FCP career scenario: I'm an advanced MSK physiotherapist

If you are working as an advanced physiotherapist in secondary care, there are plenty of ways you can prepare for making the move into primary care as a First Contact Physiotherapist (FCP).

An advanced MSK physiotherapist who is interested in FCP

I work in secondary care in an orthopaedic triage service. I would like to consider doing some clinics as an FCP in primary care as well. What can I do to get ready for these opportunities?

If you are already working in a musculoskeletal (MSK) advanced practice role or service, you should be able to map your experiences and learning to the four pillars of advanced practice. There are also country-specific documents available in our local FCP career guidance.

Your experience for the clinical pillar will be focused on your current area in secondary care. Therefore, you may have further steps to take to ensure you are able to work at an FCP or advanced practice level in primary care.

Steps you can take to prepare for an FCP role

If you are interested in exploring FCP as a possible career opportunity, you should speak to your line manager about your aspirations as they may have an established into FCP or the option of covering clinics across settings. You may want to understand more about what FCP work is like in practice before you make further plans, and in this case you should speak to colleagues about their experiences. If there are no FCPs in your current organisation, you could put a post on the FCP network on iCSP or follow some key figures in FCP and primary care on Twitter (start by following @thecsp).

More ways to develop into an FCP role

See our essential information page for tips on increasing your understanding, evidencing your experience and enhancing your education.

For example, find out about postgraduate qualifications and how to use evidence from a previous MSc in your portfolio.

And for more information about how FCP works in your area, see our country-specific guidance.

Get to know primary care

As an advanced practitioner working in secondary care, you are incredibly skilled in MSK physiotherapy. However, primary care is a very different environment to secondary care. It is vital for you to appreciate the differences.

Working as an FCP may mean moving away from the treatment aspects of physiotherapy and into a role more heavily weighed towards assessment and diagnosis of patients rather than rehabilitation. To get a sense of the joys and challenges this involves, you should definitely seek out opportunities to spend time in primary care and speak to primary care clinicians about their workload and patient population.

You could talk to your line manager, supervisor or mentor about opportunities to spend time in primary care. Perhaps you could shadow an FCP, an advanced nurse practitioner, a clinical pharmacist or a GP. You could read the FCP case studies on our website to gain insight, follow prominent FCPs on Twitter or reach out to FCPs you know or have heard of to ask about their experiences. You could also use the CSP mentoring platform to find a mentor who can support your FCP development, and within England, you should use your Primary Care Training Hub to find a supervisor or find out if you could be a supervisor.

You should review your current portfolio against the relevant MSK and/or FCP frameworks in your country (see our country guides for more information on this).

Transferable skills

As in secondary care services, in primary care, there is a strong focus on self-management, preventative healthcare and population health. This focus has a different flavour because patients return to primary care again and again over many years. Having a number of interactions over a long timeframe with patients enables discussion of lifestyle factors and behaviour changes. There are many courses and opportunities you can take to develop your skills in population health, public health, self-management, change behaviour, pain management and Making Every Contact Count. Developing these skills would be very valuable if you are considering moving into or dipping into FCP work. 

Pillars of advanced practice

As an advanced practitioner, you will be aware of the four pillars of advanced practice and you should continue to seek out ways to develop your non-clinical pillars as an Advanced Practitioner in MSK as this will also be relevant to any primary care opportunities you may look towards in the future. You should consider leading and taking part in audit, research or quality-improvement and transformation projects as these are all examples of opportunities which could be evidenced, at Level 7, against the pillars of education, leadership or research.

You could shape your service development and quality-improvement projects to feature primary care more prominently. For example, offering an educational session to GPs about your physiotherapy service or a clinical topic, or developing stronger links between your local primary care providers and your secondary care service. You could also consider supporting the teaching and assessment of pre- or post-registration students within practice or at your local university to develop your education pillar. 

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