Physiotherapist

Physiotherapists help patients with physical difficulties resulting from illness, injury, disability or ageing to restore and maximise their movement and reduce the risk of problems arising in the future

You'll meet with patients to assess their physical problem/disorder. Having made a diagnosis, you'll then design and review appropriate treatment programmes using a range of techniques, including manual therapy, therapeutic exercise and electrotherapy.

As well as treating patients, you'll also promote their health and wellbeing, and provide education and advice on how to avoid injury and self-manage long-term conditions.

Patients can include children, the elderly, people with sports injuries, intensive care patients who require chest physiotherapy and stroke patients.

Types of physiotherapist

There are many clinical specialties and sub-specialties within physiotherapy, which have grown over time. These include:

• cardiovascular - includes chronic heart disease and rehabilitation after a heart attack
• neurology - includes multiple sclerosis, Parkinson's disease and stroke patients
• neuromusculoskeletal - includes arthritis, back pain, sports injuries and whiplash
• respiratory - includes asthma, chronic obstructive pulmonary disease and cystic fibrosis.

You can also work with particular patient groups such as infants, children and young people (paediatrics), older adults (geriatric) and in men's and women's health.

Other areas include learning disabilities, mental health, oncology and palliative care.

There are also generalist roles available where physiotherapists treat patients with several co-existing, long-term conditions and complex needs.

You can get involved in education, research and service management.

Responsibilities

As a physiotherapist, you'll need to:

• work with patients who have a range of conditions, including neurological, neuromusculoskeletal, cardiovascular and respiratory, sometimes over a period of weeks or months
• make a clinical assessment and diagnosis in order to treat their physical problem/condition
• design and review clinical management plans that encourage exercise and movement by the use of a range of techniques, and which may include specialist rehabilitation, life-style medicine, long-term strategies, and clinical techniques
• involve parents and carers in the treatment, review and rehabilitation of patients
• educate patients and their carers about how to prevent and/or improve conditions
• empower patients, through education and advice, to take control of their own care
• write patient case notes and reports, and collect statistics
• liaise with other healthcare professionals, such as GPs, consultants, occupational therapists and social workers, to exchange information about the background and progress of patients, as well as to refer patients who require other medical attention
• keep up to date with new techniques and technologies available for treating patients
• supervise student and junior physiotherapists and physiotherapy support workers
• be legally responsible and accountable
• be caring, compassionate and professional at all times
• manage clinical risk.

Salary

• Jobs in the NHS consist of nine pay bands and are usually covered by the Agenda for Change (AfC) pay rates. Starting salaries for qualified physiotherapists in England (Band 5) range from £29,970 to £36,483. Senior physiotherapists can earn between £37,338 and £44,962 (Band 6).
• As a clinical specialist/team leader, you can earn between £46,148 and £52,809 (Band 7).
• Salaries for extended scope or clinical lead physiotherapists are around £53,755 to £60,504 (Band 8a), rising to between £62,215 and £72,293 (Band 8b) for consultant physiotherapist roles.
• Salaries can rise to in excess of £74,290 (Band 8c) for management roles such as head of service.

Those working in London and the surrounding areas may receive a high-cost area supplement of between 5% and 20% of their basic salary.

Almost all qualified physiotherapists start at Band 5 and can move up the bands by furthering their skills and experiences in the workplace. Those in higher bands will have more responsibilities but are also paid more.

AfC pay bands differ across the four countries of the UK. Pay negotiation happens annually at different times, so salaries will change when each country agrees their new pay award. Check your country's AfC scales for the most up-to-date NHS salary information.

Salaries and conditions outside the NHS vary. The Chartered Society of Physiotherapy (CSP) has advice on pay and conditions for physiotherapists working outside the NHS, who are not covered by the AfC.

Salaries in private practice depend on what you are able to charge and how successful you are. Factors affecting what you can charge include your location, experience and reputation, and any specialist skills you have. You also need to take into account factors such as the time and costs involved in setting up a practice.

It's possible to combine NHS work with private work. Experienced physiotherapists may combine clinical work, university lecturing and research.

Income figures are intended as a guide only.

Working hours

Physiotherapists typically work 37.5 hours a week. Working hours usually take place Monday to Friday during the day, although you may have a seven-day work pattern. You will usually have to work some weekends and nights on an on-call basis.

