Extended Scope Physiotherapy

The ESP page is primarily looking at Extended Scope Practitioners from an MSK perspective, as that’s my area of interest and the impact that can make on physiotherapy services and healthcare. However the information can be extrapolated and attributed to the plethora of areas that ESPs are currently involved in within the NHS.

The face of healthcare is changing and requires innovative use of skill, resources and finance. For many years ESP’s have been developing skill, knowledge and frameworks that have allowed us to stretch the foundations of training, competency and scope of practice. Providing safe patient care is one of the greatest single issues to be addressed by the physiotherapy profession in order to practice in roles historically occupied by medical professionals (Farrell, 2014). Therefore, robust governance frameworks, on-going competency, clinical leadership, learning & development alongside sound stakeholder management are all key pieces in the jigsaw that can help facilitate the impact of ESP and physiotherapy services, in particular first contact roles in MSK healthcare.

There are some great examples of where ESP and physiotherapy services are working alongside, challenging and leading on MSK and orthopaedic decision making.  Improved patient outcomes, enhanced patient journey, increased patient satisfaction,  improved use of resources and finance are just some of the results we are starting to see. These service developments can not be done in silo and require a synergy from AHP’s, cross-discipline education and clear communication throughout organisations and to patients.

We also know from recent research that Physiotherapists can safely manage a minor trauma caseload in the emergency department and may also reduce length of stay and imaging requests for these patients (Sutton et al, 2015).

In essence the drive for ESP services to be the decision makers in MSK healthcare with appropriate medical support, structure, competency and leadership provides endless opportunities for the profession. We must look to take the lead from and learn, build and develop on the successes that are starting to evolve in the profession.

The blog posts on the ESP page will talk about shining examples, research and opportunity for the Physiotherapy profession..!


  1. Farrell SF. Can physiotherapists contribute to care in the emergency department? Australas Med J. 2014;7(7):315–317.
  2. Sutton M, Govier A, Prince S, Morphett M (2015). ‘Primary-contact physiotherapists manage a minor trauma caseload in the emergency department without misdiagnoses or adverse events: an observational study’ Journal of Physiotherapy (61): 77–80

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