Being able to assure quality practice is a pre-requisite of the HCPC standards of proficiency for physiotherapist to practice within their profession (1). This is important in order to ensure that as a healthcare professional, I am delivering the most effective patient care whilst fulfilling the requirement of legal and policy frameworks governing practice (2). Considerations had to be made during different components and modules of the course, an example of this would be: a video business proposal I delivered where I considered the legal and policy frameworks governing practice (evidenced – Business Case PowerPoint Presentation Video) for my proposed business idea - respiratory first contact practitioners in GP surgeries. My business idea was in line with key NHS drivers of: NHS long term plan and local trust policies in order to propose my idea with considerations of the frameworks governing practice (2–4), which was reinforced with the feedback I received showing good insight into the legal and policy frameworks governing practice within this area of physiotherapy care (evidenced – SE706 Feedback) (2). Assuring quality practice also comes in the form of doing all necessary mandatory training to ensure I am safe to practice in a clinical setting, otherwise I would have not been able to go out on practice placement. However, through completing all necessary legal and policy driven training that govern practice, I was able evidence my ability to safely practice (evidence - Fitness to Practice Certificate) in a clinical environment, demonstrating this domain descriptor effectively (2). When it comes to physiotherapy practice in a clinical setting, there was always one topic that kept cropping up whilst at university and on placement, this was consent. The concept of informed consent has become a hot topic within the NHS to ensure all patients give voluntary, informed consent and have the capacity to do so due to the legal and ethical parameters involved (5,6). Therefore, I had to ensure I obtained informed consent prior to assessment and treatment of a patient and document this clearly (evidenced – Note Writing: Consent), demonstrating a fulfilment of the required legal and policy frameworks governing clinical practice (2). I found this important to uphold throughout my physiotherapy masters and I know that going forward, it is important to continue to adhere to the legal and policy framework that govern practice in order to practice safely not only for myself but for the people I work with and treat throughout my physiotherapy career (2).

Ensuring quality can come in the shape of recognising situations where effectiveness, efficiency and quality of a service is compromised and taking appropriate actions (2). Whilst on placement, I highlighted an area where service quality was compromised, this was through a lack of hand hygiene in an MSK outpatient setting. This has become a hot topic in recent months with the current pandemic situation (7), and I felt developing a service around the legal and policy frameworks of government policy was appropriate. Once I recognised a situation where effectiveness, efficiency and quality of the hand hygiene component of the service was compromised and believe this is taking appropriate action to remedy the situation (evidenced – Service Improvement Poster)(2). Being able to work within evidence-based practice is a key component of clinical governance (8), and to be able to do this it is important for clinical practice. Recognising situations or literature where effectiveness and quality of a service working less effectively than it should, compromising patient care needs to be addressed and to take appropriate actions (2). An example of this was during an assignment on a topic of our choosing where we were to analyse literature and create evidence-based practice implications of how to best interpret and utilised in clinical practice (evidenced -Task 3: CASP Tool). We utilised  the CASP tool to help appraise the strength of each paper and how to interpret for clinical application (9) evidencing – how I recognised a topic/situation where quality and effectiveness of the service was compromised, and how I took appropriate action using an appraisal tool to interpret literature and create evidence-based practical application (2), seeking to continuously improve my own practice and demonstrating a commitment to excellence (2,10). These two seperate occassions have taught me that recognising compromised situations and being able to offer solutions in not only a practical setting, but also in a theoretical setting that can impact my clinical practice. These skills will be taken forward into my future career through the reading and research I do, but also in identifying areas of a service that can be improved for the quality and safety of practice for my colleagues and patients that I can come into contact with.

Reflection has been a concept that has had to grow and develop throughout the course and has helped understand new situations and how these have influenced me and my practice. Being able to critically reflect on practice is something I trialled during and after each placement (evidenced – Placement 4: Reflection & Placement 5: Reflection), where I reflected on topics such as: my own communicative techniques and how they I can do things differently going forward to be able to continuously progress, team working in an inpatient setting and note writing. Where I have been able to critically review my practice and trial learning from them for my own future practice in line with HCPC standards of being able to reflect and review practice (1,2). These skills of critical reflection have taught me to consider different clinical and non-clinical contexts and how these have affected me in practice and how they can be improved in future scenarios through the use of critical reflection.

Reference List

1. Council H and CP. Physiotherapists | The Standards of Proficiency For Physiotherapists [Internet]. 2013 [cited 2020 Mar 24]. Available from: https://www.hcpc-uk.org/standards/standards-of-proficiency/physiotherapists/
2. Physiotherapy CS of. Chartered Society of Physiotherapy Framework [Internet]. 2013 [cited 2020 Mar 23]. Available from: http://www.csp.org.uk/professional-union/careers-development/cpd/csp-eportfolio/my-eportfolio/cpd-
3. NHS England. The NHS Long Term Plan [Internet]. 2019 [cited 2020 Apr 14]. Available from: www.longtermplan.nhs.uk
4. Essex NM. Mid Essex Clinical Commissioning Group. 2013;
5. NHS. Consent to treatment [Internet]. 2019 [cited 2020 Jul 1]. Available from: https://www.nhs.uk/conditions/consent-to-treatment/
6. Hall DE, Prochazka A V., Fink AS. Informed consent for clinical treatment [Internet]. Vol. 184, CMAJ. Canadian Medical Association; 2012 [cited 2020 Jul 1]. p. 533–40. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307558/
7. How to wash your hands - NHS [Internet]. [cited 2020 Jun 7]. Available from: https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/
8. The main components of clinical governance [Internet]. [cited 2020 Jun 3]. Available from: https://www.uhb.nhs.uk/clinical-governance-components.htm
9. Nadelson S, Nadelson LS. Evidence-Based Practice Article Reviews Using CASP Tools: A Method for Teaching EBP. Worldviews Evidence-Based Nurs [Internet]. 2014 Oct 1 [cited 2019 Jun 3];11(5):344–6. Available from: http://doi.wiley.com/10.1111/wvn.12059
10. Charted Society of Physiotherapy. Chartered Society of Physiotherapy xx Professional Values of Members’ Code and Behaviour 2 Code of Members’ Professional Values and Behaviours [Internet]. 2019 [cited 2019 Apr 9]. Available from: https://www.csp.org.uk/system/files/csp_code_of_professional_values_behaviour_full.pdf