidence-based practice and these apply to any area of practice, including interventions and treatment approaches, models of service delivery and activity in all sectors, settings and roles. Members needs to;

  • Consider whether peers within physiotherapy or other professions, with relevant expertise and experience, acknowledge this area of practice?This does not necessarily mean that they support it, but that there is a body of discussion on the area. 
  • Critically engage with available and emerging evidence that relates to their professional activity and service delivery, including evidence that supports its safety, effectiveness and economic value.
  • Critically appraise their practice, service delivery and professional development needs in the light of available and emerging evidence, identifying where elements of their approach or activity need to change.
  • Engage with and appropriately respond to evidence that challenges the safety, efficacy or effectiveness of a particular area of practice.
  • Engage with developments in the evidence base that highlight new ways of meeting patient needs in more clinically- and cost-effective ways.
  • Engage in collecting data to evaluate and demonstrate the quality of outcomes and service user experience and to identify areas for service improvement.
  • Contribute to identifying evidence gaps and priorities for new research to inform the professions and others’ research activity and evidence base and to enhance the quality, research and cost-effectiveness of patient care.

Please review the full version of the CSP position statement on Evidence-based practice in UK physiotherapy

Question 3: risk mitigation

Consider whether you are taking adequate steps to ensure safe integration of the proposed area into practice? These could be risks which challenge safety and/or the quality of the service to the patient population or to yourself?

Still unsure?

If after working through the questions above you still have questions, then contact our Professional Advice Service, who will be able to help you.