As a sports physiotherapist you're likely to work at the weekend. In private practice your hours will reflect the needs of your clients.

Locum and part-time work opportunities are also available.

What to expect

• If employed by the NHS, you may be based in hospitals, health centres, clinics or GP surgeries. Physiotherapists working in the community may need to visit patients in their own homes. You may have to travel between appointments if working in the community.
• Self-employment and private practice work is common.
• The work may be physically demanding, with busy caseloads. Although patients' problems may be complex, physiotherapy can be a very rewarding job.
• There may be opportunities to work abroad to further your experience. Do your research and check whether registration is in operation in the country you want to work in.

Qualifications

To practise as a chartered physiotherapist you must be registered with the Health & Care Professions Council (HCPC). To achieve this, you must successfully complete either an undergraduate or an accelerated postgraduate degree course in physiotherapy approved by the HCPC. All degree courses also hold Chartered Society of Physiotherapy (CSP) accreditation.

For a place on a full-time undergraduate course, lasting three years (four in Scotland), you'll typically need two or three good A-levels (or equivalent), including biology or human biology and/or PE. You'll also usually need a minimum of five GCSE passes at Level 4/grade C or above, including maths, English language and sciences.

Part-time courses are available at several universities, although some of these are aimed at physiotherapist support workers, already working in a healthcare setting, who want to become chartered physiotherapists. Courses typically last between four and six years.

It's also possible to take a four-year integrated Masters degree, which allows you to develop enhanced skills in areas such as leadership, management and research.

To be accepted onto the two-year accelerated postgraduate course, you'll usually need a 2:1 degree or above in a subject such as biological sciences, psychology, physiology, sports science, sports therapy or chemistry.

Both undergraduate and postgraduate routes include a mix of theory and practical training.

Alternatively, you can qualify by taking an HCPC-accredited degree apprenticeship (England only), which combines work-based learning modules and specialist education. Search for apprenticeship vacancies with a healthcare provider on the Find an Apprenticeship and NHS Jobs websites.

For a list of accredited undergraduate, degree apprenticeship and postgraduate courses, see CSP Physiotherapy degrees. Entry requirements vary between courses, so check with the course provider for exact details.

You will also need to complete a health screening by Occupational Health and a criminal records check.

All eligible pre-registration undergraduate and postgraduate physiotherapy students studying in England can receive funding support of at least £5,000 per year. You don't have to pay it back and are still able to access funding for tuition and maintenance loans from the Student Loans Company. For more information, see Health Careers.

For details of financial support available to students in Scotland, Wales and Northern Ireland, see:

• Student Awards Agency Scotland (SAAS)
• Student Awards Services (Wales)
• Northern Ireland Direct Government Services

Skills

You'll need to have:

• excellent communication skills, both written and verbal
• interpersonal skills to establish a rapport with patients and their families
• the ability to explain treatments simply to patients and their families
• teamwork skills to collaborate with other healthcare professionals, such as doctors, nurses, occupational therapists and social workers
• good manual skills and the ability to move equipment
• problem-solving ability
• tolerance, patience, sensitivity and tact
• organisation and administrative skills
• a firm but encouraging and empathetic attitude
• the ability to motivate others in order to get them to engage with their own care
• a genuine concern for the wellbeing and health of patients
• a real interest in anatomy and physiology
• the ability to work under pressure and manage your time effectively
• IT skills
• a flexible approach to work.

You'll also need business skills if working in private practice.

Work experience

To get a place on a pre-registration degree or Masters course, providers expect you to have researched the profession and have a real insight into the role of a physiotherapist and the settings they work in. You will also need to show that you have the qualities and attributes needed to be a physiotherapist. Communication skills are key as physiotherapists work with patients of all ages and from diverse backgrounds.

Try to visit a local physiotherapy department and ask to shadow a physiotherapist to get an idea of what the work is like and whether it would suit you.

It's also useful to get some voluntary or paid experience in a health or care setting to show your interest in the area and your ability to communicate with a range of different people. There may be opportunities with private physiotherapy clinics, sports clinics, football clubs, special schools and units, and nursing homes.

Voluntary work for charities such as the British Red Cross, St John Ambulance or the MS Society, for example, may also be valuable as it shows your commitment to working in the healthcare profession and allows you to develop communication, teamworking, organisation and time management skills.

