Best Physiotherapy & Sports Injury Clinic, Rehabilitation Center Kent

First Contact Physiotherapy

A First Contact Physiotherapist (FCP Physiotherapist) is an experienced, autonomous clinician, typically working at Agenda for Change Band 7 or above, trained to assess, diagnose, and manage musculoskeletal (MSK) conditions at the first point of contact within general practice—without the need for prior GP triage or referral.

FCPs operate under a model of advanced clinical practice, allowing for independent, complex decision-making, escalation, and integration within the wider multidisciplinary primary care team.

Clinical Competencies and Scope of Practice

FCP Physiotherapists must demonstrate proficiency across the four pillars of advanced practice:

Pillar	Examples in FCP Practice
Clinical Practice	Autonomous MSK assessment, differential diagnosis, management planning, safety netting
Leadership	MDT contribution, service improvement, mentoring junior staff or students
Education	Patient empowerment, coaching behaviour change, practice-based learning
Research	Contribution to audit, outcomes evaluation, evidence-based service development

Core clinical responsibilities include:

Identifying red and yellow flags (e.g. Cauda Equina, inflammatory conditions, malignancy)
Ordering and interpreting investigations within local pathways (e.g. X-rays, bloods)
Initiating early management including rehab advice, manual therapy, medication recommendations
Streamlining referrals to orthopaedics, rheumatology, community physio, or pain services
Supporting shared decision-making and self-management strategies

Regulatory Requirements

FCP Physiotherapists are:

HCPC-registered and must hold an appropriate degree in Physiotherapy
Required to meet the Health Education England (HEE) FCP Roadmap to Practice, including:

Stage 1: Portfolio of evidence against the capabilities
Stage 2: Verification by a clinical supervisor or Advanced Practitioner

Supervised in line with HEE guidance and integrated into local governance and appraisal structures

Clinical Impact and Benefits

Clinical Benefit	Explanation
Early, accurate diagnosis	Prevents deterioration, avoids unnecessary investigations, accelerates recovery
Reduced secondary care pressure	Reduces inappropriate orthopaedic/rheumatology referrals
Improved MSK pathways	Supports right care, first time – essential for NHS Long-Term Plan delivery
Reduced GP burden	Up to 30% of GP appointments are MSK-related – FCPs absorb a significant share of this demand
Better outcomes	Up to 30% of GP appointments are MSK-related – FCPs absorb a significant share of this demand

Integration into General Practice

FCP Physiotherapists are embedded within PCNs or practices and contribute to:

Clinical triage (patients directed from reception or care navigation)
Face-to-face, telephone, or video consultations depending on presentation
Joint working with GPs, ANPs, social prescribers, and secondary care consultants
Support for population health, such as falls prevention or managing osteoarthritis in LTCs

All FCPs should be covered by indemnity (via NHS Resolution or employer-provided)
Must be included in regular clinical supervision (minimum 1 hour per month recommended)
Participation in audit, FFT collection, and clinical outcomes evaluation
Clinical leads should review red flag identification, imaging usage, and conversion to referral rates

Appointments: 20–30 mins per patient, typically 12–14 patients/day
Caseload: Predominantly MSK but may see a spectrum of functional complaints
Admin time: Needed for safety netting, documentation, and onward referral
Training pipeline: FCP roles are part of an ACP career pathway—important for succession planning