An Exploration of the Developing Role of Hand Therapists as Extended Scope Practitioners

Extended scope practitioners (ESPs) are specialist occupational therapists and physiotherapists working beyond their recognised scope of practice. The aims of this study were to identify the number, training and scope of practice of hand therapists working as ESPs. Thirty-five ESPs were identified and sent a questionnaire examining aspects of their practice. Thirty-two ESPs (91%) replied. The findings show that the ESPs worked in four models of practice: own clinic environment, rheumatology, preoperative and post-operative clinics. Their activities included making diagnoses, injections, joint aspirations and wound care. ESPs referred patients for surgery, investigative procedures and therapy. Training was largely experiential and there were unmet training needs. It can be concluded from this study that ESPs are undertaking aspects of care that traditionally have been undertaken by doctors and nurses. The development of ESPs has training implications.