Working as a physiotherapy support worker provides a valuable insight into the role and shows your commitment.

It's also worth joining the CSP as a student member to get an insight into the profession and network with other professionals.

Find out more about the different kinds of work experience and internships that are available.

Employers

You can work in a range of settings including the:

• public sector - public services and enterprises such as the NHS
• private sector
• third sector - includes charities, and voluntary and community groups.

The NHS is the major employer of physiotherapists. Your skills are needed in most departments, such as:

• elderly care
• intensive care
• mental health
• musculoskeletal
• neurology
• occupational health
• oncology
• orthopaedics
• outpatients' departments
• paediatrics
• respiratory
• rheumatology
• stroke services
• women's health.

You may also work in the community, for local authorities or the private sector in:

• private hospitals and clinics
• GP practices and community health centres
• schools and children's centres
• nursing and care homes, and day centres for elderly people
• charities and voluntary organisations, particularly those serving people with disabilities
• sports clinics, professional sports clubs, gyms and leisure centres
• prisons
• the armed services
• veterinary clinics.

Some physiotherapists work in a variety of settings. For example, you may work part time at a sports injury clinic and have another part-time post with an NHS or private hospital.

Once you have enough experience you could also open your own practice.

Look for job vacancies at:

• Health Jobs UK
• Physiotherapy Jobs - jobs board of the CSP.
• NHS Jobs - for vacancies in England and Wales.
• NHSScotland Jobs
• Jobs.hscni.net - health and social care jobs in Northern Ireland.

Specialist recruitment agencies such as Pulse and Your World Healthcare also advertise vacancies.

Professional development

Once qualified, you're likely to receive a range of support such as an induction, clinical supervision on the job and mentoring support. You may also undertake a preceptorship, which is a structured programme of support for physiotherapists moving into a new role.

In Scotland, newly qualified physiotherapists can access Flying Start NHS. This programme supports your learning during your first year of practice in NHS Scotland.

Membership of the CSP provides access to professional advice and career development opportunities, as well as the chance to network with colleagues. The CSP lists details of post-qualifying courses and events. These can range from short one-day courses to postgraduate certificates, diplomas and MSc qualifications in areas such as advanced physiotherapy and advanced musculoskeletal assessment and practice.

If you're working in private practice, you may want to join Physio First, which provides a range of events, resources and business advice.

With experience, there are opportunities to undertake further training in areas such as injection therapy and supplementary or independent prescribing. In order to prescribe, you must successfully complete an HCPC-approved training programme in prescribing and have an annotation (mark) on your record on the HCPC register. You can then prescribe all licensed medicines that are within the scope of physiotherapy prescribing practice. For more information, see the CSP - Medicine use in physiotherapy practice.

As you gain experience, through clinical practice and further training, you will move in to an advanced level of practice. An alternative route to becoming an advanced practitioner is to take an Advanced Clinical Practitioner apprenticeship (England). This route is aimed at experienced physiotherapists and allows you to continue practising while studying part time for an MSc in Advanced Clinical Practice. Once you're working as an advanced practice physiotherapist, you can join the Advanced Practice Physiotherapy Network (APPN).

Career prospects

If you're working in an NHS hospital, there's a defined career structure. You may begin in a rotational role, working in different departments to get more experience in different specialties, e.g. outpatients and orthopaedics.

Following this initial clinical experience, you may choose to specialise in a particular area of practice such as neurology, sports injuries or critical care or with particular types of patient, such as the elderly, children or cancer patients.

As you gain experience, there are opportunities to work your way up the grading structure into senior physiotherapist and clinical specialist/team leader positions.

With further clinical experience and training, you can progress into advanced clinical practice and consultant roles with a high degree of autonomy. You'll often work in specialist consultant clinics, where you'll assess, manage and list patients for surgical/medical procedures on behalf of orthopaedic consultants, spinal consultants, rheumatology consultants or medical consultants (if ward-based).

There are also some opportunities to move into a management post within physiotherapy services, with responsibility for strategy, budgets and staff, or into general health service management. Other options for career development include teaching, training or research.

Whatever level you're working at, you're encouraged to consider how you meet the four pillars of practice:

• clinical practice
• leadership and management
• education
• research.

This is especially important to demonstrate at the advanced level of practice and beyond.