Abstract
Introduction: Health and Wellbeing 2026 Delivering Together, articulated a vision to enhance the Multidisciplinary Team in Primary Care with three new professional roles:- Social Workers, Mental Health Practitioners and First Contact Physiotherapists (FCPs). It outlined a road map for the long-term plan in Northern Ireland to improve the mental, physical and social well-being of the local population shifting the focus from reactive medicine to one of prevention, early diagnosis and management.
The First Contact Physiotherapy Service, within the enhanced Primary Care Multidisciplinary Team in West Belfast, was implemented in April 2019. It serves an estimated population of Belfast West Area of 94,402, of which 44,748 (47.4%) identify as male and 49,654 (52.6%) identify as female with 16 GP practice providing primary care services across 19 localities.
Background: There are 16 GP practices within the West Belfast GP Federation with a range of patient populations between approx. 3,000 to over 10,000. The number of FCP sessions allocated is determined by the patient population of the practice (1 WTE per 10,000 patients). The current total allocated FCP resource to West Belfast is 9.4 WTE (94 sessions per week) with physiotherapy staff co-located across 16 GP practices.
The core aims of the FCP Physiotherapy service are to:-
- Deliver safe, highly effective quality service at earliest point in patient journey
- Enhance MSK knowledge within the Primary Care MDT “Expert Next Door”
- Supporting Physical Activity and Health Promotion
- Manage conditions early within Primary Care to prevent chronicity
- Provide self-management skills
- Provide local care and reassurance
- Improve accessibility to integrated holistic MDT care
Results:
Activity Data
Since implementation there has been a growth in demand for FCP services with current patient contacts 20,276 patient contacts for financial year 22-23 demonstrating an increase demand of 20.7% from year ending 21-22.
Review of service activity data demonstrates 81% of patient management in primary care with no secondary care onward referral.
From the data there is a statistically significant reduction in referrals to secondary care from the West Belfast Federation following the introduction of the FCP physiotherapy service. Of 20,273 patient contacts - 19.5% constituted referral to access secondary care service (AHP secondary care referral 16%, Secondary care medical lead pathways 3.5%). This mirrors similar findings from FCP services across UK implementation sites.
Patient experience measures:
150 completed Friends and Family forms Nov - Dec 22-23
90% of respondents would be extremely likely to recommend FCP service
Main recommendation route from GP (81%) with 39% signposted from receptionists.
43 patients comments on excellent service provided by FCP team members
Themes of professionalism, easy of use, knowledgeable, supportive service reported by 43 patients.
Conclusion:
Patient experience measures and referral activity data supports the value of first contact physiotherapy in primary care setting.
Further evaluation of the service aims to examine complexity of FCP caseload to enable workforce planning, training and educational programme for sustainable workforce provision.