Physiotherapists Working with Assistants Standard

How Consultation Feedback was Incorporated into Final Standards

The College approved the Working with Physiotherapist Assistants Standard and it came into effect on June 29, 2016. All physiotherapists are expected to review and implement the final Standard into their practice.

We would like to thank everyone who submitted their feedback and contributed to this policy review.

Below is an overview of the comments received and Council’s rationale for incorporating changes and approving the final Standard.

More than 77% of respondents felt the Standard was clear and patients and physiotherapists would understand it. For those who did not feel this was true, they highlighted the issues below.

Concerns

Some suggested that more information was needed to explain certain parts of the Standard, such as what a communications plan would look like.

This lack of clarity was identified and corrected by rewording the Standard. As well, Council directed that the Standard should contain links to additional supports, definitions and resources when needed.  

A number of respondents indicated that they felt there was information missing from the Standard, on topics such as record keeping, supervising physiotherapist students, controlled acts and fees for services delivered by assistants.

Council agreed that these topics are intertwined and essential to applying the Standard, however they are covered in other Standards that are currently under review. Physiotherapists should refer to the related Standards and should amendments be needed to the Standard: Physiotherapist Working with Physiotherapist Assistants these can be made at a later date.

When the Standard: Performing Controlled Acts and Other Restricted Activities Standard was approved, associated amendments were made in the Standard: Physiotherapists Working with Physiotherapist Assistants Standard to address gaps identified in regards to controlled acts.

More than half of people who responded to the consultation indicated that physiotherapist assistant (PTA) was the preferred term to be used by the College in our communications.

Council accepted this recommendation and approved using physiotherapist assistant (PTA) in College materials moving forward. Please note this does not imply that the term “physiotherapist assistant” or “PTA” is protected.

Consultation

The College is holding a public consultation on the Standard: Physiotherapists Working with Assistants. Gathering feedback and comments from the public, the profession, and other interested groups helps the College to develop Standards and policies that best support the College’s work in protecting the public interest.

All feedback is appreciated—both what you think works well and what you think does not work well. Please note your comments submitted online will be published anonymously and you are welcome to read what others have said by clicking the button that says Interested in Reading What Others Said?—Read Their Comments Here.Read the current Standard: Physiotherapists Working with Physiotherapist Support Personnel.

Standard

1. When assigning and supervising physiotherapy care a physiotherapist must:

   1. consider the appropriate balance of: the patient’s best interest, quality of care, and risk
   2. assume responsibility for all care and services assigned to an assistant
   3. roster with the College to work with assistants
   4. have a written communication protocol that states how and why the physiotherapist and the assistant will discuss patient care

2. A physiotherapist who assigns care to an assistant must:

   1. discuss the roles and responsibilities of the physiotherapist and the assistant with each patient or substitute decision maker (SDM)
   2. obtain consent for the assistant to perform the assigned tasks

3. A physiotherapist must not assign the following activities to an assistant:

   1. care the physiotherapist does not have the knowledge, skills, and judgement to perform
   2. initial assessments
   3. re-assessments
   4. treatment that would require the assistant to make an independent analysis and decision to modify the treatment outside of an established plan
   5. controlled acts that have been delegated to the physiotherapist
   6. any part of acupuncture

4. When assigning care, a physiotherapist must make sure that an assistant:

   1. will be able to reach the physiotherapist according to the communication protocol
   2. has the appropriate knowledge, skill, and judgment to deliver the assigned care safely and effectively
   3. can deliver the same quality of care that would be delivered by the physiotherapist
   4. is identifiable to patients by name and job title

5. When supervising an assistant, a physiotherapist must make sure that:

   1. the level of supervision is reasonable in the circumstances (including but not limited to, the patient’s condition, the clinical environment and the abilities of the assistant)
   2. the assistant can receive appropriate direction from the physiotherapist according to the communication protocol
   3. an alternate physiotherapist contact is designated when the physiotherapist who assigned care cannot be contacted according to the written communication protocol

6. A physiotherapist agreeing to be the alternate contact for an assistant must:

   1. be able to assume responsibility for the care delivered by the assistant
   2. have the knowledge, skill, and judgement to perform the assigned care
   3. be available to intervene according to the communication protocol
   4. assume responsibility for the patient and the care delivered by the assistant when the alternate physiotherapist makes decisions about the care (at which time a transfer of care occurs)

7. An assistant’s name and job title must appear on invoices whenever all or part of the treatment has been provided by the assistant.