Primary Care Improvement - First Contact Physiotherapy

The First Contact Physiotherapy model (FCP) is an alternative to GP appointments for musculoskeletal problems (MSK). It means that, instead of seeing a GP about a new muscle, joint or back problem, you will be given an appointment with a senior Physiotherapist. So your first contact will be with the physiotherapist, not the doctor.

The aim of your appointment with the Physiotherapist is to give you early advice on how to manage your recent musculoskeletal problem and they will also ensure that you are referred for Physiotherapy treatment in the outpatient department if this is required. They can also refer you to see a doctor in your practice or Secondary Care (hospital specialist) if needed. In most cases people just need the one appointment.

The Chartered Society of Physiotherapy (CSP) estimated that 85% of patients going to see their GP with musculoskeletal problems (MSK) can be safely and effectively seen by a Physiotherapist straight away, without having to be referred by their GP. These conditions, which could be better dealt with by MSK Physiotherapy, make up about a third of all GP consultations. Physiotherapists are an expert professional group. They have a high safety record and are trained to spot serious problems and act on them. Physiotherapists utilise their wider knowledge and skills as part of their assessment. Seeing the Physiotherapist first means patients get to see the right person more quickly.

Reception staff at each practice - who are now also patient advisers - have been trained to offer patients appointments with the Physiotherapist where this is appropriate. This means that the Receptionist will have to ask you for information about why you want an appointment to make sure your first appointment is with the right specialist. You can also ask the Receptionist directly for a Physiotherapy appointment if your issue is related to your muscles or joints.

The Physiotherapists are key members of the Primary Care multi-disciplinary teams of GPs, Pharmacists, Advanced Nurse Practitioners and others, but are likely to be based in Physiotherapy Hubs. The hubs serve a cluster of GP practices rather than being based in individual surgeries. Some of the hubs may be located within a GP practice, but they're mostly within your local Physiotherapy department.

Your appointment may be on the telephone, via video (a system called Near Me) or will be in person with the Physiotherapist.

The Physiotherapists can request clinical investigations for their patients such as x-rays and MRI scans, and soon they should be able to complete Fit Notes. They can also request some diagnostic tests and some are able to prescribe or request medication, and refer patients to specialists at the hospital if this is required.