This research studies delegation in outpatient physiotherapy and attempts to solve its
deficiency by designing a theoretical model of constructive delegation (CD model). The CD
model is functional and uses a systematic and rational approach to plan the level of
delegation by using task and cost-benefit analysis and it supports delegation dynamically by
organising training, working partnerships, communications and the working environment.
An initial survey of tasks carried out by physiotherapists and assistants at ten sites found
inconsistent approaches to delegation, with 80% of physiotherapists expressing concerns.
This mirrored similar experiences in the literature where there was evidence of some
delegation of technical clinical tasks, but also resistance within the profession. Generally in
the literature delegation was defined and eluded to, but was not constructed in order to
provide a planned system. The CD model was offered as a tool to, by construction,
implement delegation safely and without loss of quality to ensure appropriate skills for
appropriate tasks and to analyse current practice and implicitly suggest improvements....cont'd.
A Doctoral Thesis. Submitted in partial fulfilment of the requirements for the award of Doctor of Philosophy of Loughborough University.