Case studies : Physiotherapist: Fiona Heath-Brown

Fiona completed a degree in physiotherapy at the University of Birmingham in 2004. She is now a clinical specialist musculoskeletal physiotherapist for Solihull NHS Care Trust.

My first job was as a rotational junior physiotherapist at a large teaching hospital, where I gained important experience in the many different specialities of physiotherapy whilst working in a large NHS teaching hospital.

I was promoted to a senior physiotherapist within that Trust, where I developed my interest in musculoskeletal physiotherapy, including gym work, hydrotherapy, musculoskeletal outpatients and elective orthopaedics. Attending a range of postgraduate courses enabled me to gain more specialist skills, and as my knowledge and experience grew, opportunities to progress within the NHS became more readily available for me.

I then moved to a Primary Care Trust where I carried out a static job in musculoskeletal outpatients and then moved on to be a team leader of a small community hospital. I also continued my postgraduate training and studied for the Diploma in Orthopaedic Medicine.

Earlier this year I secured my current job. I am really excited about this new role, as it involves working in a newly set-up musculoskeletal triage service. All patients with musculoskeletal conditions are triaged in the community by physiotherapists to avoid unnecessary referrals to orthopaedic consultants. Not only does this help to keep orthopaedic waiting lists down, as patients are only referred to secondary care at the point of actually needing surgery, but it also promotes the development of the physiotherapy role in the community.

I work in two different places - a GP practice and a community health clinic. On two half days a week I triage new patients every half hour. This involves carrying out a physiotherapy assessment to decide where each patient should be sent within the musculoskeletal service, e.g. individual physiotherapy, group classes or orthopaedic assessment (for further investigations or injections). The rest of my week is mostly spent seeing follow-up patients for treatment, as well as attending team meetings and in-service training sessions. Educating and advising patients how to self-manage and take responsibility for their own condition is also a really important element of every treatment regime.

I hope to specialise further in the future, by developing more skills in extended scope practitioner work such as injection therapy. I also enjoy teaching students and other physiotherapists on an informal basis during in-service training sessions, so would be keen to develop a teaching role in the future, perhaps as a lecturer practitioner.

I find musculoskeletal physiotherapy really interesting and enjoy the fact that my knowledge and skills are constantly developing both informally on a daily basis though new patient interactions, as well as formally through postgraduate courses.

The biggest challenge to working in outpatient physiotherapy in the NHS is keeping the waiting list down, without affecting the quality of care. An efficient, well-run service with knowledgeable, motivated staff is vital to achieving this.

I would advise anyone who is looking for a career in physiotherapy to try to gain as much work experience as possible in a variety of settings. Physiotherapy is a very popular career choice and the demand for university places remains high year on year. Therefore, it is vital to make sure you are totally committed to becoming a physiotherapist and able to demonstrate this if you apply for the degree course.