Policy statement: Physical therapist support personnel

The World Confederation for Physical Therapy (WCPT) advocates that policies for using physical therapist support personnel have to be determined at a national level. 

Physical therapy is an internationally recognised health profession. It may be practised only by qualified and, where required by state or national legislation, duly licensed/registered physical therapists. WCPT advocates that where physical therapist support personnel are utilised, direction and supervision from a physical therapist are essential in the provision of quality physical therapy services. The degree of direction and supervision necessary for assuring quality physical therapy services is dependent upon many factors, including the education, experiences, and responsibilities of the parties involved, the needs of the patient/client, as well as the organisational structure in which the physical therapy services are provided.

WCPT acknowledges the different stances held by member organisations about the employment of support personnel, some of whom may decide that they do not support the employment of physical therapist support personnel in direct patient/client physical therapy services.

The term support personnel is used in a generic sense to encompass a range of employment classifications, such as physical therapist assistant, physical therapist aide, physical therapist technician or physical therapist helper.

Where physical therapist support personnel are employed, WCPT advocates that member organisations should ensure that:

• physical therapist support personnel only assist the physical therapist in administration of physical therapist selected interventions/treatment and only in a properly conducted physical therapy service under the direction and supervision of the physical therapist
• supervision of physical therapist support personnel by the physical therapist requires that the physical therapist is preferably physically present and immediately available
• the physical therapy profession is actively involved in human resource discussions, decisions and policy changes concerning the potential use of physical therapy support personnel and their roles and required competencies
• they use effective consumer and marketing policies to assure that employers, governments and the community understand that such support personnel do not replace a qualified physical therapist
• the scope of work for physical therapist support personnel must be clearly identified to ensure compliance with state or national legislation/regulation/recognition
• physical therapist support personnel are adequately trained to perform effectively and safely any direct intervention/treatment which the member organisation has deemed within the province of a physical therapist to delegate
• services employing physical therapist support personnel ensure they are always clearly identified so that the patient/client is not in doubt that the person is not a physical therapist
• the ethical principles guiding the conduct of physical therapists should contain specific reference to the proper use of physical therapist support personnel in direct patient/client intervention/treatment [1] [2]

WCPT advocates that, regardless of the setting in which the physical therapy service is provided, the following responsibilities must be carried out solely by the physical therapist and may not be delegated to physical therapist support personnel:

• interpreting referrals when available
• performing the patient/client examination/assessment, evaluating the data from the examination/assessment, establishing the diagnosis and prognosis/plan, and providing interventions/treatments that should not be delegated
• developing or modifying the plan of care which is based on the initial examination/assessment or re-examination and which includes the physical therapy anticipated goals and expected outcomes
• determining when the expertise and decision-making capability of the physical therapist requires the physical therapist to personally provide the treatment/interventions and when it may be appropriate to utilise the physical therapist support personnel
• determining the most appropriate utilisation of the physical therapist support personnel that provides for the delivery of a service that is safe, effective, and efficient
• re-examining the patient/client in light of their goals, revising the plan of care when indicated, implementing those interventions which should not be delegated
• establishing the discharge plan and documenting the discharge summary

Glossary

Support personnel — a generic term to encompass a range of employment classifications such as physical therapy assistant, aide, technician or helper; rehabilitation assistant and classroom therapy assistant. Support personnel will function only in a properly conducted physical therapy service under the direction and supervision of a physical therapist when implementing direct care programmes.

References

1. World Confederation for Physical Therapy. Ethical principles. London, UK: WCPT; 2011.  (Access date 22nd September 2011)

2. World Confederation for Physical Therapy. Policy statement: Ethical responsibilities of physical therapists and WCPT members. London, UK: WCPT; 2011.  (Access date 22nd September 2011)