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Life as a Physiotherapist at DCHS - Hayley’s story

Hayley’s story

Hayley Grice qualified as a physiotherapist in 2007 and it was clear from the outset that stroke rehabilitation was her passion. Hayley spent eight years working in stroke rehabilitation roles in her native Birmingham before spotting an opportunity within DCHS to use her expertise and take the next step in her career progression. 

How long have you worked at DCHS? 

I joined DCHS in January 2016 to take up a promotion in a newly created role in my specialist area of stroke rehabilitation. 

What is your current job title? 

My job title is stroke clinical specialist physiotherapist (band 7) working within the early supported stroke discharge team (ESSD), intermediate care and community therapies team for Derby city. It is a new post established to support the rehabilitation of stroke patients enabling earlier discharges and also to care for longer term, more dependent stroke patients in the community. 

Where are you based/which area do you cover? 

My base is at London Road Community Hospital in Derby. However, the majority of my caseload is with patients in their own homes around the Derby city area. 

Do you have a particular specialty within physiotherapy and what sort of patients do you treat? 

My role is a varied mix. About 40 per cent of my time is working with ESSD patients, an intensive six-week treatment course that enables patients to receive their rehabilitation at home rather than stay on the wards at the Royal Derby Hospital. 

The other 60 per cent of my time is caring for patients who are already living with the longer-term effects of strokes and neurological conditions, helping them get the most out of their rehabilitation. 

Skill sharing and teaching is a vital component of this role to support my community team colleagues around the care of stroke rehabilitation patients. 

On the ESSD programme you can be seeing individual patients for 45 or 60 minutes a day, five days a week for six weeks, so it is very intensive. The challenge in stroke rehabilitation is to balance restorative versus compensatory approaches. This entails thorough continuing assessments to quantify rehabilitation potential in complex presentations. 

When did you qualify and where? 

I qualified from the University of Nottingham in 2007. As a student I completed two placements within Derby city services. I was always interested in returning to this area as I knew it had well-regarded acute and community stroke services within friendly teams. 

Completing student community placements influenced my career choices and gave me the confidence to apply for a band 5 role based initially in the community when I first qualified. 

From the start I gravitated towards the stroke patients. Within 18 months I was promoted to a band 6 role involved with stroke services, which meant I treated patients across the stroke pathway, in acute and community settings. To further specialise I completed the Bobath weekend courses and in 2013 the basic Bobath 3 week course. 

Additionally I sought a ‘Prepare to Lead’ qualification in 2012 to enhance my non-clinical skills. In 2015 I was accepted onto the NIHR Clinical Academic Internship Programme in partnership with University of Birmingham and Birmingham Health Partners. This enabled me to complete a master’s module in project management and research governance and provided me with further tools to challenge clinical reasoning and drive for evidence-based practice. I now aim to complete a full masters and ultimately, work along the clinical academic pathway to achieve a clinical research post, combining care for patients and further research in stroke rehabilitation. 

What attracted you to physiotherapy as a career? 

I knew I wanted to have a job where I had the opportunity to work directly with the public and have the ability to help make a difference. I undertook physiotherapy work experience when I was 13 and knew I wanted to be a physiotherapist from that moment, which then directed my GCSE and A level choices. I actually did not quite get the grades to study physiotherapy initially and was encouraged to consider history or English degrees. However, I was passionate about my goal of becoming a physio, so this did not deter me. I re-sat my exams and began studying the following year at the University of Nottingham. 

What do you like about your job? 

Every day is different. I gain huge job satisfaction from my work and I am truly passionate about the NHS and particularly stroke services. I have the opportunity to work in multi-disciplinary teams (MDT) and my new role gives me the scope to influence service developments and pathway planning. I have been a Chartered Society of Physiotherapy (CSP) steward and a committee member with the Association of Chartered Physiotherapists in Neurology (ACPIN), both of which have broadened my horizons. 

I have a privileged role working with inspiring stroke survivors who are some of the most engaged and motivated patients to treat. Patients’ goals vary from those wanting to improve their arm strength so they can make a hot drink to those that want to improve mobility for an important event, such as their granddaughter’s wedding or returning to watch their favourite football team. Integrated working within a multi-disciplinary team is integral for successful patient outcomes. I am committed to stroke patient care that ensures patients are: empowered to engage, given informed choices and able to maximise their quality of life through patient-set goals. 

What makes a good physiotherapist? 

You need to care and ask why? An enquiring mind with a thirst for observing problems and wondering why is essential. Experience will then expand your treatment skills. Strong communication and negotiation skills to enable you to build rapport and trust are required to achieve success when setting collaborative patient goals. Finally, a commitment to life-long and continuous professional development (CPD). 

What attracted you to work in DCHS? 

I was impressed by DCHS’ reputation and status within the Top 10 NHS organisations and runner up for best NHS community service. The clinical specialist role on offer was just so appealing and unique. It has meant I have been able to progress my career whilst remaining in a clinical, patient-facing role. The attraction of this new role at DCHS has meant that I now commute from Birmingham to work in Derby. 

Since being in post, what is good about working in DCHS? 

The team is so supportive of each other and everyone is motivated to do the best for their patients, and for the team, within a trust that believes ‘everyone matters’.