An First Contact Physiotherapist, is an experienced physiotherapist with advanced skills in assessing, diagnosing, and managing musculoskeletal (MSK) conditions, allowing them to be the first point of contact for patients with these issues. Instead of going to a GP first, patients can directly see an FCP physio at their GP surgery for conditions like back pain, neck pain, or joint pain by:

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

For more information please read NHSE Roadmap to practice and the NHSE First contact physiotherapist guide.

First Contact Physiotherapists (FCPs) are transforming how musculoskeletal (MSK) conditions are managed in GP practices and Primary Care Networks by.

• Reducing GP Workload: FCPs can manage up to 30% of MSK cases, freeing GPs to focus on patients with more complex or urgent needs.
• Providing expert MSK Care: With specialist training, FCPs provide accurate assessments, tailored advice, and effective treatment plans from day one.
• Providing faster Access for Patients: No more long waits for physiotherapy referrals—patients are seen quickly, getting the right care at the right time.

By bringing expert physiotherapy skills into the first point of contact, we improve patient outcomes, ease pressure on GP teams, and keep care closer to home.

Musculoskeletal core capabilities framework for first point of contact practitioners

The scope of practice for First Contact Physiotherapists (FCPs) is set out in the NHSE Roadmap to practice for First Contact and Advanced Practitioners. These roadmaps provide a clear educational pathway from undergraduate study through to Advanced Practice, detailing the knowledge, skills, and professional attributes required to work as an FCP or Advanced Physiotherapist in primary care. They also outline the supervision structures and clinical governance arrangements necessary to support safe and effective practice.

By defining the capabilities of FCPs and Advanced Physiotherapists, the roadmaps help employers and workforce planners understand the value these roles bring to a multi-professional team, supporting high-quality, patient-centred care.

Here are examples of what a First Contact Physiotherapist can see, this may change dependent on the individual Physiotherapists and their previous experience and training:

• Advanced MSK assessment and diagnosis
• Provide information on self-care and enable and support behaviour change
• Discuss fitness for work
• Undertake social prescribing
• Discuss physical activity and health (e.g. smoking cessation and weight management)
• Refer to a course of treatment (e.g. physiotherapy or podiatry)
• Refer to orthopaedic / rheumatology / pain services
• Request investigations
• Medicines optimisation
• Administer joint / soft tissue injections (if qualified)

Care Navigation for FCP

Recruiting First Contact Physiotherapists through ARRS

Primary Care Networks (PCNs) can recruit First Contact Physiotherapists (FCPs) via the Additional Roles Reimbursement Scheme (ARRS). This scheme funds a range of roles to help build bespoke, multidisciplinary teams that meet local population needs. All PCNs are eligible for reimbursement, with funding allocation based on their weighted population share.

Through ARRS, PCNs can employ FCPs and be reimbursed for 100% of the specified salary and associated on-costs. This makes it a cost-effective way to integrate advanced musculoskeletal expertise into primary care teams, improving access and outcomes for patients.

More information can be found in:

• DES contract.
• Additional Roles at a Quick Reference Summary.
• CQC Mythbuster.

To practice as a First Contact Physiotherapist (FCP), clinicians must be registered with the Health and Care Professions Council (HCPC), which requires a BSc (Hons) in Physiotherapy—typically a three-year undergraduate programme.

Physiotherapists working at Advanced Practice level are generally expected to hold a Master’s degree or equivalent postgraduate qualification to support extended clinical decision-making, independent prescribing, and leadership responsibilities.

NHS England recommends that physiotherapists have 3–5 years of post-qualification experience before entering primary care training to become a First Contact Practitioner. This ensures they have the clinical expertise needed to manage musculoskeletal patients safely and effectively in a first-contact setting.

In addition, First Contact Physiotherapists should:

• Hold a Master’s-level qualification or demonstrate equivalent specialist knowledge, skills, and experience.
• Be able to demonstrate Level 7 capability in musculoskeletal practice, including advanced assessment, diagnosis, and treatment.

Further information can be found here:

First contact Physiotherapy posts in general practice

NHSE Musculoskeletal First contact practitioner’s

The educational training pathway to Advanced Practice in Primary care

Physiotherapists can train to be a First Contact practitioner via 2 routes:

University taught route – there are several fully funded courses available for Physiotherapists to attend:

Physiotherapists can also undertake the portfolio route, this route is aimed at individuals with previous post graduate training and / or primary care experience. 

Physiotherapists wishing to become NHSE Accredited Advanced Practitioners see the Advanced Practice page for more information.

Musculoskeletal first contact Practitioner services

Job Description

Example of interview questions

First contract physiotherapy GP resources

First contact physiotherapy resources for primary care networks

First contact physiotherapy

Supervision under ARRS

The Network Contract DES specifies the minimum supervision requirements for staff hired through the ARRS. The table below outlines the recommended minimum frequency for supervision meetings and identifies who can provide this supervision. Each clinical supervision session should last at least one hour.

These recommendations are based on the Network Contract DES requirements, professional regulatory standards, and expert guidance.

More information can be found in NHS England’s’ supervision guidance for primary care network multidisciplinary teams.

 Physiotherapist  acting as supervisors:

Physiotherapists established in primary care may provide clinical supervision for junior staff members across different professions. Physiotherapist  working in a supervisor role should have undertaken the necessary training to be able to do so, depending on the requirements set out in the relevant national workforce plan (England, Northern Ireland, Scotland and Wales).

Supervision of the MDT

FCP Portfolios

• Agilio (Clarity)

Free Portfolios

• Physio FCP EXCEL portfolio
• FCP MSK NHSE Roadmap

FCP Portfolio Blank Templates

• Audio COT
• Case Based Discussion FCP
• Clinical Supervisor’s Report
• Consultation Observation Tool – MSK
• FCP Verification Form
• Level 7 Module Performa
• Multi source feedback form
• Patient Satisfaction Questionnaire
• Personal Development Plan
• Patient survey questionaire and multi source feedback form via accuRx guide
• Tutorial Evaluation
• Tutorial Record

A Non-Medical Referrer (NMR) is a nurse, allied health professional or clinical pharmacist who has extended their role to include referral to radiology to improve the delivery of care to patients.

The Ionising Radiation (Medical Exposure) Regulations 2017 (and subsequent amendments) {IR(ME)R17} defines an NMR as being a member of a profession regulated by a body mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002(a).

For more information regarding IR(ME)R please see:  The Ionising Radiation (Medical Exposure) Regulations 2017

IR(MR)R training dates

What training is required?

All NMRs should receive IR(ME)R training which is updated every 3 years. The training should cover the principles of radiation protection, legislation, benefits and risks of the examinations being referred for including an understanding of the dose.

Training Dates and FAQs

For more information regarding Imaging requesting for Non-Medical referrers please see the Avon Local Committee website Radiological Imaging for non-medical referrers – Avon LMC.

Further advice or information about imaging for Non-Medical Referrers (NMR)

Please use the dedicated email addresses below:

• NBT: nmr@nbt.nhs.uk
• UHBW: RadiationProtectionTraining@UHBW.nhs.uk