GIRFT has shared the findings of a nationwide review of First Contact Physiotherapist (FCP) services, offering a clearer understanding of current practice in primary care and highlighting opportunities for improvement.
The evaluation report follows a widescale survey of GP practice managers and Primary Care Network (PCN) leads with responsibility for musculoskeletal FCP services, which was carried out by GIRFT’s community MSK (cMSK) workstream in partnership with the government’s Joint Work and Health Directorate (JWHD) and the Chartered Society of Physiotherapy (CSP).
As well as offering valuable insight into how the FCP role is operating in primary care in England, the report contains a series of recommended enablers of good practice which can support commissioners, providers and Primary Care Networks to strengthen the quality, safety and value of FCP services.
MSK conditions are among the most common causes of pain, disability and reduced quality of life, and represent a significant and growing demand on NHS services. Through its cMSK workstream, supported by the JWHD, GIRFT is working with integrated care systems (ICSs) across England to strengthen community provision, improve access to treatment and reduce long waits for care.
FCPs are an important component of this model of care, providing advanced clinical assessment, triage and management for people presenting with MSK problems, offering timely specialist assessment and helping to release capacity within general practice.
The new GIRFT evaluation report looks at factors such as how FCP roles are employed and planned, education and training, scope of practice and governance of quality and safety.
For example, it highlights variation in how FCP roles are operationalised within primary care, showing that the extent to which FCPs can utilise responsibilities such as access to prescribing, fit note certification, diagnostic requesting, injection therapy and direct referral to secondary care, is inconsistent. This in turn can limit the system wide benefits of the role and may affect quality and consistency of care.
Andy Saunders, GIRFT’s cMSK clinical adviser for FCP, who led the review, said:
“We’d like to thank everyone who supported and engaged with this evaluation, particularly the practice managers and PCN leads in primary care who completed the survey. We managed to capture responses from every ICB in England, alongside approaching 20% of PCNs who currently employ FCPs.
This survey and the strong engagement it has seen have enabled us to gain a better understanding of the current provision of FCP services, highlighting where unwarranted variation is occurring and identifying opportunities for improvement.
We hope the report, and the recommended enablers of good practice it contains, will now support commissioners, providers and oversight bodies in improving the consistency, effectiveness and safety of FCP services within England.”
Sue Hayward-Giles, assistant director of practice and development at the CSP, said:
“This is an important piece of work that provides a valuable insight into how the role is operating across England.
The rapid expansion of FCP has been highly beneficial to patients but has inevitably led to variation and it was important for us to understand that in greater detail.
This evaluation builds on the growing evidence base around the role and it is important for everyone involved in the role, from policymakers to commissioners to the FCPs themselves, to take forward the recommendations.”
Watch our recent GIRFT webinar below: FCP national evaluation themes and initial findings, held on 12 March 2026.
