The Developing Role of Hand Therapists within the Hand Surgery and Medicine Services: An Exploration of Doctors’ Views

Abstract

Extended scope practitioners (ESPs) are specialist occupational therapists and physiotherapists working beyond their recognised scope of practice. Thirty-five hand therapists were identified as working in this role in Britain, primarily in pre- and post-operative settings. A postal survey of the 31 consultants with whom they worked investigated their views on the nature of this role and service; the facilitating and constraining factors to this development; and on required qualifications, training and supervision. Seventeen consultants, all hand surgeons, replied. They reported that the principle reasons for the development of ESPs were the need to reduce the waiting list and the consultants’ workload. A variety of roles had been created, reflecting the different service needs and the skills of the therapists. Training was largely experiential. Extended scope practitioners had had a significant impact on waiting lists. There was variation in the surgeons’ views regarding further development of these posts. Concerns were identified regarding these posts, such as professional isolation, the transferability of skills, inappropriate extension of the role and the potential for litigation.