What is a First Contact Practitioner? (FCP)

What is a Musculoskeletal First Contact Practitioner

By Harry Holder
First Contact Practitioner, Chartered Physiotherapist

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7 minute read


First Contact Practitioners (FCPs) were introduced to NHS general practice after extensive pilot studies in 2018-19. These FCP services offer patients access to an expert Physiotherapist at their very first contact in their GP practice. This ensures patients receive expert assessment and advice for their muscle, joint or bone condition and frees up time for GPs to help patients with other, more medical problems. These services have demonstrated excellent outcomes for patients, and service efficiencies. 

Horder Healthcare has developed a team of FCPs to work across East Sussex and I am one of them. I work across a number of practices and as a team we provide clinicians to 6 primary care networks in East Sussex. I have a degree in Physiotherapy (BSc) with 8 years of experience working in NHS, private hospitals and elite sport and like other members of my team am qualified to deliver musculoskeletal joint injections.  

The FCP role is new to primary care and therefore not widely understood.  The following questions came from a recent patient group and the answers hope to give you a better understanding of how the FCP service can be of help to you.  

What is A First Contact Practitioner?

A First Contact Practitioner (FCP), is a healthcare professional working at the GP surgery, and being the ‘first contact’ for a patient. This means that you do not need to see a GP in order to see the FCP, you can ask to see them directly without referral if you have a musculoskeletal (MSK) problem. The FCP can undertake specialist assessment and provide appropriate advice and establish a management plan that is appropriate for you.
Physiotherapists working as FCP’s are experienced musculoskeletal clinicians who have experience of assessing and managing bone, muscle, nerve or joint conditions. In the local area, the majority of FCP’s are physiotherapists, however, FCPs can also come from other clinical backgrounds such as Osteopathy and Podiatry. Regardless of their profession, FCPs provide evidence-based healthcare in line with best-practice NHS guidance and can make referrals to other services if required.

What additional training /expertise/experience does an FCP have that qualifies them for the role?

If your FCP is a Physiotherapist, they will have a Bachelors or Master’s physiotherapy degree and will be registered with the Health and Care Professional Council (HCPC). It is common for FCP’s to have additional masters level training that provides higher level of clinical practice such as joint injections and the ability to independently prescribe medication.

What can an FCP do?

• Provide expert musculoskeletal assessments in person or on the telephone.
• Advise on best management of MSK conditions.
• Refer onwards if further treatment is required to services including physiotherapy, rheumatology, pain management or orthopeadics.
• If clinically indicated, can refer you for X-rays, blood tests, ultrasound scans, nerve conduction studies or MRI scan.
• Some FCPs can inject joints for pain relief.
• Some FCPs can prescribe specific medicines.

What can an FCP not do?

An FCP does not provide a physiotherapy service. They cannot, therefore, provide ongoing, regular treatment. If this is required an FCP can refer you to a physiotherapy team.

What is the difference between an FCP and an Advanced Practitioner (AP)?

An FCP works in primary care (general practice), so is usually the first clinician to assess and advise you. They aim to provide an accurate diagnosis and an early management plan. Their scope of practice is more general, so they see lots of different musculoskeletal problems. They may refer you onto an Advanced Practitioner (AP) for further assessment or for investigations.
An AP is a clinical specialist, often focusing on specific areas of the body. They will help to establish a diagnosis and work with you to come to a shared decision regarding how to manage your problem. They work closely with Physiotherapists and Orthopedic surgeons. Some AP’s also work as FCP’s.

Why would you see an FCP rather than a GP?

FCP’s are experts in seeing patients with musculoskeletal (MSK) problems. Often they will be able to see you sooner than you can get a routine GP appointment. However, you should see your GP for any medical issues.
GPs can and will see you for a musculoskeletal problem, if you prefer,and it’s your choice who you see, but the GP may still recommend a review with the FCP if they feel that it is would be appropriate.

Does seeing an FCP delay access to active treatment, onward referral etc?

Absolutely not. Because of their experience and training, seeing an FCP can minimise delays in diagnosing your problem. They can give you specific advice on how to manage your condition and refer you on quickly if that is required.
FCP’s are specialists in musculoskeletal healthcare and will provide you with an accurate diagnosis and evidence-based management plan. FCP’s are familiar with the local NHS pathways, and if appropriate, can send detailed referrals that will ultimately reach the patient’s desired location more efficiently.

How can a patient be seen by an FCP?

You can choose to see your GP first or just ask the receptionist for an appointment with the FCP. Reception teams are specially trained to determine who is appropriate for review by the FCP so if you are happy to share that your problem is related to a muscle, bone, nerve or joint issue at the time of booking, they will arrange an appointment for you.


1.      Evaluation of the First Contact Physiotherapy (FCP) model of primary care (2020) Goodwin R, Jordan K, Moffatt F. Keele University, University of Nottingham

2.     firstcontactpractitioner.org.uk

3.     csp.org.uk/professional-clinical/improvement-innovation/first-contact-physiotherapy-0

4.   csp.org.uk/system/files/documents/2018-10/001536_First_Contact_reception_info.pdf