First Contact Physiotherapy in Primary Care (FRONTIER)
Research type
Research Study
Full title
First Contact Physiotherapy in Primary Care (FRONTIER): A Realist Evaluation of effectiveness and costs.
IRAS ID
261530
Contact name
Nicola Walsh
Contact email
Sponsor organisation
UWE Bristol
Duration of Study in the UK
2 years, 3 months, 1 days
Research summary
Musculoskeletal Disorders (MSKDs) are the leading cause of disability in the UK. They account for 10.8m lost work days annually and consume a significant amount of the health budget. In 2014 there were 340m GP consultations in England, an increase of almost 12% over five years; approximately one third related to MSKDs. Given the increasing demand for GP services, and current difficulties surrounding GP recruitment and retention, alternative models of care are essential.
One evolving service initiative is First Contact Physiotherapy (FCP), whereby patients attending GP surgeries for MSKDs are treated by experienced physiotherapists on a first point of access basis; thereby providing timely specialist advice and reducing demands on GP time. A national search conducted by the applicants found 85 locations in England and further initiatives in Wales offering FCP, but considerable variation existed in the way in which it was implemented and funded. The search revealed two key models:(1) some locations employ traditionally qualified ‘standard’ physiotherapists who deliver assessment and non-pharmacological management, with or without onward referral; (2) others employ physiotherapists who have additional validated competencies traditionally undertaken by the medical profession, that permit them to prescribe, inject, order/interpret investigations and list for surgery.
Local audits of both FCP models indicate that they reduce GP appointments and requests for unnecessary investigations, improve patient satisfaction and incur cost savings, in comparison to standard GP led approaches. Further robust research is needed to examine the diversity of FCP models across the UK and determine the impact of emerging FCP models on patient outcomes, costs and impact on MSK services. This research will provide robust evidence by conducting a realist evaluation (a theory driven methodological approach, used to evaluate social programmes) of delivery models to identify how FCP works, for whom, under what circumstances, and with what resource implications.REC name
HSC REC B
REC reference
19/NI/0108
Date of REC Opinion
18 Jun 2019
REC opinion
Further Information Favourable Opinion