What can First Contact Physios do in Primary Care?
The terminology of First Contact Physiotherapists is used interchangeably with physio and MSK First Contact Practitioners. Please note that whatever terminology is used physios within Primary Care, under the ARRs scheme should be working at an FCP (first contact practitioner level). This is explained further below.
Roles may include:
- Assess, diagnose and manage people with MSK conditions. This could include neck pain, back pain, muscle pain, joint pain, soft tissue pain, and arthritis
- Self-care advice and enable and support behaviour change
- Discuss physical activity and health (e.g. smoking cessation and weight management)
- Refer to a course of treatment e.g. physio/podiatry
- Refer to specialist clinics as appropriate e.g. secondary care MSK services, rheumatology and pain services
- Request investigations (this will be dependent on experience. We are trying to support non-medical radiology requesting with system colleagues at present)
- Prescribing where appropriately qualified and within competency
- Administer joint and soft tissue injections (if qualified)
- Support MDT work in relation to the PCN DES e.g. Enhanced Health in Care Homes
A short and brilliant video below on the role from Cheltenham Central PCN.
The short video below shows a First Contact Physio and a patient explaining their experience.
This next video discusses embedding a physio within General Practice.
The slide below is from the Musculosketal First Contact Practitioner Services – Implementation Guide (hee.nhs.uk). Download the entire guide here
The video below is a case study of the role.
Training and Supervision
The PCN DES stipulates the following for First Contact Physios under ARRs:
a. has completed an undergraduate degree in physiotherapy;
b. is registered with the Health and Care Professional Council;
c. holds the relevant public liability insurance;
d. has a Masters Level qualification or the equivalent specialist knowledge, skills and experience;
e. can demonstrate working at Level 7 capability in MSK related areas of practice or equivalent (such as advanced assessment diagnosis and treatment);
f. can demonstrate ability to operate at an advanced level of practice, in order to deliver the key responsibilities outlined in section B7.2.
Please note in relation to Chiropractors and Osteopaths NHSE have provided us with the following statement (related to ARRs): Therefore, a Chiropractor/Osteopath would not be eligible for reimbursement under the Network Contract DES unless they meet the above conditions.
As mentioned above First Contact physios within Primary Care are banded at level 7, as FCPs. To become an FCP, professionals will need a minimum of 5 years postgraduate experience (please note the roadmap refers to a minimum of 3yrs postgraduate experience, which was later updated to 5yrs). Workforce Transformation and Education have developed ‘roadmaps’ to outline the required training and experience needed to progress to an FCP level, and onwards to advanced practice, as required/appropriate.
The roadmap for First Contact Physios can be found here.
Stage 1 of the roadmap should be completed prior to entry into Primary care, with stage 2 completed within 6mths. An extension to stage 2 completion can be requested via the commissioners. If this is likely to be needed, please contact the training hub (firstname.lastname@example.org), the earlier the better, and we can support. We will then provide a recommendation to the commissioner around an extension.
WT&E Roadmap FAQs can be a useful source of information: Roadmap FAQs | Workforce Transformation and Education (hee.nhs.uk).
For further information on FCPs please click here (link coming soon).
A roadmap supervisor will be needed to support First contact physios in their training and ongoing development. Eligibility for roadmap supervisors includes:
- GP Trainers/Educational Supervisors (ES’s do not need to do the 2 day course but have an optional top up session available on e-learning for health). Click here to watch the top Top Up Training Video for GP Educational Supervisors.
- Clinicians who have a post registration Masters degree (Pre registration Masters degrees DO NOT qualify)
- Full MACP member
- First Contact Practitioners who are recognised by the WT&E Centre
- Advanced Practitioners who are recognised by the WT&E Centre
The Gloucestershire Primary Care Training hub has an FCP/AP lead and 2 Primary Care supervision fellows who are available to support with roadmap and supervision queries. Please contact PCWC inbox (email@example.com) with your query and this can be forwarded onto the right person. Funding has been given to each PCN to support backfill for attendance of GPs who are not already GP trainers, to attend the 2 day roadmap supervisor course.
A job description pack from NHS futures can be found on the right of the page. This can be adapted for the needs of PCNs. A checklist to help shortlist applicants in relation to roadmap requirements can also be found on the right of the page.
Resources for practices to explain the physio role (including posters, graphics for waiting room screens, phone scripts to support care navigation and more) can be found at: First contact physiotherapy GP resources | The Chartered Society of Physiotherapy (csp.org.uk).