Qualitative exploration of consultant level therapy practice in critical care.

Introduction: Non-medical consultant level roles have been in existence for over 30 years, however the number of allied health professionals (AHPs) working at this level, particularly in critical care, remains relatively small. National guidance highlights the importance of clinicians in these roles to work across the four pillars of practice. However, little research exists regarding the roles undertaken by these consultant-level practitioners, the contributions made to service delivery and their perceived impact on patient and service outcomes. Based on this, the aim of this project was to explore the perceived impact of consultant-level AHPs working within critical care.

Methods: Qualitative methodology was used involving a combination of interviews and focus groups. Purposeful sampling was used to recruit AHPs in consultant-level positions within critical care. Senior medical and nursing staff were then recruited via the AHPs. Data were analysed thematically using the Braun and Clarke methodology.

Results: Five consultant-level AHPs were recruited to participate in interviews, with a further 7 participants from senior medical and nursing roles participating in one of two focus groups. The AHPs had been in a consultant-level role for an average of 3.2 years, with all participants reporting over 15 years' experience within critical care. Four core themes were generated from 105 unique codes and 13 subthemes. Personal characteristics were apparent across all themes and therefore was included as a central element. The core themes were (1) scope; (2) status; (3) supportive leadership and (4) impact.

Discussion: Through four core themes, this study has highlighted the roles undertaken by consultant-level AHPs working in critical care, their perceived impact on patient and service outcomes, and their contribution to local, regional and national workstreams. Where these roles exist, they appear to be well received by senior medical and nursing staff, reporting the benefits of highly experienced members of clinical staff to improve service delivery, patient outcomes and contribute to strategic planning.