As in the other home nations, health is devolved in Northern Ireland. This means that Stormont makes its own decisions about healthcare investment, education and workforce plans. This leads to differences in healthcare systems and in the implementation of First Contact Physiotherapy (FCP). Health and Social Care in Northern Ireland is part of the Northern Ireland Executive and sits under the Department of Health at the devolved Northern Ireland Assembly.
The Department of Health published the Advanced AHP Practice Framework () in response to recommendations in the Bengoa Report. The Advanced AHP Practitioner is a clinically focused role. The Advanced AHP Practice Framework defines the role of advanced practitioner, identifies educational and experiential pathways to achieve this level of clinical practice and promotes the importance of the four pillars of advanced practice.
The Advanced AHP Practice Framework therefore outlines a career structure for physiotherapists to become First Contact Physiotherapists (FCPs) in Northern Ireland. It outlines the knowledge, skills and postgraduate requirements to work at advanced practice level.
Within Northern Ireland, FCP is being introduced as part of the enhanced multidisciplinary teams (MDT) in primary care. This is a new model of service delivery, which enhances the primary care team to include FCPs, mental health practitioners and social work practitioners and assistants. Physiotherapy professional heads of service for the five Nothern Ireland Trusts, primary care and the Department of Health have worked collaboratively in implementing FCP. Best practice and consistency has been achieved by ensuring a regionally agreed approach. This includes regionally agreed FCP job descriptions for both the FCP consultant (band 8b) posts and the FCP (band 8a) posts. Regionally agreed criteria have been set to ensure that the career pathway for FCP posts is clearly identified.
Postgraduate education is available via the Clinical Education Centre (CEC) and Ulster University. Workforce planning and development has been ongoing to ensure that, as funding is rolled out, active recruitment can proceed and musculoskeletal (MSK) staff will be in a position to move forward for these roles. This has been a long-term endeavour by the department and the profession.
The implementation of FCP as part of the primary care MDT in September 2018 was identified in the recent Northern Ireland Physiotherapy Workforce Review, which was commissioned by the Department of Health.
- FCPs are employed by NHS trusts and work in primary care within GP practices.
- In Northern Ireland, the agreed model is based on one full-time equivalent FCP for each 10,000 of patient population, and an FCP consultant band 8b per GP federation. The Department of Health, Primary Care Federations and Health and Social Care Trusts have agreed this.
- A regional job description is in place for FCP band 8a and for FCP consultant band 8b. A run-through post has been developed for areas where recruitment is challenging. These posts commence at band 7 advanced practitioner level 1 and move to band 8a advanced practitioner level 2 when competencies are reached.
- All FCPs in Northern Ireland are working at advanced practice level
Education and training
Ulster University has modules in independent non-medical prescribing and advanced practice, with optional modules on subjects such as research evidence in health science, foundations of mental health and wellbeing, and collective leadership. FCPs could opt to do these as part of an advanced practice MSc or as individual modules.
Candidates from Northern Ireland can apply to and attend courses/modules on advanced practice at mainland UK higher education institutions.
To understand more about education and training for these roles in Northern Ireland, individuals should refer to the regional job description. Postgraduate training has been commissioned through the ECG and is available through regional and national providers. For those working outside the NHS, postgraduate training is available from higher education institutions. Extensive MSK CPD is widely available through multiple providers and trusts. Specialist/advanced training is available through trusts and other local providers.