A first contact practitioner (FCP) is an experienced physiotherapist who has the advanced skills necessary to assess, diagnose and recommend appropriate treatment or referral for musculoskeletal (MSK) problems on a patient’s first contact with healthcare services e.g. when they visit their GP surgery.

Patients with MSK complaints can be booked in to see an FCP by a GP receptionist, GP or online. An FCP offers expert MSK assessment and diagnosis, however, is also integrated within the multi-disciplinary team in each GP practice. If appropriate, an FCP may prescribe a programme of exercises, refer for blood tests or X-ray, administer steroid injections, or refer a patient to an appropriate secondary health service e.g. rheumatology or orthopaedics.

All FCPs are trained to identify ‘red flag’ symptoms which may require medical attention.

To become a First Contact Practitioner, a clinician must:

• Meet the requirements in qualification and experience to be named as an Extended Scope Practitioner (ESP) or Advanced Practice Physiotherapist (APP).
• Be able to assess, diagnose and manage musculoskeletal problems within the allocated 15-minute timeframe.
• Be able to identify inappropriate referrals which may require medical intervention.
• Be comfortable working independently, but also communicating as part of a multi-disciplinary team.
• Have a good understanding of referral pathways and processes.
• Be able to identify and prescribe self-help exercises and advice where needed; empowering patients to take control of their own recovery.
• Be able to appropriately document the outcome of assessments using GP clinical recording systems.
• Have an awareness of policy and procedure relating to information sharing and shared decision making.
• Be able to take note of patient feedback and direct it toward the appropriate channels.
• Be able to participate in service audit and development.
• Be familiar with sign-posting to local services, charity support and council services.

Introducing FCPs to primary care is an important part of the NHS Long Term Plan (2019); with the goal of fully integrating FCPs into all primary care networks (PCNs) by April 2020. It is therefore essential that all primary healthcare providers are aware of the FCP role, how an FCP service operates and have plans in place to implement an FCP service in the near future.

First Contact Practitioners may be physiotherapists or osteopaths, as the term applies to Allied Health Practitioners with MSK training. We have both physiotherapists and osteopaths working in the role of FCPs.