First Contact Practitioner - 3 Valleys Health Primary Care Network

Job responsibilities

• To be the first point of contact for expert MSK clinical assessment and diagnosis of patients presenting to primary care/GP practices. This will include patients who present with a range of needs and underlying pathologies. Use of advanced assessment techniques, arranging investigations eg radiology, neurophysiology, forming treatment options plans and explaining those to patients, will be required.
• Be the link between primary, community and acute services.
• Lead on & develop effective communication between primary care services/GP practices and relevant care providers. Educate on the role of the FCP
• Maintain relationships with orthopaedic, rheumatology & other MSK consultant teams, relevant MDT and physiotherapy services in community and acute settings.
• Liaise with other agencies, for example mental health teams, local authorities, third sector providers and patient groups.
• provide awareness to primary care multi-disciplinary teams on physiotherapeutic management of MSK conditions. This will include the provision of highly specialist advice on issues ranging from the provision of expert opinion on individual patient treatment options to be a contributor to MSK services and related pathway development.
• Work with other FCPs and primary care teams to develop collaborative working within the primary care multi-disciplinary team and provide l expert advice to support the contribution of FCPs to MSK pathways.
• Use local and national evidence-based practice to contribute to suitable research and audit programmes evaluating the effectiveness of the FCP programme. This will include communicating outcomes and integrating findings into own and wider service practice and pathway development.
• Partake in formal research projects evaluating the FCP role, including multi-provider and academic led research projects.
• Provide education and expert training to specialist clinicians from a range of disciplines including supporting the development of the BANES FCP MSK service.

• To be the first point of clinical contact for patients presenting with MSK conditions or symptoms, providing the patient with the primary assessment, arranging investigations, diagnosis and management options for their condition.
• Use advance clinical practice skills and clinical reasoning to provide comprehensive diagnostic and treatment options to support patients who present with complex musculoskeletal conditions and/or multiple pathologies and/or mental health and/or pain management needs.
• Independently request diagnostic tests
• Carry own caseload as an autonomous practitioner, providing direct clinical/physiotherapeutic assessment for patients with a range of complex musculo-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 clinical skills that may include:

Joint/soft tissue injection therapy, including administration prescription only medication [POM] to aid treatment.

Joint aspirations

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.
• To be able to work autonomously as a lone practitioner.
• 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 managed as part of own caseload 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. This requires advanced knowledge of the role of other specialist health professionals.
• An ability to recognise potential underlying non-MSK related disease and conditions that 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.
• Develop integrated and tailored care programmes in partnership with patients:
• Use effective shared decision making with a range of first line management options (appropriate for the persons level of activation)
• Assess levels of Patient Activation to confirm levels of knowledge, skills and confidence to self-manage
• Agree appropriate support for self-management through referral to rehabilitation focused services and social prescribing provision.
• 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 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.

Service/Professional Leadership/Consultancy

• Plan and organise your locality FCP service efficiently, ensuring delivery in-line with service expectations.
• 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.
• Contribute to 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.
• Work with other specialists to support the development of MSK pathways across the primary care network. This may include 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 to support preventative strategies for local populations, patient groups and individuals.
• Participate in local, regional and national peer networking and support underpinned by active engagement in peer review and embracing evidence-based practice.
• Demonstrate a detailed knowledge of wider health, healthcare and social care agencies related to MSK conditions and physiotherapy.
• Contribute to organisational and service policies that support the maintenance of good clinical governance, manage risk and ensure patient safety is paramount.
• Be responsible for identifying and reporting any risk/clinical governance issues in the FCP service.
• Contribute to monitoring and review of service standards for MSK primary care services. Including established clinical, professional and service standards.
• Be aware of and able to demonstrate how the FCP role contributes to the achievement of key performance indicators [KPIs] for MSK primary care services. Identifying where own FCP role is supporting delivery of KPIs.
• Work within the FCP service, contributing to the development of musculoskeletal physiotherapy and related services across the healthcare economy.
• Represent the FCP primary care service at internal primary care meetings and at external forums/service meetings including CCG and other strategic regional forums involved in the development of FCPs and/or MSK pathways.

Participate in/support investigations into complaints and clinical errors/incidents when appropriate.

SEE ATTACHED JD FOR FULL DETAILS

Analytical Skills

Essential

• able to understand and analyse complex issues and balance competing priorities in order to make difficult clinical decisions.
• support individual patient care by an ability to analyse and interpret complex clinical/ often incomplete information, pre-empt and evaluate issues, and recommend and appropriate course of action to address the issues

Desirable

• experience of working within a primary care setting
• evidence of working across organisational boundaries within health and social care
• independent thinker with demonstrated good judgement, problem solving and analytical skills

Personal Attributes & abilities

Essential

• ability to co-ordinate and prioritise workloads
• able to multi-task as well as be self-disciplined and highly motivated
• demonstrates a flexible approach in order to ensure patient care is delivered

Desirable

• high degree of personal credibility, emotional intelligence, patience and flexibility
• ability to cope with unpredictable situations
• confident in facilitating and challenging others

Qualifications

Essential

• BSc degree in Physiotherapy
• Registered with the Health and Care Professional Council
• can demonstrate working at Level 7 [within the ACP framework] capability in MSK related areas of practice or equivalent (such as advanced assessment diagnosis and treatment

Desirable

• MSc degree in Physiotherapy
• completed or working towards a Supplementary Prescribing qualification non-medical prescribing qualification

Communication Skills

Essential

• excellent interpersonal and organisational skills
• ability to evidence a sound understanding of the NHS principles and values
• excellent interpersonal and communication skills
• able to influence and persuade others
• articulating a balanced view and able to constructively question information

Desirable

• evidence of inspiring and motivating teams with the ability to communicate passionately, effectively.
• ability to negotiate effectively within the MDT or across a range of services/providers.

Experience

Essential

• can demonstrate working at Level 7 [within the ACP framework] capability in MSK related areas of practice or equivalent (such as advanced assessment diagnosis and treatment
• experience in applying the physiotherapy process to include MSK assessment, interpretation, individual care planning, motivation, monitoring and evaluation of highly specialized MSK treatment
• working knowledge of Microsoft and GPIT systems, alongside prescribing data monitoring systems
• Experience of contributing to service delivery/evolving evidence led practice and delivery in a changing environment
• ability to demonstrate leadership when introducing change

Desirable

• working towards advanced clinical practitioner status
• previous supervisory experience
• Experience of working with a diverse range of stakeholders
• cognitive behavioural and motivational interviewing approaches / skills

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).