Advanced Physiotherapy Practitioners (APPs) or “First Contact Practitioners” in General Practice
The 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.
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 APP; they can also be directed to them by reception staff. GPs can also request an expert MSK opinion from the APP. This service is now available in all Midlothian GP Practices.
“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).
An 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.
How does seeing a APP work?
You contact you GP practice with a muscle. bone or joint issue and request an appointment. You may be asked why you are calling.
You can request at this stage to see an APP.
You are given a phone or face to face appointment with an APP as requested, or if you have been triaged to them as having a likely musculoskeletal (MSK) problem.
You have an appointment with your APP who may:
- ask you some questions
- examine you
- help find out what the problem is and what options
are available for you
Following on from your appointment, your APP will make a decision jointly with you about the next steps.
These may include:
- advice, information and/or exercises
- onwards referral to physiotherapy
- onwards referral to another service that can best meet your needs
- further investigations e.g. x-rays
Do you have low back pain?
If you have pain in your lower back (including sciatica) you can now self-refer directly to a new digital support service which offers same-day appointments 24/7. The service is delivered by NHS Lothian’s clinical partner, Flok Health.
To self-refer to this new service and find out more click on Flok Health Register . You will be directed to a digital appointment immediately.
For other conditions, or if you prefer to see or speak to a physiotherapist, then please contact your GP practice and ask to see the advanced physiotherapist (APP).
