Consent and Clarity Count When Working with PTAs

Posted: July 21, 2025

The Case

The College received a complaint from a patient who attended two physiotherapy appointments for pain in their knee. The patient expressed concerns about the care they received, including a lack of hands-on treatment, unclear communication, and confusion about who was providing their care.

At the first appointment, the physiotherapist used a TENS machine on the patient’s knee. The patient didn’t find it helpful and would have preferred hands-on care.

During the second appointment, the physiotherapist asked a physiotherapist assistant (PTA) to show the patient some exercises.

The patient reported they were not told who the physiotherapist assistant was, what their role would be, or asked for consent to involve the PTA in their care. The patient also felt the physiotherapist assistant was distracted and that the exercises didn’t seem right for their condition.

The physiotherapist did not document that they got the patient’s consent to involve the physiotherapist assistant in their care. The physiotherapist assistant’s name was also missing from the invoice.

The Standards

According to the Working with Physiotherapist Assistants Standard, physiotherapists must discuss both their own roles and responsibilities, and those of the physiotherapist assistant, with each patient.

Patients should know the physiotherapist assistant by name and job title and give their consent to the care. That didn’t happen in this case.

Physiotherapists are also responsible for ensuring the physiotherapist assistant’s name and job title appear on any invoices where they have provided treatment.

In this case, the treatment plan – including the exercises demonstrated by the PTA – was appropriate for the patient’s condition. But the physiotherapist didn’t take the time to understand what the patient wanted. That made the patient feel left out of their own care.

Good communication is key. According to the Communication Standard physiotherapists should engage in active listening to ensure that the patient’s perspective, needs, and preferences are heard and understood.

The Outcome

The physiotherapist was required to complete a number of educational activities including working with a practice enhancement coach and reviewing College standards and resources.

Record of the case will not appear on the Public Register.

Details of this case have been changed to maintain anonymity.