Job responsibilities
First
Contact Physiotherapists (FCP) provide the first contact for patients
presenting with MKS conditions or symptoms, providing the patient with primary
assessment, diagnosis, and management options. Using advanced clinical practice
skills and clinical reasoning to provide comprehensive diagnostic and treatment
support to simple and complex musculoskeletal conditions and multi-morbidity,
mental health and pain management needs.
FCPs
are the link between primary, secondary, community and acute services and are
responsible for managing an integrated care pathway for patients (e.g. by
triage and referral, as well as direct management advice).
This
role will allow patients to experience a high level of care for MSK problems,
working closely with GPs and advanced practitioners to provide a management
plan and onward care.
To
provide clinical expertise and making decisions about the best course of
actions for patients care (including in relation to undifferentiated
conditions) This will involve seeing patients, without prior contact with their
GP, in order to establish a rapid and accurate diagnosis and management plan.
Lead
on and develop effective communication between primary care services/GP
practices and other relevant care providers
Initiate,
develop, and maintain relationships with MDTs, orthopaedic and physiotherapy
consultant teams in the community and acute settings.
Where
appropriate, develop relationships with wider health and social care agencies,
for example mental health teams, local authorities, third sector providers and
patient groups
Provide
leadership and support on MSK clinical and service development across the PCN,
alongside learning opportunities for the whole multi-disciplinary team (MDT)
within primary care
Provide
highly specialist advice on issues ranging from the provision of expert opinion
on individual patient treatment options to be a primary contributor to MSK
services and related pathway development.
Encourage
collaborative working across the health economy and be a key contributor to the
primary care networks providing leadership and support on MSK clinical and
service development across the network
Work
independently, without day-to-day supervision, to assess, diagnose, triage, and
manage patients, taking responsibility for prioritising and managing a caseload
of the PCNs registered patients
Receive
patients who self-refer (where systems permit) or from a clinical professional
within the PCN, and where required refer to other health professionals within
the PCN
Work
as part of an MDT in a patient facing role, using their expert knowledge of
movement and function issues, to create stronger links for wider services
through clinical leadership, teaching and evaluation
Develop
integrated and tailored care programmes in partnership with patients, providing
a range of first line treatment options including self-management, referral to
rehabilitation focused services and social prescribing
Make
use of their full scope of practice, developing skills relating to independent
prescribing, injection therapy and investigation to make professional
judgements and decisions in unpredictable situations, including when provided
with incomplete or contradictory information. Take responsibility for making
and justifying these decisions
Manage
complex interactions, including working with patients with psychosocial and
mental health needs, referring onwards as required and including social
prescribing when appropriate
Implement all aspects of
effective clinical governance for own practice, including undertaking regular
audit and evaluation, supervision, and training
Develop integrated and tailored
care programmes in partnership with patients through:
o
effective
shared decision-making with a range of first line management options
(appropriate for a patients level of activation)
o
assessing
levels of Patient Activation to support a patients own level of knowledge,
skills, and confidence to self-manage their conditions, ensuring they are able
to evaluate and improve the effectiveness of self-management
interventions, particularly for those at low levels of activation
o
agreeing
with patients appropriate support for self-management through referral to
rehabilitation focused services and wider social prescribing as appropriate
Designing
and implementing plans that facilitate behavioural change, optimise patients
physical activity and mobility, support fulfilment of personal goals and
independence, and reduce the need for pharmacological interventions
Request
and progress investigations (such as x-rays and blood tests) and referrals to
facilitate the diagnosis and choice of treatment regime including, considering
the limitations of these investigations, interpret and act on results and
feedback to aid patients diagnoses and management plans.
Carry
own caseload as an autonomous practitioner, providing direct clinical/
physiotherapeutic care for patients with a range of complex muscular-skeletal
conditions and who may have significant other primary or secondary
conditions/multi-pathologies
Be
able to decide when appropriate to use advanced clinical practice skills that
may include:
o
Joint/soft
tissue injection therapy, including administration of prescription only
medication [POM] to aid treatment.
o
Joint
aspirations
o
Non-medical
prescribing
Use
professional judgement and advanced clinical reasoning skills to make decisions
about safe and effective patient care in unpredictable situations, including
when there is incomplete/contradictory information
Be
able to demonstrate understanding of the impact of physiotherapeutic
interventions on existing conditions and treatment programmes e.g. podiatric
treatment, drug therapies, etc.
Ensuring
physiotherapy interventions are integrated and supportive of the whole
treatment aims promoting a holistic approach to condition management
Be
able to clinically justify referral onto appropriate MSK pathways within the
community or wider healthcare services. Including referral to the appropriate
stage of the pathway and the use of social prescribing
For
patients that remain the responsibility of primary care services, take the lead
for the management of the patients journey on their care pathway, acting as
the link for the patient between primary care and other services/ professionals
Be
able to justify clinically referrals to other specialist services. This will
include referral to acute and specialist services such as surgical orthopaedics,
rheumatology, and neurology, other AHP services, nursing services and to the primary
care medical teams
Recognise
RED flags, serious pathology and potential underlying non-MSK related disease that
may present as MSK symptoms and to refer appropriately. When needed accelerate
the patients referral to other health professionals/services
Work
in partnership with the patient at all times to attain maximum participation in
treatment programmes. This will include working with patients from diverse
social background and cultures and understanding how this will affect treatment
proposals and models
Provide
expert advice and act as source of expertise in the management of
musculoskeletal conditions and provide a specialist advisory service to
patients, specialist physiotherapists other specialist healthcare professionals
and members of the primary care team, including advising GPs on management of
MSK conditions
Provide
clear advice, instruction and teaching on aspects of management of a condition
to patients, relatives, carers and other health professionals
Continually
review and develop specialist clinical and diagnostic skills in response to
service need
Be
accountable for own decisions and actions via HCPC registration and
professional standards
Integrate
the FCP role into the wider primary care team, proactively working with the
primary care team to build robust relationships and integrate working
practices.
Attending
primary care strategic and practice level meetings to represent
FCP/physiotherapy when appropriate.
Be
the FCP/ physiotherapy lead on the development of referral guidelines for MSK
and MSK related conditions from primary care to other NHS services that will
direct referrals to other primary care services, community, secondary and
tertiary [specialist] services
Lead
or be a primary contributor to the development of MSK pathways across the
primary care network, NHS providers across the health economy. This includes
contributing to pathways that are not primary MSK pathways, but which have MSK
interventions along the pathway
Work
collaboratively with the primary care team, including working across the
Primary Care Network [PCN] and also in partnership with business managers,
professional managers, and lead clinicians of secondary, community and other
care providers to improve service delivery and meet the identified needs of the
local patient population
Use
influence and contribution to the PCN to promote the contribution of FCPs to
MSK services in primary care and to the wider related services in the health
economy
Work
with the primary care team, public health professionals and other agencies to
introduce a strand of service provision that highlights preventative strategies
for local populations, patient groups, and individuals
Participate
and lead in ensuring a professional culture of peer networking and support
underpinned by active engagement in peer review and embracing evidence-based
practice
