What is FCP?

First Contact Physiotherapy (FCP) is a rapidly developing approach to managing MSKD in primary care, whereby a specialist MSK physiotherapist located within general practice undertakes the first patient assessment, diagnosis and management without the requirement for prior GP consultation. Co-location in general practice may be important to facilitate multi-disciplinary management.

The expanding physiotherapy competencies means that some FCPs can also prescribe medication, order and interpret scans, and inject joints.

Why do we need it?

Musculoskeletal Disorders (MSKDs) are the leading cause of disability in the UK and account for approximately 30% of GP consultations. The volume of people with MSKDs is contributing to the significant financial and service delivery burden faced in primary care which is experiencing unprecedented workload pressure.

This is compounded by current difficulties with recruitment and retention of GPs. The impact this is likely to have on patient care is substantial, and will inevitably affect waiting times, safety and levels of satisfaction. Given the exponentially increasing demand, coupled with the difficulties associated with GP recruitment and retention, alternative models of care that are implementable with relative ease, timeliness and affordability are essential.

what is the evidence?

Pilot schemes and local audits throughout the UK indicate freeing up of GP appointments; reduction in secondary care referrals; fewer scan requests; increased patient satisfaction; and potential cost-savings. However there is currently limited robust research evidence on the effectiveness of this approach. 

FRONTIER is the first study to robustly investigate the impact of this model on healthcare provision, utilisation and patient outcomes across the UK. It is independently funded by the Health Services and Delivery Research programme of the National Institute for Health Research (NIHR).