Delivering a first contact physio service

Top tips from the London Fields PCN team 

1. Identify what will give most impact to your population- the London Fields team chose to prioritise back pain, which was identified as a widespread MSK issue in their local population.

2. Overcoming the barrier of time in the busy FCP schedule 
   
   Share your ideas with your PCN team to obtain buy in and ask for support- this will help share the load of organising the event and help to spread the message more widely. The London Field’s FCPs identified a PCN team member who was experienced in setting up webinars and were able to use their expertise. 
   
   Keep your plans simple- use evidence based resources that are already available to shape your event. 

3. Make your approach inclusive 
   
   Keep your message simple- this will ensure that the purpose of the event will be understood by a broader range of people across your community and therefore give your event a greater reach. 
   
   Offer different options if possible- the London Fields team offered a virtual event (which people could view remotely or come into the practice to watch in a set-up viewing area) and an in-person event making the sessions accessible to a wider proportion of their community. 

4. Safety first- the team ensured that patients were aware of red flags, that the event was not to replace an appointment with a healthcare professional and to encouraged people to seek help if they have individual questions or concerns. Please see the CSP guidance webpages on understanding Duty of Care- which may be of help when planning your event. 

5. Have support on the day- the team appointed a moderator from their PCN team to monitor the chat to ensure attendees were appropriately signposted if they brought up a personal concern but also brought appropriate questions to the presenters to answer that would benefit the audience. 

6. Gain feedback from the people who attended the event- this will help evidence the impact of the event and help influence future plans. 

Summary of the benefits from running the sessions

• The team reached 150 members of their community with their sessions. 

• Increased their local populations knowledge and understanding of the role of a FCP- making it more likely that people will choose to see an FCP instead of the GP in the future for an MSK issue. 

• Increase the visibility and demonstrate impact of FCP in the PCN. 

• FCPs saw an increase in patient’s understanding of their back pain when attending an appointment following attendance at the webinar. 

• Good networking opportunity to develop relationships with healthcare partners and third sector contacts - including organisations to promote patient’s access to virtual technology- therefore having a positive impact on health inequalities and digital inclusion for their local community. 

Top tips for your data project 

1. Define the problem- What is the key issue/problem that you need to solve with your data project, e.g. time barriers/using the data you collect meaningfully and with impact/standardising your data collection or collation processes. 

2. Understand why is it important to solve the problem? 
   
   Why is the solution important to you? For example to evaluate and improve services, to reduce the burden on staff or to reduced unwanted variation in patient care.  
   
   Having a clear and shared understanding of the problem helps to keep you motivated and helps to get others on board with your plan. 

3. Get the right people involved- identify the key players who can help power your project 
   
   Expert power: who has high expertise and experience to help with your project? This could include service users, your Information Governance Lead, clinicians or your organisations business architects. 
   
   Network power: who can link you with key players e.g. your organisations Chief Clinical Information Officer, line managers, digital champions and other members in the Physiotherapy Digital and Informatics Group DIPG.
   
   Legitimate power: those who can open doors and action change- the decision makers e.g. budget holders. 
   
   Connected connectors: those who will champion your work, give you energy and ideas. 

4. Co-design the solution 
   
   Who are your end users of the data? Who will benefit from the data? 
   
   This will ensure that it is fit for purpose to achieve your outcome. An example of how Dom did this was by asking multiple stakeholders- including his FCPs and PCNs what they would want from a standardised dataset and could then tailor the information collected to ensure that it met the needs of multiple roles. 

5. Setbacks are normal, don’t let them derail your plan, be agile- Re-evaluate your plan using the skills and knowledge accrued so far. You may find you need to go back a few steps in your process, reconnect with your key players, are there new key players you need to connect with? Make the changes necessary, refocus and move forward. 

You can find Dom’s team (the Midlands Partnership NHS Foundation Trust) dataset template and pertinent resources via the NHS Futures platform (which is open to both NHS and non NHS physiotherapists).

Top tips for successfully integrating an ethos into the primary care team

Getting started

If you are new to the FCP role, ensure that you understand the expectations of the role. This will enable you to be clear with PCN MDT colleagues about how the FCP role should be used from the outset. There are useful resources on the CSP website to support you, which can be shared with PCN MDT colleagues to support their understanding of the FCP role and vitally how it differs from an in-house physio service. 

Effective induction is key

• Your induction: it is vital for new FCPs to get a thorough induction into the workings of the PCN. Inductions also give the opportunity for FCPs to promote a greater understanding of the role across the PCN MDT. Take opportunities to introduce yourself and the FCP role, either formally or informally.  
  
  The CSP has an FCP induction template that can be adapted to any practice to support effective induction. 

• Be part of new team member’s induction: when new colleagues are being inducted it is a great time to ensure they understand the FCP role. You may want to invite staff to observe one of your clinics. 

Develop a greater understanding of your colleagues’ roles

Ask PCN colleagues to explain their roles and look at how you can work most effectively together. For example, FCP Kate meets regularly with Lead Social Prescriber Abi to enhance patient pathways between the services and with the practice reception staff to develop their care navigation skills for patients. 

Meeting expectations

Being involved in relevant meetings will help FCPs embed in the PCN MDT and improve patient care. Kate found it helpful to request to attend meetings that would benefit from the contribution of an FCP. 

Develop knowledge and understanding of how your FCP role works across the MSK pathway and wider healthcare system locally

Clearly understanding the referral criteria for an onward referral and being able to explain to patient’s what they can expect from the service will enhance personalised care. It can also provide networking opportunities for FCPs, encouraging peer-to-peer support and knowledge sharing across systems.  

Don’t be afraid to showcase your impact, knowledge and skills as an FCP

• Share your successes: this could be positive patient feedback or successfully identifying a serious underlying condition. Kate has found sharing quick wins with appropriate colleagues has helped demonstrate the impact of the FCP role. 

• Data matters: collect data to illustrate how your role is having impact. The CSP has resources to support you, also see our webinar above on how to be a data instigator. 

• Share your expert MSK knowledge to upskill PCN colleagues: this could be in a 121 or a larger team meeting. 

Take action if you are feeling isolated

Access support by connecting with your colleagues- across the ARRS roles, PCN or wider system. The CSP has a directory of FCP peer networks that you can join across the UK.  

Stay connected

If you are working across a number of different practices,- use tasks system on System One or Emis to keep in contact with your practices even when you are not in the building so you can continue the dialogue.