Megan works as an Advanced Practitioner in hand therapy and plastic surgery at Salisbury NHS Foundation Trust. Megan is an Occupational Therapist who specialises in supporting adults and children with hand and upper limb conditions. Megan had been working in this role for several years, having completed her Hand Therapy MSc in 2018. Megan has subsequently completed the NHS England ePortfolio (supported) route and gained her advanced practice digital badge, which recognises both her prior academic learning and her experiential learning in the role.
Megan works at Level 7 across the four pillars of
advanced practice
| Clinical | – Adult clinics which provide assessment, diagnostic testing, therapy treatment and if required injection therapy or onward referral for surgery – Paediatric clinics for children born with congenital hand conditions and complex upper limb presentations – Clinical oversight and mentorship for trauma services, including post-operative care in plastic surgery |
| Leadership | – Hand therapy service leadership, including supervision and mentoring a team of hand therapists – Integration of transformational and compassionate leadership training into practice – Part of the senior leadership team across both therapy and plastic surgery, supporting strategic service development |
| Education | – Teaches on national courses – Organises and leads regional hand therapy network, including annual training events & opportunities for collaboration between services – Supports local in-service training for the multi-professional team |
| Research | – Primary investigator – currently enrolled on two Randomised-Control Trial studies – Condition specific annual audits of patient outcomes – Regular updates to clinical guidelines based on recommendations of evidence-based practice – Publication in peer reviewed journals |
What inspired you to become an Advanced Practitioner?
I have always been enthusiastic and motivated to learn and progress. I’ve wanted to be proactive in developing in my role, both through formal education and peer learning from medical and therapy colleagues.
My previous role within our hand therapy team had been a balance between a clinical specialist role and service team lead. Our plastic surgery leads were keen to scope opportunities for different ways of working to improve patients care, service efficiency, improve waiting times and patient outcomes, resulting in the creation of a training opportunity for advanced practice. It seemed like an amazing opportunity.
Feedback from a patient’s parent – “My daughter was born with a hand difference. I was very worried about her being able to be independent as she grew up and potentially being bullied about it’s appearance. Meg has provided support since she was born with understanding her limb difference, acceptance and functional problem solving for all of her daily activities, sports and hobbies. We recently were able to get her first prosthetic which has helped her to play the guitar and hold the ball playing tennis. She is delighted and so are we!”
Can you give an overview of your journey to becoming an advanced practitioner?
I undertook a Hand Therapy MSc, which I completed in 2018. Since then, I have continued to develop my scope of practice, advancing my clinical skills, whilst continuing to develop my leadership and research skills. I found developing in line with the four pillars of advanced practice allowed me to meet the full potential of the advanced practice role.
I was very excited for the opportunity to consolidate my learning and progression by undertaking the ePortfolio (supported) route and was supported by my wider Multi-Disciplinary Team (MDT) during this process. Already having a masters, and a wide range of clinical, education, leadership and research opportunities , we felt that this would support my completion of this route.
The ePortfolio did take a significant amount of time to complete. However, however it brought together and demonstrated how the four pillars of advanced practice are essential in my role, and in January 2024 I successfully completed it.
How would you describe your role as an advanced practitioner to a patient who does not understand the role?
I am an occupational therapist who specialises in supporting adults and children with hand and upper limb conditions and injuries. I have undertaken a range of additional training and learning activities to develop advanced skills to enable me to provide holistic and patient centred care.
I work closely with our wider local teams including plastic surgery consultants, nursing teams and paediatricians, so I have a good access and understanding of the best options for treatment and care. I can perform some minor procedures, order and interpret imaging and coordinate patient care.
Feedback from a Service Manager – “Meg has been innovative and proactive in supporting service change and development in Plastic Surgery. She thinks out of the box and challenges the way we do things to improve care for patients”
How has your role changed and enhanced service delivery?
My role is ever evolving, this is to meet service needs and demands of our plastic surgery service. At present I am developing additional skills and knowledge to be able to accept and support new referrals to the service, offering advanced assessment, therapy treatment and where required list for surgery of specific conditions.
This supports reduction in waiting times for new appointments and enables patients to receive a comprehensive care package based on their individual needs, including therapy treatments. Patients report satisfaction in being able to been seen in a timely manner, and that this includes a package of care based on their needs, rather than just assessment and onward referral.
What is your future vision for advanced practice in your service?
The future vision includes exploration of further clinical developments, such as some minor surgical procedures and expansion of existing injection treatment pathways to include a wider range of conditions. I would also love to support the development of an advanced practice role within our hand trauma service, which could provide a smoother and more patient-centred pathway for hand injuries.
What advice would you give to aspiring advanced practitioners?
I would encourage aspiring advanced practitioners to be thoughtful and planned in their approaches to training and service development. It helps with role integration in their service to have prior planning and buy in from all stakeholders involved in this service development.
Have clear vision and evidence to support the service development and their role for the future.
Feedback from a colleague – “We are lucky to have a very knowledgeable and approachable advanced practitioner. She takes time to help with our learning, development and is always available to support us with patient care when needed. She is a good advocate for changes that help our service become better.”
Read more advanced practice case studies from the South West region here