General Practice Advance Physiotherapy Practitioners (GP APPs)- or “First Contact Practitioners”
The GP APP works within a GP practice as part of the primary care team assessing and managing people with muscle, bone or joint symptoms. They provide an alternative to a GP appointment and work as “First Contact” clinicians.
GP APPs provide advanced level assessment and management for people with musculoskeletal symptoms. They can recognise when a condition is not musculoskeletal and take appropriate action (i.e. referring on to the most appropriate service).
Patients can request an appointment with the GP APP; they can also be directed to them by reception staff. GPs can also request an expert MSK opinion from the GP APP. This service is now available in an increasing number of GP practices in Edinburgh.
“Advanced Practice is a combination of advanced skills, knowledge and attitudes together with a core set of physiotherapy skills and knowledge, tailored to individual patients and local environments” (Chartered Society of Physiotherapy, 2018).
A GP APP provides
- Advanced level assessment, clinical diagnosis and management of patients presenting with MSK symptoms
- MSK triage: a very quick route to brief intervention, advice and support to facilitate self-management
- Identification and appropriate escalation of those with a non-MSK presentation
- Identify the need for and refer for x-ray investigations
- Provide advice on simple analgesia under protocol
- Sign post to pharmacy, community and voluntary sector support
- Referral to physiotherapy, orthopaedics, integrated pathways and the Leisure sector where indicated
“The results suggest that patients with musculoskeletal conditions may be assessed and managed independently and effectively by physiotherapists instead of GPs. This has the potential to significantly reduce workload for GPs as the service requires minimal GP support. The majority of patients were managed within primary care, with low referral rates and highly appropriate referrals to orthopaedics. Patients reported positive views regarding the service.”
Downie et al. 2019 BJGP
