Role Description & Competencies: First Contact Physiotherapist

First Contact Physiotherapists (FCPs) – also known as Physiotherapy Advanced Practitioners (APs) have enhanced skills and an expertise in the management of Musculoskeletal conditions. The role of First Contact Physiotherapists in Primary Care is to assess patients with soft tissue muscle pain at their first point of contact or for follow-up management as appropriate within the healthcare system. First Contact Physiotherapists enable adult patients to be seen in their GP practice without being referred by a doctor.

FCP’s will have the skills to assess, diagnose and manage a range of conditions appropriate to their knowledge and expertise and work at an Advanced Clinical Practice level as advanced practitioners (APs). This is defined as “a level of practice characterised by a high degree of autonomy and complex decision making… It includes the analysis and synthesis of complex problems across a range of settings, enabling innovative solutions to enhance people’s experience and improve outcomes”.

FCPs working in this role can be accessed directly by self-referral, or staff in GP Practices can direct patients to them to establish a rapid and accurate diagnosis and management plan to streamline pathways of care. 

What are the benefits of having a First Contact Physiotherapist in the team?

  • Increases capacity in primary care (15-20% of a GP’s caseload is made up of MSK conditions)
  • Early intervention from an MSK specialist can help to prevent chronicity and encourage self-management
  • Physiotherapists in advanced practice roles with other specialist skills (not MSK) are able to manage a range of long-term conditions, including respiratory conditions, neurological conditions and frailty
  • FCP’s working at this level have the confidence and expertise to assess, diagnose and provide first-line treatments within the appointment time without increasing referrals into secondary care or back to the GP
  • Fewer drug prescriptions
  • Fewer blood tests and diagnostic imaging requests
  • Develops a collaborative working approach/ relationships across the PCN.

What can a First Contact Physiotherapist do in General Practice?

First Contact Physiotherapist can:

  • Assess, diagnose, triage and manage patients presenting with neck pain/ back pain/ joint pain/ soft tissue pain/ muscle pain/ conditions such as arthritis
  • Progress and request investigations (e.g. X-Rays/ Blood tests) and referrals to facilitate diagnosis and choice of treatment
  • Develop integrated & tailored care programmes in partnership with patients
  • Provide a range of first line treatment options
  • Make use of their full scope of practice, including skills relating to independent prescribing, injection therapy and investigation
  • Work as part of an MDT to create stronger links for MSK services through clinical leadership, teaching and evaluation skills
  • Support the delivery of the DES and new Service Specifications through a multi-disciplinary team approach to Enhanced Health In Care Homes, Structured Medication Reviews* & Early Cancer Diagnosis.

*with appropriate Independent Prescribing qualifications

What is the maximum reimbursable amount for primary care organisations to recruit to this role?

£55,670 over 12 months (with on cost) – 2020-21

What is the recommended salary for a First Contact Physiotherapist?

In general practice a First Contact Physiotherapist’s salary can be negotiated, although there is a suggested range of AFC equivalent Band 7-8A.

Is there any additional support available to support the recruitment of First Contact Physiotherapists into General Practice?

Please visit the Initiatives/ Support available link at the bottom of this page to find out more. 

What are First Contact Physiotherapists trained to do? 

Specialist/ Advanced Clinical Practitioners in MSK are trained to advance their clinical, therapeutic and reasoning skills, developing their skills in communication and leadership to bring about more evidence-based, efficient and effective services. 

The MSK First Contact Practitioner Physiotherapist is expected to demonstrate compliance with the Musculoskeletal Core Capabilities Framework (2018) which sets out a standard for consistent, safe and effective practice across a range of practitioners working as part of a multi-professional team.

Download the Musculoskeletal Core Capabilities Framework here


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