First contact physiotherapists – a workforce whose time has come

First contact physiotherapists – a workforce whose time has come

By Larry Koyama, Head of FCP Implementation at the Chartered Society of Physiotherapy and NAPC Faculty Member.

The case for first contact physiotherapists (FCPs) has always been based on their expertise in managing musculoskeletal conditions, the additional capacity they provide for GPs and the pressures they help ease elsewhere in the system.

As we learn more about the NHS response to Covid-19, it is becoming clear that those fundamental arguments have only been strengthened during the pandemic.

Switching to virtual appointments, whether on the phone or by video, has offered FCPs the opportunity to showcase their ability to assess and diagnose MSK problems while safe-netting for serious pathology.

Supporting self-management is integral to this approach and a survey of physiotherapists working in primary care for the CSP revealed an enthusiasm on the part of patients to act upon this advice.

FCPs use personalised care to enable this self-management and effective management in the community where possible and make appropriate onward referrals where indicated, demonstrating their system wide impact.

As the lockdown continues to ease, and public confidence in accessing health services returns, we are likely to see a significant backlog of MSK conditions emerging.

This will be a combination of existing problems for which people were reluctant to seek help, and the consequences of physical activity levels dropping as people spent more time at home.

The stress of the pandemic – whether related to health, family or work – could also contribute to more people finding themselves in pain and turning to primary care for help.

It will be crucial, then, that the primary care workforce is designed to take on this challenge.

FCPs can use their expertise to meet this demand, allowing GPs to concentrate on medical cases and the expected increase in appointments sought by people recovering from Covid-19.

The approach is also shown to reduce onward referrals and the number of patients sent for tests, which will help ease some of the pressures experienced elsewhere.

Darren Cocker, GP and Deputy Governing Body Member for Kent and Medway CCG, has seen the benefits of the role for patients, GPs and the system.

‘In my view and experience FCP are a valued and now essential member of the primary care team,’ he said.

‘The role is effective both in delivering great outcomes and experience for patients but also in our area resilience for practices.

‘Their approach in my experience empowers patients to better self- manage their condition and become less reliant on traditional medical approaches such as analgesia.’

The role is now fully-funded under the GP contract and the results of a national, NHS England-backed evaluation will be released in July to help design services and identify workforce needs.

There is a whole structure in place to support implementation, with guidance on service design, employment models and training, as well as resources for practice staff and for promoting the role to patients.

First contact physiotherapists are a workforce whose time has come.

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