Provision of first contact physiotherapy in primary care across the UK: a survey of the service

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 37.5 hours/week; 37% (26/70) ≤10 hours; most (71%, 50/70) used 20-minute appointments (range 10–30 minutes); 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.