PRISM Feasibility
Research type
Research Study
Full title
PRISM: The PRimary Care Individual Social Norms MSK Data Dashboard: a cluster randomised feasibility trial in First Contact Physiotherapy management of musculoskeletal patients.
IRAS ID
361359
Contact name
Emma Dunphy
Contact email
Sponsor organisation
Homerton Healthcare
Clinicaltrials.gov Identifier
Clinicaltrials.gov Identifier
NIHR303556, NIHR Advanced Clinical Academic Fellowship -
Duration of Study in the UK
0 years, 7 months, 30 days
Research summary
Over 20 million people in the UK live with a musculoskeletal (MSK) condition; accounting for one in three GP consultations. To relieve pressure on GPs, patients with MSK problems can consult a First Contact Practitioner (FCP) based in primary care instead of their GP, improving patient access to MSK management and freeing GP capacity. The role has been successful but some challenges and risks have emerged. Whereby initially, only ‘Advanced Practice’ physiotherapists were recommended for these roles, growing demand has led to the recruitment of less experienced clinicians. Access to supervision, training and governance and oversight vary, leading to growing concern about safety and unwarranted variation in care. New methods of supervision and oversight are needed to meet this challenge.
This study proposes the PRISM (Primary Care Individual Social Norms MSK Data Dashboard), a tool that provides clinicians with personalised feedback on their clinical decisions compared to the national data of their peers, eg ‘you are in the top 20% for MRI requests’ or you are in the top 20% of referrals to orthopaedics’ or ‘you are in the bottom 20% of those referring to social prescribing’. This form of ‘social norms’ feedback has been shown to be effective in changing clinician behaviour toward quality indicators. The dashboard can also nudge clinicians toward an array of best practice interventions that were identified in a previous work package. The dashboard is then discussed in clinical supervision to give the data context and so learning needs or operational issues can be addressed.
This is a pragmatic feasibility cluster randomised controlled trial, where sites will have the PRISM dashboard as part of their supervision or TAU. The trial will continue for 6 months and the primary outcomes are about feasibility of a future RCT.REC name
East Midlands - Leicester Central Research Ethics Committee
REC reference
25/EM/0256
Date of REC Opinion
11 Dec 2025
REC opinion
Further Information Favourable Opinion