A Delphi study of the role parameters and requirements of extended scope practice in hand therapy

Physiotherapists and occupational therapists working within hand therapy in the United Kingdom are undertaking roles working beyond their normal professional boundaries. The aim of this study was to reach consensus on the role parameters and required knowledge, training and competencies desirable for such extended roles. A panel of 21 expert stakeholders comprising hand therapy clinicians, educators, doctors, existing extended scope practitioners and a representative from a patient group participated in three survey rounds using the Delphi technique. They examined three groups of parameters with reference to the competencies, knowledge and activities desirable for such extended roles. A prioritised list of parameters was developed. Data were analysed using descriptive statistics. Response rates for each round were consistently 95% or greater. The results showed areas of clear consensus, with prioritisation supporting the development of an independent practitioner working without direct supervision by a medical practitioner. Specific criteria were identified for such practice with regards to knowledge, training and activities, such as the ability to order, understand and interpret clinical investigations. In-house formal training tailored to individual service needs was the favoured approach. The results of this study can inform the development of a national strategy for the implementation of new ways of working while ensuring the provision of a quality health service