Moving up from Band 6 to 7 MSK Physiotherapy - Frequently asked questions

This will come down to clinical mileage with complex patients. In a lot of NHS departments, the buck stops with you as a Band 7. Most of the pathways will indicate the ESP or APP as the person to talk to in case of any problem; however due to ESP availability, the Band 7s will often be more approachable. You will therefore need to be highly confident with departmental red flag and urgent problem pathways and likely have managed a few of these patients too. It will be that previous experience and exposure to complex / red flags patients that will separate you from a Band 6 physio and give you the confidence to answers those complex questions and patients you will get passed on. A B7 job involves a higher level of responsibility, including leadership, research, audit and quality improvement. Some people are more ready than others, but your confidence with interviews shouldn’t stand in the way of you applying for the job.

As far as job descriptions go, yes, to a certain degree. But that doesn’t necessarily mean you need to have a Master’s degree, it could be that you’ve started a Master’s module or have been working at MSc level by completing other high level validated courses. Having that extra layer of learning, and being able to use clinical reasoning models, will give you clearer thinking and will increase your chances of presenting as a highly qualified, specialised healthcare professional. Especially in such a competitive environment, funding for Band 7 positions are reducing and more candidates are applying for the same job.

It will depend on the job. For instance, in a post-orthopaedic environment, additional training in image recognition and how to order imaging will be useful. For a first contact practitioner (FCP) post, you may benefit from more triage training, or medical training in red flag recognition. A Band 7 job or equivalent in the private sector may require you to have skills such as being trained in providing shockwave therapy, acupuncture or joining a network of consultants you have previously worked with.

In less clinical roles, such as more managerial Band 7 positions, some in-depth experience in service development (not just a couple of random audits!), and training in leadership / managerial skills will be useful. There are many relevant models available, including project management training, but LEAN and SCRUM, in addition to PRINCE2 are the most popular in the UK. Training in quality improvement and research methodology can also be useful. You don’t need to wait for permission to do one – if you in the course of your daily practice as a band 6 notice a system or process that is inefficient (long waiting times, disorganised reception area, complaints from patients, long referral processes times etc) then you can initiate an audit or quality improvement project. This will look good on your CV, and you may have a quality improvement lead in the trust who can help you set this up.

Sometimes you may find it hard to get band 7 experience, without being a band 7 (I know, right?). The classic interview catch22, some interviewers will ask for more Band 7 experience to give you the job, but not offer it in the first place. Try and seek it elsewhere: seek out additional roles, such as the Health & Safety rep of your department. Get involved early! The earlier the better.

Not necessarily. You are given safeguarded time to do your managerial duties, but you will need to sharpen your organisational and planning skills. There will be a lot of extra- clinical pressures that will be new to you, and like anything new – they will take more time to complete at first. Make sure you discuss this with supervisor, so you get enough support.

You are a team leader, so there will be more people management and responsibilities that come with that. You still answer to someone else, but ultimately many day to day decisions will fall to you. You will have to engage discussions and build relationships with people that previously may have been a bit daunting (outpatient managers, orthopaedic leads / consultants / GP’s...). The amount of support provided is reduced, and your presence within the department will be much increased. Much like a student vs band 5, or band 5 vs band 6, the primary difference is scope of practice – but it is useful to mention a few more specific responsibilities; leadership, research, audit, quality improvement, financial support, specialised assessment and treatment skills, imaging recognition, key performance indicators and post graduate training.

A Band 7 clinical caseload can be very similar to a Band 6 one. It may differ in other roles such as a FCP, where you are the first person to see the patient, as opposed to a standard OPD where the patient would have been vetted by one or two other people already (i.e. GP + screening PT). In some other roles your patient caseload may be more specific, for example if you are leading a clinic (ortho clinic, pain clinic) with a consultant. When this happens, your caseload becomes a bit more streamlined.

Most departments have a supervision tree that is similar. You will be supervised by an ESP / APP, and you will still need to set goals with them, but they will often be more flexible, and direct supervision is not as frequent. You will be supervising a Band 6. You will be more of a mentor for your Band 6 than you may have been for your Band 5 when the supervision process may have felt more like ticking boxes at times.

You will be play a key role in service development, often through “senior meetings”, where you may discuss the implementation of new services, audits, team performance, CQC reviews/upcoming audits, complaints, datix reports etc. Even though you will be allocated non-clinical duties, you will still answer to someone else, so make sure to use those senior meetings to get as much guidance as possible from the other seniors. These meetings often serve as a way to brainstorm ideas, don’t think that because you are a Band 7 you need to do it all by yourself. In addition, don’t be afraid to raise your voice and share your own thoughts or ideas, this is your opportunity to shine. There are no bad ideas in that sort of environment (or rather, there shouldn’t be). The hallmark of a well-run team using project management methodology is the development of a free and open environment to any and all ideas, however ‘out there’ they may initially seem. That is where true innovation and creativity comes from.