Exceeding expectations, together
First contact practitioners
Musculoskeletal (MSK) conditions account for up to 30 per cent of GP consultations in England. In a traditional model, patients with MSK problems are seen by their GP and then referred for a physiotherapy appointment, a process which can take up to 6 weeks or more. Our challenge was to free up GP time and to make NHS referrals for MSK conditions more effective.
What we did
Healthshare mobilised 4 WTE First Contact Practitioner Physiotherapist services across Central London covering 34 practices and approximately 190,000 patients. The services started initially virtually due to COVID-19 restrictions but started seeing patients face-to-face in practice from summer 2021. So far, the FCPs have taken half of the face-to-face MSK workload from GPs, allowing GPs to focus on other priorities within their practices.
Benefits to patients
Patients are getting early access to specialist care. Waiting times to see a physio in Westminster have reduced from 6 weeks to 1.
Patients are happy! 99 per cent of patients reported complete confidence in the competence of our FCPs and 97 per cent were likely or very likely to recommend them to friends or family.
FCP appointments are 20 minutes as opposed to a 10-minute appointment with a GP. Our initial audit demonstrated that 77 per cent of patients leave the FCP with a clear management plan and there is better adherence to self-care because the clinician has been able to spend time explaining the condition and rationale for the management plan.
22% of patients are referred onward to the MSK service where they can expect a standardised approach to more in-depth care or immediate onward referral to secondary care.
Benefits to Central London GPs
Healthshare provides over 2,000 appointments per quarter, effectively reducing GP workload. 49 per cent of patients consulting an FCP have a co-morbidity so it is important that FCP continue to reduce GP workload by delivering a range of public health messages and independently refer to other roles within primary care, such as social prescribers. FCPs also sign-post to other services, e.g. IAPT, where needed.
By working together both FCPs and GPs feel the benefit of each other’s knowledge. Healthshare FCPs will upskill the practice team in their MSK care and in return FCPs will get a greater understanding of primary care management.
Benefits to FCPs
Healthshare FCPs work on a portfolio role system where most of our clinicians will spend up to 50 per cent of their role in our community services. This maximises the sense of being in an MDT role in primary care, but also have peer support when in the community setting. This increases staff retention and allows Healthshare to deliver the continuing professional development required and ensures that the GPs do not have to deliver this.