The educational training pathway to Advanced Practice in Primary care

With the advent of First Contact MSK physiotherapy roles in primary care the development of a career pathway with an educational training roadmap and supported by specific supervision has evolved.

This has created an exciting opportunity to work at the front of the MSK care pathway as a diagnostic clinician.

by amandahensman

For the first time, physiotherapy under graduates will be able to see primary care as a career choice as a developmental journey from the day that they register with the HCPC.

The national route into MSK primary care roles as set out by Health Education England (HEE) is highlighted in the table below.

All clinicians completing the required training via a portfolio or a taught route, will be recognised and held on a directory of practitioners at the HEE Centre for Advancing Practice.

From April 2022, all clinicians will need to have completed the required training prospectively and retrospectively prior to entry into primary care.

This is a great opportunity for structured CPD and to have recognition of meeting the new standard of practice in primary care.


To work in primary care, although MSK knowledge and clinical expertise to level 7 (masters level) is essential, unlike other areas of MSK specialty, it is a diagnostic role working with undifferentiated and undiagnosed conditions as the first point of contact.

You will you work with complexity, uncertainty, co-morbidity, polypharmacy, frailty, public health, mental health, long term conditions and safeguarding.

All of which need to be integrated to inform an MSK assessment and form a diagnosis and management plan for the patient.

Working in this way means that as well as developing an MSK specialty, it is as equally important to nurture development of:

  • broad non MSK knowledge (eg respiratory, neurology, surgical, elderly care etc)
  • recognition of red flags
  • serious pathology and visceral masqueraders
  • the ability to work and integrate multi professionally
  • and to develop cross system knowledge and across care pathways

This skill set is essential for any clinician wishing to travel along the advancing practice pathway, and if built upon from graduation, it becomes a natural progression as you move through your career.

The entry level into primary care as a First contact physiotherapist has a pay minimum threshold of band 7 and as you progress as an Advanced Practitioner, you would be a band 8a.

 It is important to note that it is the capability of the clinician that dictates the renumeration. To help understand the difference in capabilities, please see the table below.

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