Shahbaz Afzal

To draw on advanced clinical physiotherapy knowledge and practical skills to define physiotherapy within
the area of clinical responsibility – a variety of chronic respiratory conditions e.g., COPD, ILD, Bronchiectasis,
Chronic Asthma, and respiratory failure.

To lead on service improvement exercises and support junior staff in gaining competence and confidence
in respiratory patient management.
CASE MANAGEMENT
-To autonomously manage and take on clinical responsibility for a designated caseload of patients with
respiratory diseases/Chronic Obstructive Pulmonary Disease (COPD) .
-To provide high quality complex respiratory patient assessments and monitoring to ensure that care is
provided appropriately in a proactive and responsive manner in line with current guidance.
-To carryout triage of referrals to ensure that suitable patients are accepted onto the caseload and receive an initial holistic assessment within expected referral time frame in line with expected KPIs
-To provide patient care supported by a mixture of home visits, clinic reviews, virtual clinics, MDTs as well as educational clinics.
-To identify and provide patients within the caseload with clinical interventions such as blood tests, sputum cultures, ordering x-rays, Co monitoring, etc. as required or refer to appropriate service for intervention.
-To work closely with other community specialist teams, such as oxygen service, primary care teams and social services and the Rapid Response Team to reduce hospital admissions, unplanned admissions and premature readmissions.
have received appropriate support for their quit smoking attempts to ensure the best possible outcome
for the patient.
-To provide support with medicine optimization, inhaler technique support as well as providing the patients with a self-management plan tailored to the individual care needs as well as sign posting and linking patients into other supportive services such as Pulmonary Rehabilitation.
-To be responsible for transferring and or escalating individual patient case in weekly MDT with Respiratory Consultant and other relevant respiratory senior clinicians within the community respiratory team as appropriate, to maximise the efficiency and effectiveness of patient care.
PULMONARY REHABILITATION
-Identify, recruit and assist supervise and assess patients, in providing exercise classes and deliver educational sessions, to chronic respiratory patients.
- Provide a day-to-day oversight of the expected patient flow in the Pulmonary Rehabilitation service in relation to timelines and service expectations
- Perform comprehensive holistic PR assessments and advise on appropriateness for PR classes,
-Adhere to PR Quality Standards and PR Guidelines in care of patients.

-To be responsible for providing respiratory physiotherapy assessments for patients attending community based Pulmonary Rehabilitation (PR) Programmes.
- In conjunction with the Clinical lead developed the Standard operating procedure (SOP) for the Service.
- Supported and developed both the onsite and Home delivery of the evidence based practice Pulmonary
Rehabilitation programme.
-Delivery of home-based Pulmonary Rehabilitation programmes using digital remote formats.
- Proactive management of the waiting list (Subjective and Objective assessments to enrol the patients into PR)
- Audit and evaluate the program.
- Production of clinical outcomes reports associated with PR programmes.
-Timely submission of key performance indicators to the commissioners.
-To be responsible for providing respiratory physiotherapy interventions in community based Pulmonary Rehabilitation (PR) Programmes.
-Working on PRSAS accreditation and developing logbooks to manage data to speed up the process of accreditation.
OXYGEN SERVICE
- Be able to interpret spreadsheets and monthly reports of patient's oxygen activity
-To be able to perform arterial blood gas sampling – CBG
-Perform assessment for LTOT and ambulatory oxygen options and select equipment / device that suits
patients' individual needs.
-Attend / organise MDT meetings with regards patient's oxygen use if required, with identified patients who
are under / overusing oxygen, to identify a plan and even possible removal if warranted.
-Follow national guidelines for prescription of Oxygen and understand Oxygen ordering system i.e. HOOF
process

-To be responsible for providing respiratory physiotherapy assessments for patients attending community based Pulmonary Rehabilitation (PR) Programmes.
-Documented and developed a framework for band 4 competencies.
-In conjunction with the Clinical lead developed the Standard operating procedure (SOP) for the Service.
-In conjunction with the Clinical Lead, support and develop both the onsite and digital delivery of the evidence based practice Pulmonary Rehabilitation programme.
-Delivery of community-based Pulmonary Rehabilitation(PR) programmes.
-Delivery of home-based Pulmonary Rehabilitation programmes using digital remote formats.
-Proactive management of the waiting list (Subjective and Objective assessments to enrol the patients into PR)
-Audit and evaluate the program.
-Production of clinical outcomes reports associated with PR programmes.
-Timely submission of key performance indicators to the commissioners.
-To be responsible for providing respiratory physiotherapy interventions in community based Pulmonary Rehabilitation (PR) Programmes.
-In conjunction with the Clinical Lead, support and develop both the onsite and digital delivery of the evidence-based practice Pulmonary Rehabilitation programme.
-In conjunction with the Clinical Lead, provide supervision of junior staff members.
-In collaboration with the Clinical Lead, support Physiotherapy student university placements.
-To be actively involved in research and audit to ensure an evidence-based approach is used in physiotherapy practice to make informed judgements regarding patient care and service development.
-Ensuring CSP standards of practice, education and conduct are adhered to.
-Skilled in the assessment of complex/specialist respiratory care/support needs and in the development, implementation and evaluation of care/support packages for patients and families.

