The changing face of Consultant Physiotherapy standards

Andrew Cuff, Consultant Physiotherapist and Head of MSK. Connect Health blogs about the importance of external validation and higher standards for advanced-level and consultant-level practice and how he has been the first person to go through the MACP accelerated portfolio validation route.

12 January 2022

I have blogged previously on leadership and how as a leader, you are in the business of change. Allied Health Professionals (AHPs) are currently experiencing a change that requires each profession to respond, prepare, and adapt as we collectively aim to develop and implement standards that govern our practice. This change will ensure that members of the public and patients can be assured of the capability of those that they see in practice. This change relates to the development of advanced-level practice and consultant-level practice standards; mechanism to demonstrate capability against these standards; and an independent registry that confirms and validates this capability.

Speaking from a Physiotherapy perspective, for years we have adopted various titles that we considered synonymous with extended or advanced clinical practice such as Extended Scope Physiotherapist (ESP), Extended Role Physiotherapist (ERP), Advanced Practitioner Physiotherapist (APP) so on and so forth. These titles provided often following a job interview and governed via local competency frameworks. This has been explored in more depth here by Dr Neil Langridge (Consultant Physiotherapist).

At the 2021 PhysioUK conference I was fortunate to Chair a focused symposium involving Neil, Tina Price (Expert with Lived Experience and curator of the excellent Living Well with Pain) and Assistant Professor Paul Millington (University of Bradford). This symposium was titled “Advanced Practice Physiotherapist: Advanced in name, Advanced in Nature?” In this symposium we discussed in depth the requirement of external standards for advanced-level and consultant-level practice; the current variation that exists between job title, job role, capability, and educational background; why this matters and the opportunities that exist for the profession by embracing the proposed standards.

As a Consultant Physiotherapist, I am expected to demonstrate capability across the four pillars of practice at the standard outlined by Health Education England (HEE) within their Consultant framework. I was first appointed a Consultant in 2019 after completing a two-year Developing Consultant Physiotherapy programme and applying for a vacant post, entering a competitive process. My current role as Head of MSK necessitates that I demonstrate a Consultant-level of practice, but how do I demonstrate this? To date, it has been through job interviews and an annual internal capability assessment against the HEE standards. If I left Connect, would I still be regarded as a Consultant Physiotherapist? The answer is probably not, as my ‘title’ is linked to my employment.

When we consider this alongside the process our Orthopaedic colleagues go through; a specialist training programme, end of training verification, and recognition as a Consultant via FRCS within their specialty enabling them to apply for vacant Consultant jobs. If they were to leave their job, they would still be regarded as a Consultant Orthopaedic Surgeon indeed, they cannot use such a title without going through such a process. Tina’s face when we were planning the symposium and she realised a physiotherapist could qualify and from day one refer to themselves as a Consultant Physiotherapist was a picture but also highlights the point from a patient and public safety and assurance perspective.

Whilst national routes to external validation and verification are being developed, the Musculoskeletal Association of Chartered Physiotherapists (MACP) in parallel have widened the access routes toward full MACP membership. Previously, membership was via an MACP accredited MSc programme and for years, there has been critique of the MACP as being an organisation that does not represent the full spectrum of MSK physiotherapists given that more MSK physiotherapists are not members than are. To close this gap to representation and provide opportunity for capability to be externally validated in a number of ways the MACP have launched two portfolio routes to membership.


1 – The standard portfolio route which maps capability to the IFOMPT standards document 2016 at a Master’s level and is benchmarked at advance-level practice.

2 – The accelerated portfolio route which maps capability to the IFOMPT standards document 2016 at a Doctoral level and is benchmarked at consultant-level practice.


In September 2021, I decided that I would submit my portfolio of evidence for the accelerated portfolio route. I did this for a number of reasons. I have noticed the MACP become a more inclusive, forward-thinking group that really has the potential to close the representation gap alluded to above, not only close the gap but also at the same time raise standards and external credibility to MSK practice in the UK. I want to be part of such a group and such a movement. Further, from a personal perspective I wanted to submit my evidence to an external organisation that verifies and validates that I am working at a consultant-level.

Having gathered my evidence and mapped this to the IFOMPT standards, I wrote my accompanying critical narrative of my career to date and submitted my portfolio in October 2021. I am generally pretty reasonable at keeping a portfolio however, the process of organising the evidence in a logical way in itself was a valuable ordeal as I reflected on where my career has been and where I want it to go. Following my portfolio being assessed, I was invited to sit a viva in November 2021 and was informed shortly after that I had passed. The whole experience was very humbling however, now through to the other side I am very proud to both be the first physiotherapist to submit a consultant-level portfolio up for external scrutiny and validation but also, to join the MACP via a portfolio route.

The aim of this blog was to hopefully inspire those reading this to consider to do the same, whether that be through the MACP or to the newly formed Centre of Advancing Practice (the first round of submissions is currently live – closing 14th January 2022). As things stand, engaging with such a process is optional for AHPs and who knows what the future holds. Personally, I now feel that I can look people in the eye with greater credibility than before, and I encourage others to consider the same – ensuring you follow your own organisational governance processes that enable this.

Neil Langridge, chair of the MACP education committee and president of the advanced practice physiotherapy network, who was directly involved in the accelerated portfolio process, commented

The MACP is delighted to welcome our first accelerated member in Andrew Cuff. As an organisation we are looking at as many ways to support the MSK community in advancing their practice, exchanging ideas and opening up across the broad spectrum of care to ultimately improve patient care. We are very excited about the portfolio route, and what it can offer clinicians.


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MACP Validation

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