First Contact Practitioner

MSK First Contact Physiotherapist Services

By far the biggest challenge facing General Practice is that it doesn’t have enough people to do the work required!

• Musculoskeletal conditions can account for up to 20% of a GP’s workload
• 91% of people with arthritis say they are not given information about exercise/self-care
• Only 43% say they can manage their arthritis well (Arthritis Care, 2017).

With a growing population and increase in the prevalence of long term MSK conditions there is a need to do things differently if we are to effectively meet the challenges in an already stretched Primary Care sector.

We believe that a First Contact Physiotherapist with advanced skills can become an important member of the expanding general practice teams responsible for delivering optimal services to patients within primary care.

First Contact Physiotherapists (FCP’s) are qualified autonomous clinical practitioners who are able to assess, diagnose, treat and discharge a person without a medical referral. They have developed advanced competencies to be able to request and interpret appropriate investigations, offer soft tissue and joint injections and write fitness for work reports

Common questions?

Does an FCP replace the need for a physiotherapy service?

No, the FCP roles will manage in the region of 20% of the physiotherapy caseload and ultimately reduce the pressures on the existing physiotherapy services. Rehabilitation will continue to be required as part of the MSK pathway.

We already have self referral to physio, what is the difference?

As most FCP appointments are booked through the general practice’s reception, FCPs see many patients who had not considered seeing a physiotherapist in the first instance. Should the patient require further treatment, then the FCP can make a referral.

Won’t it deskill GP’s in the management of MSK disorders?

While FCP services will take a significant proportion of the MSK workload from GPs, there is no intention to de-skill GPs. GPs will continue to see a proportion of MSK patients, with FCPs providing advice and expertise into the whole GP team.

Who employs FCP’s?

Through the Additional Roles Reimbursement Scheme, Primary Care Networks are offered 70% of the actual ongoing salary costs of FCP’s. Each network is able to decide which provider organisation employs the staff.

The benefits of an FCP in General Practice…

For the Patients?

• A shorter pathway, so patients have fewer appointments to attend
• Good patient experience with 90-99% satisfaction rates in pilots
• Longer appointment times, meaning patients feel listened to, cared for and reassured
• Reduced sickness absence
• Accelerates recovery

For the General Practice?

• Less MSK related appointments
• Reduced need for locum appointments
• More time to manage complex medical cases
• In-house MSK expertise gained
• Support in meeting practice targets

For the Health Economy?

• A return on investment of up to £3 for every £1 spent on implementing FCP services (Davies C, 2017)
• A reduction of unnecessary imaging
• A reduction of prescribing costs
• Reduced secondary care referrals
• Improved conversion rate to surgery when referrals are required

Why choose Physiotherapy Matters?

We have a long history of providing effective community NHS MSK services in the Northeast of England and have been delivering FCP services since 2020, which included a remote service during COVID. We believe in working closely with the General Practice team and have a track record of working in an integrated manner. We offer highly competent Physiotherapists for such roles who are supported with mentorship and continual professional development to ensure that patient safety is maintained. We ensure appropriate governance arrangements are in place so that patient documentation, onward referral and the safe delivery of the service. To reduce the burden on the GP practice, Physiotherapy Matters handle any patient complaints, data collection and reporting, and arrange all of the HR processes involved in the delivery of the service. We also pride ourselves on our flexibility to the client needs and can adjust the service offering in a timely manner.

We believe that patients with MSK disorders should be able to access the Right Person, at the Right Time, First Time. If you would like to discuss our FCP service further please contact us on FCP@physiotherapymatters.co.uk.

Further information about the benefits of FCP services can be found at:

• CSP/RCGP Implementation Guide https://www.csp.org.uk/system/files/001404_fcp_guidance_england_2018.pdf
• NHS England: Elective Care High Impact Interventions https://www.england.nhs.uk/wp-content/uploads/2019/05/elective-care-high-impact-interventions-first-contact-practitioner-msk-services-specification.pdf
• Health Education England: First Contact Physiotherapist Video Series https://www.youtube.com/watch?v=XHDpmoRzadM

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