A service evaluation of a community NHS trust's first contact practitioner physiotherapy pilot service

Abstract

Keywords: Evolving; FCP; Practice Purpose:•To analyse the effectiveness of the FCP pilot service•The objectives of this service evaluation were to analyse the pilot's efficiency and effectiveness along with exploring the experience of stakeholders. Methods: Mixed methods service evaluation with inductive thematic analysis. Included interviews of staff (GP, FCP, B7 physiotherapists) and patients. Results: This evaluation produced positive results comparative to other studies regarding the number of secondary care and imaging referrals. The DNA rate was high and a large percentage of patients were referred on for further physiotherapy. Initially, there were many inappropriate referrals into the service, however, this improved towards the end of the pilot. Themes from the interviews included ‘it's all good’, ‘staff get it, patients not yet’, ‘admin is key’, ‘communication is crucial’. Conclusion(s): Findings: The evaluation was found to be effective and efficient and it highlighted the benefits of using advanced physiotherapists. All stakeholders were satisfied with the service, patients especially appreciated the short waiting times and seeing the right professional first time, whilst staff found the inter-professional working beneficial. Efficiency could have been improved by reducing the number of DNAs and inappropriate referrals. The GP administrators were found to be key to the service, and future services should look at making administrators central when implementing FCP services.•The trust and providers should consider implementing FCP services.•This evaluation suggests advanced clinicians are effective and using less experienced clinicians may provide a false economy.•Placing FCPs in individual practices will probably reduce DNA rates compared to using a hub model.•Appointment information should ideally be sent via text message or emails.•Strong communication links are needed between FCP and GP staff.•FCP services need to improve marketing.•Services should preferably utilise existing pathways for secondary care and imaging referrals.•Future services should look at making administrators central when implementing FCP services. Suggestions for future work:-Further studies are required to investigate optimal methods of marketing FCP services.-Future studies are needed to analyse the views and experiences of staff outside of the host practice in hub models.-Targeted data is needed to identify staff who are referring patients inappropriately.-Optimisation of GP admin training should be explored for FCP services. Impact: The project strengthens the case for implementing FCP within the trust and enhances the provision for patients if the service is implemented. It provides baseline data and informs providers who are implementing FCP services. Funding acknowledgements: This work was not funded.