CSP head of practice improvement, Abigail Henderson, explains amendments to the route into first contact physiotherapy.
NHS England (NHSE) has made significant changes to the roadmap process for first contact physiotherapists (FCPs) working in primary care. While there has been no national announcement, we are aware these changes are being shared in some regions.
The changes affect FCPs currently undertaking the portfolio route of the FCP roadmap – originally established by Health Education England (HEE) now NHSE Workforce, Training and Education team (NHSE WTE) – those about to do so, and members currently acting as supervisors in the process.
This blog sets out the changes in more detail, our position and what happens next.
What is changing
The key changes are as follows:
- The independent portfolio route is to be closed (date to be confirmed). There will be a six month run-off period after this date, to allow those already undertaking the portfolio route time to complete it. And instead, a supported portfolio route via higher education institutes (HEIs) will be established. This will run alongside the existing taught routes.
- Responsibility for supervision will lie with Primary Care Training Hubs (PCTHs) and schools, in collaboration with the HEIs. Any ongoing role for Roadmap supervisors is not entirely clear.
- Stage 3 of the roadmap (which outlined a route to AP from FCP) is being removed.
- NHSE WTE will no longer offer recognition of FCP level of practice through a digital badge for those who have already completed the Roadmap, as part of a move to self-regulation.
The CSP’s position
The changes being implemented now by NHSE WTE should lead to a more effective, better governed system of recognition using HEIs’ quality assurance processes, which will be easier for members to navigate. But problems now being addressed by NHSE WTE could have been avoided and many members will feel understandably, let down.
The independent portfolio route has been challenging to members due to lack of clarity from what was then HEE, and the absence of quality assurance measures that were initially planned. This has resulted in concerns over governance in the current process, expressed by CSP members and the system.
The CSP therefore supports this change but pushed for a longer timeframe because six months after any deadline date is an unrealistic and an unfair deadline for those who have already started the current portfolio route.
The CSP fully supports the intention to improve governance and process around the roadmap by moving supervision into Primary Care Training Hubs and HEIs.
However, CSP members who have undertaken the training to become a supervisor – possibly around 900 in total – may be disadvantaged by this decision.
Although there may be opportunities for them to undertake further training to get to the required standard for a broader supervision role, this decision undermines the efforts of CSP members and professional networks who supported HEE at their request to support the roadmap to be operationalised.
In addition, some services and organisations have employed members purely to coordinate or provide this supervision, and NHSE WTE has not yet provided sufficient assurance or clarity to the CSP on this issue.
The CSP is aware of significant confusion among members around Stage 3, and we accept that removing it is the correct action to ensure frameworks around advanced practice are aligned.
HEE and now NHSE have continually moved the goalposts around recognition.
Initially members were offered recognition via the Centre for Advanced Practice, which was to hold an FCP directory.
This was then changed to only a digital badge, which has now been withdrawn.
The CSP has pushed NHSE WTE to provide an alternative, but it has not found a viable option.
We believe that the backtracking by NHSE WTE on recognition is unacceptable for CSP members who followed a process in good faith that had been originally designed and implemented by HEE. The CSP has consistently raised these issues with NHSE WTE and is pleased to see a renewed focus on governance and quality.
However, we strongly advocate that members who have already completed the roadmap should be recognised as such and not be disadvantaged by the new process.
What happens next
The NHSE WTE team plans to email all members who have completed the recognition surveys in the roadmap, and further communications are planned in the coming months about the new training route.
If members have questions these should be directed to local primary care training hubs.
To reiterate, in the longer term these changes should lead to a more standardised, more effective and better governed system of recognition that will provide members with a better quality learning experience.
The CSP continues to ask WTE to take on board feedback to ensure the next stages of change are handled well. The CSP will continue to work with the NHSE team to ensure the physiotherapy voice is heard.
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