First Contact Physiotherapy

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Introduction[edit | edit source]

Musculoskeletal (MSK) conditions are among the leading causes of years lost to disability[1], with an annual loss averaging 30 million working days in the UK[2]. The demand for MSK healthcare continues to rise as the number of General Practitioners (GPs) across the UK decline[3]. One of the solutions for this growing need is the employment of First Contact Physiotherapists (FCPs)[4] as a considerable fraction of the total GP consultations are MSK in nature, approximately 20-30% in England.[5]

First Contact Physiotherapy Model[edit | edit source]

First Contact Physiotherapy is a primary care model where expert MSK physiotherapists undertake the first patient consultation, to enhance MSK-patient care and free-up GP capacity[4]. FCPs are mainly Extended Scope Physiotherapists (ESP) which are advanced physiotherapists with many years of experience and are typically under band 7 in the NHS grading system[6].

Roles of FCPs[7]:

  • Assess, diagnose and treat patients independently
  • Order diagnostic tests
  • Administer steroid injections and/or independently prescribe medication, such as analgesia or anti-inflammatories for MSK conditions
  • Refer patients accordingly

Benefits of FCP:

  • Immediate access to physiotherapy
  • Reduced GP workload
  • Reduce health service costs
  • Increased time allotted for consultation
  • Increased patient satisfaction
  • Improved primary healthcare quality
  • Reduced sickness absences

Case Studies[edit | edit source]

References[edit | edit source]

  1. Steel N, Ford JA, Newton JN, Davis AC, Vos T, Naghavi M, Glenn S, Hughes A, Dalton AM, Stockton D, Humphreys C. Changes in health in the countries of the UK and 150 English Local Authority areas 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2018 Nov 3;392(10158):1647-61.
  2. Office for National Statistics (2017) Sickness absence in the UK labour market: 2016. Available from: https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/labourproductivity/articles/sicknessabsenceinthelabourmarket/2016
  3. https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice-data-analysis#:~:text=September%202015%20to%20October%202022,-Partners&text=This%20has%20created%20a%20net,in%20the%20last%20year%20alone.
  4. 4.0 4.1 Goodwin R, Moffatt F, Hendrick P, Stynes S, Bishop A, Logan P. Evaluation of the First Contact Physiotherapy (FCP) model of primary care: a qualitative insight. Physiotherapy. 2021 Dec 1;113:209-16.
  5. Thomson J, Syme G. Allied health professional (AHP) musculoskeletal pathway framework: national minimum standards. Scottish Government; 2014. https://www.gov.scot/publications/allied-health-professional-ahp-musculoskeletal-pathway-framework-national-minimum-standard/pages/2/
  6. https://firstcontactpractitioner.org.uk/what-are-first-contact-practitioners/
  7. Downie F, McRitchie C, Monteith W, Turner H. Physiotherapist as an alternative to a GP for musculoskeletal conditions: a 2-year service evaluation of UK primary care data. British Journal of General Practice. 2019 May 1;69(682):e314-20.