Primary care musculoskeletal first contact practitioner

Southern Health NHS Foundation Trust considered extending the scope of a physiotherapist.

The trust wanted a musculoskeletal (MSK) physiotherapist to work in a GP practice as a first contact practitioner. It was thought this could improve the patient pathway and have a positive impact on GP capacity.

The trust proposed this would result in:

• fewer face to face contacts
• quicker access to care
• the need for fewer prescriptions

The extended MSK role allows the clinician to make radiological referrals, provide injection therapies and refer directly into secondary care. This project was part of a vanguard pilot and collaborated with a local GP practice; it has now expanded into other practices and as part of a primary care access centre providing first contact work.

Achievements

Results showed that an MSK physiotherapist:

• manages 64% of patients with advice and guidance
• refers less than 20% of patients for physiotherapy - compared to a GP practice (30%)
• makes significantly fewer prescription requests - 8% compared to 40%
• provides quicker access for diagnostics and direct surgical referrals with full diagnostic work up before referral (such as MRI)
• has high patient satisfaction

The model has been used in supporting GP hubs in Hampshire.