-Work in Secondary Care to identify patients with chronic respiratory disease, working alongside ward based staff to optimise those patients management whilst in hospital and support the patient's transition in to Primary Care.
-Work in a highly skilled and experienced team of specialist respiratory physiotherapists, nurses and consultants to meet the needs of complex respiratory patients in clinics and their own homes.
- Delivering Pulmonary Rehabilitation in conjunction with the Lead Allied Health Professional and supported by a Fitness Instructor in various locations across Southern Derbyshire (i.e. Derby City, Swadlincote, Amber Valley) .
-Performing physiotherapeutic assessment and formulate
treatment plans to patients with diverse and complex presentations who may require NIV. This includes ILD, COPD, HVS and NMD.
-Working alongside Primary and Secondary care providers to support patients in their own home and prevent hospital admissions.
-Supporting the development of links with the NIV service providing specialist respiratory assessments and treatments to patients requiring domiciliary NIV.
-Help to develop and deliver training programmes to non-specialist services. Supporting their provision of respiratory treatment to non- complex respiratory patients.
-Supporting the development to a beacon service nationally and within The Trust.
-Supporting the development of an in-reach and outreach service promoting excellent patient care and experience.
-Responsibility for own caseload and work without direct supervision. Supervision takes the form of formal training and clinical reasoning sessions, peer review. Access to advice and support from senior physiotherapists is available if required.
-Supervise, educate physiotherapy students.
-To support the Lead Allied Health Professional in auditing the service provided, implementing changes as necessary.
-Using in depth knowledge of respiratory conditions and national guidelines to identify patients whose community management is sub optimal. Using respiratory pathophysiology knowledge to perform physiotherapeutic assessment to patients with diverse presentations and complex presentations/multi-pathologies.

-Using advanced clinical reasoning skills and manual assessment techniques to provide an accurate diagnosis of their condition supported by a range of investigations i.e. PFT, CT, CXR and Microbiology results.
-Be able to effectively utilise all available resources in order to complete thorough assessment and relevant treatment of patients, such as liaison with medical, nursing and therapy colleagues, gaining a thorough subjective history from patient/carers, use of medical and inter- disciplinary records.
-Responsible for assessment and management of clinical risk within own caseload.
-Professionally and legally accountable for all aspects of professional and clinical work. Must maintain accurate, comprehensive and up to date treatment notes in line with legal, departmental and CSP requirements for each patient. When appropriate communicate timely and informative written reports and discharge summaries for other audiences e.g. GPs, Consultants, MDT
-To perform advanced physiotherapeutic assessment to patients to with diverse presentations and complex presentations/multi- pathologies; use advanced clinical reasoning skills and techniques to provide accurate diagnosis of their condition. This involve analysing information from a range of sources; x-rays, CT, MRI scans, medical notes and care pathways.

-Providing opportunities for rehabilitation with every interaction.

-Sharing knowledge and best practice with clinical, therapy and wellbeing teams.
-Enabling rest and recovery.
-Provide care and support.
-Enable participation in meaningful activities and therapeutic programmes – such as providing encouragement and keeping up the momentum in a stroke rehabilitation programme.
-Take care of the general day to day housework offer companionship and take an interest in people's lives, supporting individuals with their choice of lifestyle and wellbeing.

-I assessed the patient according to the need for physiotherapy and depending upon the condition is either neurological, musculoskeletal or cardiopulmonary condition such as to access the cardiovascular and respiratory system so, in case of impaired breathing, I worked on breathing exercises. Additionally, did neurological and musculoskeletal assessments to decide and discuss the appropriate treatment plan and goals with supervisor.
-I had the command to work with geriatric and paediatric populations moreover excellent communication skills to deal with over-aged or underaged patients.
-I mostly followed the early mobilisation principle for ICU patients which is enhancing early activities like positioning, weight-bearing activities, passive movements to improve muscle strength and joint mobility, and chest physiotherapy to improve sputum clearance and work of breathing.
-I always followed the principle of ease for patients in which I started with comforting the patient mentally and then proceeding with the treatment.
-In different wards especially the neurological ward, the basic purpose of physiotherapy is to decrease the dependence of patients on aids and devices and to make patients independent, I accomplished such activities especially for the disabled to regain functional mobility and reduce the level of dependence, spasticity and enhance motor and sensory function.
-I used different manual therapy techniques for both diagnosis and treatment and for follow-up.
-For my outpatient, I managed almost 17-18 patient cases on daily basis with a range of different conditions I used different physiotherapy treatment regimens like mobilization, manipulation and others when needed and also involved electrotherapy as a component of treatment plan to make the patient relax and to ease the symptoms.
-For continued professional development I participated in different research projects and studied the literature on different databases, I was asked by other colleagues to share my research and literature review experience.
-I was also an active participant in the matter of attending workshops, seminars and medical camps. I maintained the record for every patient.
-For my continued professional development, kept records and wrote case studies,
-I was given 3-5 students for internship under my supervision for which I trained them, gave them proper classes and checked their patient records regularly.