1 | Pressure points: Careers
The book’s aim is to make sure that you are completely well versed with the fundamentals of physiotherapy before you apply for university study; that includes knowing about the different career opportunities available to you in this profession. The field you are hoping to enter offers a great deal of options and exciting pathways.
It is equally important, when you have qualified for the profession, that you are quite open-minded in your approach and progressive in terms of your thinking. Physiotherapists normally work autonomously, as they are able to accept referrals from a range of sources (though professional autonomy is only granted to Chartered Society of Physiotherapy (CSP) members) and therefore you have to consider the business elements of the profession, i.e. balancing treatment with an understanding of how to balance the books. What this means is that physiotherapists make their own clinical judgements and treatment decisions and they also work in reflection, i.e. reviewing themselves and making corrections to their work where necessary.
Physiotherapy is a career that relies on the strength of the individual as well as the ability to work in a team. Physiotherapy as a subject is highly academic and therefore of great value; this means that employment prospects are large and varied. These prospects are not limited to the NHS; there is an enormous breadth of employment prospects that can be found across the different sectors (see here).
Physiotherapy is not, however, a profession that involves only physical therapy. Physiotherapists work with people – in most cases people who are disabled, or who have been ill or injured. Physiotherapists need to be able to communicate on a personal level with people of all ages; to be reassuring and comforting; to explain the treatments they are using; and to help patients overcome fear and pain. Physiotherapists need to be able to assess the needs of their patients and to be aware of the effects of external circumstances such as social or cultural factors.
Working as a physiotherapist
Physiotherapists work in a wide range of health and care environments that include hospitals, the local community, private practice, industry and sports settings. The majority are employed by the NHS. Physiotherapy comprises the largest group within the allied healthcare professions with approximately 60,000 state-registered physiotherapists in the UK, which compares to 42,000 in 2012.
A typical working day depends on whether you are working in the NHS or private practice. In the majority of cases, physiotherapists work in hospitals with normal working days, i.e. 9am–5pm, Monday–Friday. There are occasions when a weekend may be required, but this is symptomatic of the health profession.
The most identifiable example is of a hospital physiotherapist working in the Physiotherapy Department. A calendar booking system is in operation, as in a GP surgery, where they will see many patients per day, each one for an allotted period of time, about a range of problems, such as rehabilitation from broken bones, bad backs and arthritis, for a range of ages.
Those working in hospitals might work on the wards and visit the ward staff to discuss the treatment plans of new patients. Sometimes they then treat them as part of their ongoing care, often taking them to the physiotherapy department. A ward physiotherapist might have half a dozen wards to cover, varying from children’s wards, to orthopaedic wards or stroke units. In some cases, a physiotherapist might be required to work in the intensive care unit if it is thought essential to the immediate rehabilitation of a patient.
Physiotherapists in private practice may have more opportunities to travel, depending on the job they are doing. If you work for a professional sporting association, for example, you may find that you have to travel a lot to support the team. Sometimes patients will be referred to you, other times you will need to target your business, and that may require advertising.
The concept of travel is also becoming more common in the NHS as a result of changes, as physiotherapists are doing more home visits to support the elderly.
To qualify as a registered physiotherapist you need to gain an approved degree (see here) that has been validated by the CSP and the Health & Care Professions Council (HCPC). If you complete the degree you must then register with the HCPC to use the professional title of physiotherapist and you are eligible for membership of the Chartered Society of Physiotherapy (CSP).
As with any career, there are pros and cons to physiotherapy. It is up to you to decide if the pros outweigh the cons. That is why work experience is invaluable, as it will either confirm your decision to pursue the career or demonstrate to you that you should seek an alternative occupation. Physiotherapists have a lot of demands on their time and they often can be stretched to the limit – if you will excuse the pun – because of the nature of their work, especially within the NHS, where, as a result of staffing cuts, there is more work for an individual physiotherapist. However, the variety and nature of the work is what physiotherapists thrive on and it is a hugely rewarding career, as you get to see the continuing progress of an individual patient over time.
The question of what attributes a physiotherapist needs is a common one. It is easy to say ‘be physically fit’; at the end of the day, practise what you teach. Not to be flippant, it is a good point, as in any very demanding job that requires you to be on your feet most of the day, you want to make sure that you are looking after yourself. Additionally, you also need to consider the psychology of the patient. As with the relationship between a client and a personal trainer in a gym, a patient will have more confidence in their instructor if they can see that the instructor takes good care of themselves. Being active is also necessary for clear thinking, as it gives you the energy to get through the week.
However, over and above that, there are other characteristics that define a good physiotherapist. You need to have patience, peace of mind, the strength of character to encourage a patient and firmness to make sure that they achieve their targets. A physiotherapist is a strategist. Each individual one will find their own style – and you should be encouraged to find yours – but it all comes from this foundation and you need to consider now whether you possess those attributes.
Common career paths for physiotherapists
Once you have completed your BSc in Physiotherapy you will, hopefully, gain membership of the CSP and become registered with the HCPC – all degree courses in the UK are now accredited by the CSP and the HCPC. To say that there is a standard route is not correct. The main thing you need after graduating is clinical experience, and the usual route will be to gain experience in areas that you did not cover on your placements, usually as a junior in a rotational band 5 job with a starting salary of around £23,023.
A rotational band 5 job is a general physiotherapist role in which you rotate through the various departments in a hospital, including respiratory, stroke, orthopaedic, etc. Each rotation will last around four months. These are commonly in the NHS or in some private practices and are designed to build up your expertise before you can qualify for the next band (band 6). These bands also equate to your pay scale.
A lot of physiotherapists get their rotational band 5 job through the NHS or by having impressed on their placements during their course. However, you do not have to have worked for the NHS first before going into private practice. Some physiotherapists set up their own practices, but their success is all based on reputation and on building up the relevant experience over many years. As for anything in life, you have to prove yourself first.
Further qualifications are not essential after your degree, but you are expected to maintain your continuing professional development, which is very important and discussed below.
Private practice is one of the more lucrative career moves. Private practice, as an umbrella term, includes:
- treating patients independently for the same ailments as in the NHS
- working for a sports club or a specific team, aiding in the recovery of sportspersons from injury and helping to optimise their performance
- occupational rehabilitation, which means helping people to recover from accidents or illnesses and to return to their normal lives.
There are also additional opportunities to go off on a tangent and get involved in policy development and research, in order to ensure that physiotherapy as a profession continues to progress over time in line with NHS changes and guidelines.
The areas of work available to you as an aspiring physiotherapist are outlined in Table 2.
Area | Work |
Outpatient clinics | Advising and treating people with spinal and joint problems, or recovering from accidents and sports injuries. |
Patients in hospital | Treating inpatients, including people in intensive care units – to help very ill people to keep their chests clear of secretions while they are too weak to cough effectively; to keep their limbs mobile while confined to bed. |
Schools | Working with teachers and parents to support children with developmental movement problems. |
Workplaces and industry | Advising managers and staff on injury prevention, as well as treating specific problems. |
Sports and community centres | Promoting health, preventative health education through progressive exercise... |