Background Evidence suggests that there is an increasing need for physiotherapists in palliative cancer care services. However, there is a lack of understanding of their role, educational needs and place within the rehabilitation team. The purpose of this study was to explore a local palliative cancer care physiotherapy service provision in light of best practice recommendations.

Method A qualitative approach using a single case study design was chosen as it provided a framework to facilitate the inclusion of multiple perspectives in a complex context within an area of healthcare where little research has been undertaken. Multiple methods of data collection were used from numerous perspectives, which included four data sets: interviews (healthcare professionals [10]); interviews (service users [10]); observations (physiotherapists [2] treating service users [5]); and policy document collection (NICE guidelines; white papers [12]). Data collection occurred from 2008 to 2014 and detailed data analysis was carried out from 2012 to 2014 using a thematic approach within a framework, comparing and contrasting patterns within and across the four data sets.

Findings Emergent themes highlighted a number of important aspects relating to physiotherapists including: new ways of working, shift in mindset and treatment planning, emotional adjustment and integration of professional boundaries. This evidenced a metamorphosis of both the physiotherapist’s profession and service provision through key competencies, such as entrepreneurial, leadership, policy champion and humanisation skills, which enabled them to meet essential policy recommendations of service quality and innovation.

Conclusion This study provides a framework and unique perspective within which the physiotherapy profession can focus its attention on how physiotherapy needs to change in the future. However, a debate is necessary around the need for profession specific or service specific outcomes in this area, and how physiotherapists ‘prove their worth’ now that they are an integral part of palliative cancer care provision.