First contact physiotherapists

Low back and neck pain are the greatest cause of years lost to disability in the UK, with chronic joint pain or osteoarthritis affecting more than 8.75 million people. In addition, musculoskeletal conditions also account for 30% of all GP appointments.

By 2024, all adults in England will to be able to see a musculoskeletal first contact physiotherapist at their local GP practice without being referred by a GP.

The vast majority of musculoskeletal first contact practitioners are physiotherapists with enhanced skills. They can help patients with musculoskeletal issues such as back, neck and joint pain by:

  • assessing and diagnosing issues
  • giving expert advice on how best to manage their conditions
  • referring them onto specialist services if necessary.

Patients with back and joint pain, including conditions such as arthritis, will now be able to contact their local physiotherapist directly, rather than waiting to see a GP or being referred to hospital. Patients can also see a physiotherapist by speaking to the GP practice receptionist or by being referred by their GP.

By making it easier for patients to access physiotherapist, patients will have quicker access to diagnosis and treatment, helping them to manage their conditions more effectively and recover faster, so they can get back to normal life quickly. They will help GPs to manage their workload more effectively, and reduce the need for onward referrals.

In 2018/19, the Elective Care Transformation Programme piloted patients attending a clinic with a musculoskeletal first contact practitioner instead a GP. Evaluation of more than 6,800 appointments showed that patients were:

The GP five-year contract announced funding for new 20,000 primary care healthcare professionals such as physiotherapists. From 2020, GP practices will be able to access funding to employ their own musculoskeletal first contact practitioner. Local plans are also being developed to deliver musculoskeletal first contact practitioner services over the next 5 years.


Read the specification for first contact practitioner services for MSK conditions, watch short videos about FCP  Health Education England’s short video series and visit the Chartered Society of Physiotherapy website for more information.

Join the community

Do you work in a GP practice, primary care network, integrated care board (ICB) or integrated care system (ICS)? Find guidance, information and best practice on implementing musculoskeletal First Contact Practitioner services by requesting to join the elective care community of practice community.