First Contact Practitioner

What are FCPs?

A first contact practitioner is usually an experienced practice physiotherapist who has the advanced skills necessary to assess, diagnose and manage musculoskeletal (MSK) problems – such as lower back pain, ankle sprains or frozen shoulder, for example.

An FCP service allows patients who would normally present to their GP with an MSK issue, to self-refer to a professional with expertise in that field. This ‘cuts out the middle man’ and helps to ensure the correct advice/exercises are prescribed from day one, allowing patients to take control of their recovery from day one.

When did we first start doing FCP?

Our Surrey Physio team in North East Hants & Hampshire started in February 2018 and after great success, have expanded into providing this service into six GP practices. The service is lead by Ben Coffey with the support of Jack Petersen, both excellent physiotherapists.

What the NHS say…

NHS England reports that patients with MSK issues make up to 30% of GP consultations and 10% of all GP referrals. The FCP service has the following benefits:

  • Quicker access to treatment
  • Reduced workload on the GP's and associated costs - reducing GP waiting times
  • Reduced costs - on prescriptions and secondary referrals
  • Increased emphasis on self-management and reduction in inappropriate referrals

What you might expect from an FCP appointment…

A brief history of the problem will be taken before several clinical tests will be performed. The aim of the FCP is to assess the problem in order to decide what the patient requires to maximise their recovery.

A majority of patients with MSK problems will be discharged with advice and exercises using RehabMyPatient software; providing a clear, concise programme to manage recovery. If symptoms did persist despite this, the patient has the ability to book back in to see the FCP where further treatment options can be discussed.

Assuming the appropriate ‘MSK patients’ have been booked in, very little require GP input, but if it is, then this can easily be organised between the FCP and the GP’s. The FCP also has the ability to refer patients on for further care if deemed appropriate; this may include referral for imaging (x-rays or scans), joint injections or to the local orthopaedic team.

We do provide training to receptionists and admin teams to ensure we receive appropriate MSK referrals.

How does FCP integrate with the community physiotherapy service we provide?

The FCP also has the ability to refer patients for a course of physiotherapy, such as the community-based service we provide. This would be for patients presenting with an MSK issue that requires further input from a physiotherapist.

This may simply be further guidance and support on exercises, but often it is where treatment is indicated; e.g. manual therapy, acupuncture or shockwave.

We also use an excellent physiotherapy software tool: Rehab My Patient which allows us to send over 2500 HD videos and exercises, and over 470 advice sheets to our patients.

For further information on the FCP model, please see the below links:

www.firstcontactpractitioner.org.uk

https://www.england.nhs.uk/gp/case-studies/improving-gp-access-physiotherapy/