Supporting cast take centre stage

Providing interventions to support physiotherapy programmes, being a supportive colleague, and the font of all local knowledge about their patients and the workplace. These are just some of the qualities and activities that encompass physiotherapy support workers and assistants. 

Often support workers can work independently, offering vital therapy in hospitals and the community. For too long they have seemed the poor relations of registered physiotherapists, with limited access to career progression or acknowledgment by management or other professions.

Physiotherapist associates and support workers feel optimistic that their prospects and status will be given a boost with the launch of the CSP’s new Associates’ network which builds upon the success of the support worker reference group set up in 2020. The group were successful in changing the way we think about support workers and championed their value to the profession. 

The network now will harness this opportunity to support and promote further associate and student associate roles within therapy teams and the services that they can deliver to patients.

Membership of the network is automatically conferred on all CSP associate members and student associate members. While numbers are low, there are around 1,920 associate and 190 student associate members – and they are a crucial component of the profession.

A subscription to join the CSP, of just over £130 per year, provides full access to CSP steward support, continuing professional development, access to the CSP library, newsletters and Frontline magazine.

The new network aims to raise the profile of support workers with physiotherapists, other clinicians, and managers, improve career development and leadership skills, and contribute knowledge and expertise to CSP policy and practice.

The network is open to support workers, assistant practitioners, physiotherapy technical instructors and associate students, and will be supported by a network’s engagement officer.

CSP professional adviser Julie Blackburn started her physiotherapy career as a support worker. She said support workers have worked alongside the CSP and their unique needs and challenges required a dedicated network which would provide a safe place to offer peer support, networking and the career progression benefits of existing networks.

Julie said the work of support workers, and their potential to do so much more, would be showcased at upcoming events such as the CSP annual conference.

‘My career started as a band 2 support worker in the NHS. That was nearly 20 years ago, and the job really gave me an insight into physiotherapy and rehab and the diverse skill mix that support workers offer,’ she said.

‘Support workers are often the first people that you meet as a student and they provide some of that education when working with students on placement. They often are the people who support the team in supporting the future workforce.’

Chris Richards, a physiotherapy assistant practitioner, works for Hywel Dda University Health Board which covers much of southwest Wales. He will be chairing the associate network’s first annual general meeting, which will take place virtually on 17 April at 7pm*.

As an assistant practitioner he can, under direction from a registered physiotherapist, assess and treat patients, prescribe exercise and discharge patients. 

‘When I treat a patient, I say I am part of the community physiotherapy team, and most people are very happy with that. I have never had anyone say “I only want a physiotherapist to see me”.’

Chris started his career in the leisure industry as a personal trainer and says many associates also have disparate career paths. He says the network will be using training sessions, discussions, ARC and webinars ‘to help develop the workforce and boost job satisfaction and enhance skills and, the main aim, improve patient care.’

At the AGM* Chris says network members will have the opportunity to formally elect the leadership team of the network. 

‘We are looking for members interested in the role of equity, diversity and belonging officer and communications officer (website and social media).’

Emma Jackson is a physiotherapy assistant in the regional acute stroke unit at the Royal Victoria Hospital in Belfast and a CSP Northern Ireland associate board member.

She works in acute and medium-term rehabilitation and does administrative work such as ordering orthotics for patients and equipment for the physiotherapy team.

‘I work on doubles, triples and quads so it’s about getting patients with extreme disabilities back to being as able as they were before their stroke,’ she said.

‘I do a lot of sensory rehab, a lot of balance work and exercise plans, and recently I’ve been supporting students who are training with us.’
Emma says the fact that support workers are largely deprived of a career escalator offers continuity. 

‘Rotational staff come and go. We are static. Sometimes it’s nice for a more senior person, who is new, to be able to ask support staff questions, as we do become very knowledgeable. The continuity is nice for the ward, the multidisciplinary team have a familiar face.’

She says she loves her job.

‘It’s very hands-on and patient facing most of the time. I feel very passionate about the development of the physio assistant role because in Northern Ireland it’s not overly well-known, there is not a lot of progression where you can go up the bands, unless you are doing it off your own bat.’

She is keen for Northern Ireland to offer physiotherapist apprenticeships or other schemes to upgrade roles and responsibilities. 

‘That is what our network strives to do – to create a career path and create more autonomy in the role and develop opportunities.’

Eight years ago, Robert Minter was working as security guard at a hospital in Hull where he became interested in a career in healthcare.

He applied for a physiotherapy helper role and started in 2015. He now works at Hull University Teaching Hospitals Trust as therapy assistant in MSK outpatients and also works in rheumatology and vestibular. He is a CSP steward and CSP Yorkshire and Humber representative and rep on the ARC agenda committee.

Robert says that when students first arrive their educators are always saying make friends with your support workers, ‘because if you are in trouble, they are the ones that can help you’.

‘We always try to provide that friendly face, an ear to bend, or a shoulder to cry on. We can offer advice as we are seen as less threatening than seniors.’

Given support workers tend to spend more time with patients Robert feels they have clear insights into recovery patterns. 

‘We get asked for our opinion on a patient, are they improving, could we be doing anything more,’ he explains.

‘Senior staff take a lot of what we say on board because we spend a lot more time with the patients than they do. They see them for one or two appointments when we see them for 12 weeks or so. That continuity is very rewarding. We see patients coming in on a stretcher or in a wheelchair and they end up walking out at the end of it.’ Robert says the new network can help support workers to take greater responsibility.

‘There are unregistered staff working at band 5. We get some support for development in England but across the other nations there isn’t that support. I was given the opportunity to do a level 5 foundation degree apprenticeship, Wales are just starting level 4 and I don’t think there is anything happening in Scotland or Northern Ireland. We want to get all the other nations on parity.’

While he always thought he would become a fully registered physio, Robert says his work promoting support workers has changed his mind. 

‘I am more than happy to stay a support worker and carry on banging the drum for us. I always say support workers are unregistered but not unqualified.’

João Pereira, from Portugal, joined the NHS three years ago as a band 2 physiotherapy assistant. Now a band 4 working in paediatrics and working in adult orthopaedics at Northampton General Hospital, he hopes to get onto the physiotherapy apprenticeship scheme after passing English and Maths exams.

He will be leading, in partnership with a colleague, on training and professional development in the new network. 

‘It is one of my passions to help people be what they want to be and provide options. Not everyone wants to become a physio or go to university so it’s looking at all the development options.’

He underlines how much physiotherapists gain from support workers. 

‘Recently I had some feedback from band 5 and 6 physios who thanked us for the insight and support we provide them,’ he says.

‘They said we couldn’t do without you in so many ways. There is a change in the mentality when they come across from university to work with us. The lack of understanding of our scope of practice has been quite undermining. Now things are changing and that is why I am so happy to be involved with the network.’

Once qualified under the apprentice scheme João wants to continue in professional development, and hopefully one day become a lecturer. He is optimistic that the network will be a success. 

‘There has been a lot of work, a lot of sweat, we are all volunteers, but there is real passion within the network to raise of profile and encourage others.’