Specialist Musculoskeletal Practitioner (Spinal)

at  Somerset NHS Foundation Trust

Please see attached full job description. In the Specialist Practitioner role in the Orthopaedic Assessment Service the post holder will: - Manage patients as a fully autonomous practitioner with full responsibility for, and legal accountability for, individual clinical decisions and actions. Have a broad spectrum of musculoskeletal knowledge with specialism in one main area of work; i.e. upper limb, lower limb, foot and ankle, spinal.

Provide an initial medical assessment and triage of patients referred into the Orthopaedic Assessment Service by GPs and hospital consultants, with a variety of diverse or complex musculoskeletal problems. The post holder will be expected to assess complex musculoskeletal patients. Complex because of: * The clinical features of the patients. * Long and frequently misleading history of the patient’s condition.

• The patient’s pain state may lead to severe anxiety and possibly aggressive behaviour. Take into account the psychological and social, as well as medical aspects of the patient’s care, in order to provide a holistic, patient-centred approach, referring to other specialists as necessary. Promote simple strategies for patient management of long-term conditions for use by GPs and other physiotherapists and podiatrists. To possess highly developed physical skills where a high degree of precision is required.

Sensory coordination is important, for example the delivery of intra-articular injections and manual therapeutic techniques. Request specialist investigations such as x-rays, Ultrasound & MRI scans etc as appropriate. Sensitively explain the results of investigations and clinical diagnosis including the prognosis (of the musculoskeletal condition), the possible need for surgery; including, when appropriate, being the clinician to inform the patients of the existence of very serious pathology, i.e. tumour/metastases.

To understand and use the process of referral to other health professionals or agencies, which requires specialist knowledge across a broad range of medical conditions i.e. vascular, neurology and rheumatology. Refer patients to other consultants, for example, for neurological, rheumatological, vascular, oncology or pain management as necessary. This requires knowledge and understanding of the role of other health professionals, and a high level comparison of the range of conservative or surgical options for the patient Instigate appropriate treatment programmes: * List patients for surgery; both for major surgery requiring an in-patient stay and for smaller day cases, only the most complex cases need to be discussed with Consultant colleagues * Provide specialised advice for patients to help them with self-management and acceptance of their chronic pain/reduced function, with an emphasis on evidence based biopsychosocial model of care.

• Provide specialised and expert advice on physiotherapy /podiatry management. * Refer patients for physiotherapy, occupational therapy or podiatry as appropriate. Follow up patients in clinic after investigations and/or surgery. Carry out all interventions within personal scope of practice and in line with local and nationally recognised approaches, guidelines and standards.

• Provide specialised and expert advice on physiotherapy /podiatry management. * Refer patients for physiotherapy, occupational therapy or podiatry as appropriate. Follow up patients in clinic after investigations and/or surgery. Carry out all interventions within personal scope of practice and in line with local and nationally recognised approaches, guidelines and standards