Serena Halls1, Rachel Thomas2, Hannah Stott3, Margaret E Cupples4, Paula Kersten5, Fiona Cramp6, Dave Foster7, Nicola Walsh8. 1. Faculty of Health and Applied Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Stapleton BS16 1DD, Bristol, UK. Electronic address: Serena.Halls@uwe.ac.uk. 2. Faculty of Health and Applied Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Stapleton BS16 1DD, Bristol, UK. Electronic address: Rachel4.Thomas@uwe.ac.uk. 3. Faculty of Health and Applied Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Stapleton BS16 1DD, Bristol, UK. Electronic address: Hannah3.Stott@uwe.ac.uk. 4. Centre for Public Health Research, Queen's University, Belfast, Institute of Clinical Science, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK. Electronic address: m.cupples@qub.ac.uk. 5. School of Health Sciences, University of Brighton, Brighton BN1 9PH, UK. Electronic address: P.Kersten@brighton.ac.uk. 6. Faculty of Health and Applied Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Stapleton BS16 1DD, Bristol, UK. Electronic address: Fiona.Cramp@uwe.ac.uk. 7. Faculty of Health and Applied Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Stapleton BS16 1DD, Bristol, UK. Electronic address: Dave.Foster@rocketmail.com. 8. Faculty of Health and Applied Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Stapleton BS16 1DD, Bristol, UK. Electronic address: Nicola.Walsh@uwe.ac.uk.
Abstract
BACKGROUND: First Contact Physiotherapy (FCP) is an emerging model of care whereby a specialist physiotherapist located within general practice undertakes the first patient assessment, diagnosis and management without a prior GP consultation. Despite institutional and professional body support for this model and NHS commitment to its implementation, data regarding current FCP provision are limited. OBJECTIVES: To identify current FCP service provision across the UK, including models of provision and key professional capabilities. DESIGN: Cross-sectional online survey, targeting physiotherapists and service managers involved in FCP. METHODS: Recruitment involved non-probability sampling targeting those involved in FCP service provision through emails to members of known clinical networks, snowballing and social media. The survey gathered data about respondents, FCP services and the role and scope of physiotherapists providing FCP. RESULTS: The authors received 102 responses; 32 from service managers and 70 working in FCP practice from England (n=60), Scotland (n=22), Wales (n=14), and Northern Ireland (n=2). Most practitioners were NHS band 7 or 8a (91%, n=63), with additional skills (e.g. requesting investigations, prescribing). 17% (12/70) worked 37.5hours/week; 37% (26/70) ≤10hours; most (71%, 50/70) used 20-minute appointments (range 10-30minutes); varying arrangements were reported for administration and follow-up. Services covered populations of 1200 to 600,000 (75% <100,000); access mostly involved combinations of self-booking and reception triage. Commissioning and funding arrangements varied widely; NHS sources provided 90% of services. CONCLUSIONS: This survey provides new evidence regarding variation in FCP practice across the UK, indicating that evidence-informed, context specific guidance on optimal models of provision is required.
BACKGROUND: First Contact Physiotherapy (FCP) is an emerging model of care whereby a specialist physiotherapist located within general practice undertakes the first patient assessment, diagnosis and management without a prior GP consultation. Despite institutional and professional body support for this model and NHS commitment to its implementation, data regarding current FCP provision are limited. OBJECTIVES: To identify current FCP service provision across the UK, including models of provision and key professional capabilities. DESIGN: Cross-sectional online survey, targeting physiotherapists and service managers involved in FCP. METHODS: Recruitment involved non-probability sampling targeting those involved in FCP service provision through emails to members of known clinical networks, snowballing and social media. The survey gathered data about respondents, FCP services and the role and scope of physiotherapists providing FCP. RESULTS: The authors received 102 responses; 32 from service managers and 70 working in FCP practice from England (n=60), Scotland (n=22), Wales (n=14), and Northern Ireland (n=2). Most practitioners were NHS band 7 or 8a (91%, n=63), with additional skills (e.g. requesting investigations, prescribing). 17% (12/70) worked 37.5hours/week; 37% (26/70) ≤10hours; most (71%, 50/70) used 20-minute appointments (range 10-30minutes); varying arrangements were reported for administration and follow-up. Services covered populations of 1200 to 600,000 (75% <100,000); access mostly involved combinations of self-booking and reception triage. Commissioning and funding arrangements varied widely; NHS sources provided 90% of services. CONCLUSIONS: This survey provides new evidence regarding variation in FCP practice across the UK, indicating that evidence-informed, context specific guidance on optimal models of provision is required.