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Musculoskeletal (MSK) First Contact Practitioners

Increasing numbers of people now have the opportunity to see a musculoskeletal (MSK) practitioner as their first point of contact.

Practitioners can come from a range of allied health profession (AHP) disciplines including physiotherapy, osteopathy and podiatry. As part of HEE’s advanced clinical practice (ACP) developments, we are supporting the growth of first contact practice (FCP), designed to deliver a streamlined, person-centred service and support the growing demands on general practice and secondary care. Take a look at the NHS England website for more Musculoskeletal information

HEE is supporting the national NHS England MSK FCP programme that involves the evaluation of 41 pilots – one in virtually all Sustainability and Transformation Partnerships (STP) in England. Our support to the national MSK FCP programme includes a range of developments building upon previous work.

We have developed a series of videos on MSK first contact practitioners to explain the role and its benefits - take a look at the overview below.


First contact practice is an increasingly established model of care designed to deliver a streamlined, patient-centred service and support the growing demands on general practice and secondary care. This overview demonstrates the efficacy of this service both in quality of outcomes as well as efficiency – people see the right person, in the right place, first time.




Find out more about the long term qualitative and quantitative impact of musculoskeletal first contact practice. Musculoskeletal First Contact Practitioners in Cheshire and Wirral are increasing the skill mix, capability and capacity of primary care, whilst providing timely effective musculoskeletal care to individuals.

Watch the video on: The impact of Musculoskeletal First Contact Practitioners - Cheshire and Wirral Partnership NHS Foundation Trust.


Find out more about the host-provider model for first contact musculoskeletal care and how this can ensure both high quality timely clinical care but also provide robust training for new practitioners and support existing staff.

Watch the video on: Musculoskeletal First Contact Practitioners - Gloucestershire Care Services NHS Trust Hub Model Provider 


Hear about the musculoskeletal first contact practitioner service in Frimley Health NHS Foundation Trust including an accelerated learning programme and how this can ensure a steady flow of highly skilled clinicians into first contact practitioner posts 

Watch the video on: First Contact Practitioners - Frimley Health NHS Foundation Trust Accelerated Training programme 

Published in June 2018, the HEE-commissioned ‘MSK core capabilities framework for first contact practitioners’, sets the minimum standard for professionals working in these roles, as not all FCP roles are advanced clinical practice level. The framework is now in use to support the development of a skilled and well-integrated multidisciplinary workforce.

Related document: MSK core capabilities framework for first contact practitioners’

As part of the national work in advanced clinical practice an MSK ACP project group, is developing resources to support clinicians, higher education institutes, providers and professional bodies to understand what MSK ACP roles look like, who might do them and how we support practitioners’ learning and development. The suite of resources will illustrate these roles and how we develop them including a series of case study videos.

A national multi-professional network for MSK FCP jointly funded with the Chartered Society of Physiotherapists (CSP) has been established  and already has over 1000 multi-professional members. The network is open to all professions, as well as all interested parties, including commissioners, GP staff and researchers.

Sylvia Wojciechowski, an Advanced Practice Physiotherapist and MSK First Contact Practitioner (FCP) lead at Frimley Health NHS Foundation Trust describes the role:

“When I first graduated, senior Physiotherapy roles were more inclined to management. The development of advanced  practice has allowed senior clinicians to continue along a clinical route and first contact is a natural development of this, allowing people to see the right person at the right time and in the right place.

“GP practice patients are booked directly in to see one of my team allowing the GP to see the patients the need to see. The patients are thenassessed, given the appropriate selfcare and prevention advice about how to manage their problems and any necessary treatment.

“Since starting our service, referral rates to secondary care have reduced by 15% so there is a significant system-wide financial benefit from the FCP model and we now want to measure our belief that early intervention can prevent persistent and chronic problems developing. We have shown that we can manage 79% with self-care and physiotherapy. Capacity for general practice has increased both for the immediate and routine appointments. There has also been valuable shared learning between us, the GPs, other AHPs, and MDT clinicians working within primary care. Recent recruitment has shown that Physiotherapists are keen to work in these roles.

“The success of the FCP service has led us to create an accelerated learning program to develop other senior physiotherapists into the first contact role providing training in non-medical prescribing and injections, so that we can future proof the workforce.”

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