Patient satisfaction with the first contact physiotherapy service: Results from the national evaluation survey

Abstract

Background Musculoskeletal (MSK) First Contact Physiotherapists (FCPs) are diagnostic clinicians able to assess and manage undifferentiated and undiagnosed MSK presentations. The FCP role in primary care has been introduced to allow patients with MSK pain to see a FCP directly rather than wait to see a General Practitioner (GP) first, which improves capacity within primary care. A national evaluation was undertaken of the FCP model. This article reports the thematic analysis of the free‐text responses of patients who participated in the national evaluation. Methods An online platform collected patient‐reported experience and outcomes following the FCP consultation and at 1, 2 and 3 months follow‐up. Free‐text responses to the Friends and Family test, reasons for consulting another health care professional (HCP) and general comments were thematically analysed and grouped according to their responses. Results Over 13 months, 680 of 2825 registered patients (24%) completed the initial questionnaire and 54% (n = 370) completed the 3‐month follow‐up. During the course of the evaluation, 785 participants provided free‐text responses. Themes identified from free‐text responses were: communication and knowledge, clinicians’ characteristics, efficiency, treatment provided, assessment skills and service provided in comparison to GP care. Complaints represented 4% (n = 26 comments) of total feedback. The main reasons for consulting other HCPs after seeing a FCP were persistent pain, delays in referrals or already attending NHS physiotherapy. Conclusion Thematic analysis of free‐text responses in the national FCP evaluation provides context and detail to the positive outcomes reported by patients after consulting a FCP in primary care.

Access to first contact physiotherapy appointments in primary care: A scoping review

“…Terminology about how patients access FCP appointments was not consistent; eight sources used the term ‘signposting’ (Davies et al., 2021; Goodwin, n.d. ; R. Goodwin et al., 2020; iCSP 2, 2021; McDermott et al., 2022; Morris et al., 2021; Wood et al., 2022), four used the term ‘care navigation’ (CSP, n.d.; Goodwin, n.d; HEE, 2020; McDermott et al., 2022), and one used the term ‘walk‐in appointments’ (Halls et al., 2020). The term ‘triage’ was used by nine sources, five of which used the term on its own (Bater & Sellars, 2022; iCSP 1‐3, 2021; McDermott et al., 2022), two of which used the term ‘reception triage’ (Doran, 2021a; Halls et al., 2020), and two of which used the term ‘GP triage’ (R. Goodwin et al., 2021; Greenhalgh et al., 2020).…”

“…Personnel involved in patients accessing FCP appointments were described as ‘reception/receptionists’ or ‘admin/administration/administrators’ in 17 of the sources (Bater & Sellars, 2022; CSP, n.d.; Davies et al., 2021; Doran, 2021a, 2021b; Goodwin, n.d.; R. Goodwin et al., 2020; Halls et al., 2020; HEE, 2020; Hensman‐Crook, 2019; Jagosh et al., 2022; McDermott et al., 2022; Morris et al., 2021; Pain, 2022; Pike, 2020; Wise, 2019; Ingram et al., 2023), GPs in 10 of the studies and other materials (Doran, 2021b; R. Goodwin et al., 2021; Greenhalgh et al., 2020; Halls et al., 2020; iCSP 1‐3, 2021; McDermott et al., 2022; Pike, 2020), ‘ANPs’ in three (R. Goodwin et al., 2020; Halls et al., 2020; iCSP 1, 2021), ‘primary care team’ in one (CSP, n.d.), and ‘healthcare staff’ in one (R. Goodwin et al., 2020). Three of the studies did not provide any information regarding personnel involved (Akehurst et al., 2019; Bater & Sellars, 2022; Wood et al., 2022).…”

“…Several sources in the review did not use the term ‘signposting’, but the brief descriptions given suggested a comparable process; “booked via reception” (Wise, 2019), “direct from reception” (Hensman‐Crook, 2019). ‘Triage’ and ‘care navigation’ were other terms that appeared to indicate a process similar to that of ‘signposting’—that of determining a patient's need and directing them to the most suitable member of the GP team (Bater & Sellars, 2022; CSP, n.d.; Doran, 2021a; Wood et al., 2022). There seems to be agreement between many of the studies and other materials that signposting by reception or administrative staff is fundamental in ensuring appropriate access to FCP (Doran, 2021a; D. R. Goodwin, n.d.; R. Goodwin et al., 2020; Goodwin, 2021; Health Education England, 2020; McDermott et al., 2022; Morris et al., 2021; Pain, 2022; Wood et al., 2022).…”

“…‘Triage’ and ‘care navigation’ were other terms that appeared to indicate a process similar to that of ‘signposting’—that of determining a patient's need and directing them to the most suitable member of the GP team (Bater & Sellars, 2022; CSP, n.d.; Doran, 2021a; Wood et al., 2022). There seems to be agreement between many of the studies and other materials that signposting by reception or administrative staff is fundamental in ensuring appropriate access to FCP (Doran, 2021a; D. R. Goodwin, n.d.; R. Goodwin et al., 2020; Goodwin, 2021; Health Education England, 2020; McDermott et al., 2022; Morris et al., 2021; Pain, 2022; Wood et al., 2022). The central role of signposting may be due to a finding of two of the qualitative studies (R. Goodwin et al., 2020; Goodwin, 2021); that there is a lack of patient awareness of FCP, and confusion about what FCPs do, and how and where they do it, therefore explanations and guidance from GP Reception staff ensure patients are made aware of FCP.…”

“…The uncertainty and unfamiliarity around FCP services means that ‘patient pathways need clear articulation to patients’ (Wood et al., 2022), and that ‘communication is crucial’ (Pain, 2022). Communication was felt to be an important facet of ensuring effective utilisation of FCP; communication between clinical and non‐clinical GP staff, and communication between GP staff and patients.…”