Access to first contact physiotherapy appointments in primary care: A scoping review

Abstract

BackgroundFirst Contact Physiotherapy (FCP) is part of the drive to increase General Practice (GP) capacity by providing access to expert musculoskeletal (MSK) Physiotherapists in GP surgeries. For the FCP model to provide effective MSK care at the start of the patient's journey, it is essential that patients are directed to FCP appointments in a timely manner. It is therefore important to know how patients are accessing FCP appointments.ObjectiveTo provide an overview of the literature regarding patient access to FCP appointments.DesignScoping review.MethodsWe reviewed studies published from January 2016 to May 2023 that focused on FCP and made a mention of patient access to FCP appointments. A search was performed using six databases as well as grey literature sources. Study selection and data extraction were independently conducted by two reviewers. Extracted data were tabulated and analysed according to our research questions.ResultsFrom 186 records identified, 24 studies and other materials were included in the review. A variety of terms were used to describe access routes to FCP appointments, the most common being ‘signposting’. These studies suggest the importance of the role of GP reception/administrative staff in enabling efficient patient access to FCP appointments.ConclusionThere is a clear gap in the literature concerning how patients access FCP appointments. Since the importance of appropriate access is acknowledged as an essential feature of the expansion of FCP in Primary Care, future research is needed to refine and implement optimal FCP access models by identifying the key components needed to ensure timely and appropriate access to FCP.

The experiences of patients with musculoskeletal conditions accessing first contact physiotherapy practitioner appointments in general practice in the UK: A qualitative study

“…It provides new evidence about patient reported facilitators and barriers to access, as well as confirming key access routes, and the challenges of low awareness of the FCPP role. A previous study found that there are a variety of access routes into FCPP appointments, with the most common way being booking via Reception (Lamb et al, 2023a); another study noted that many patients have seen or spoken to a GP about their MSK condition before receiving an FCPP appointment (Lamb et al, 2023b). In this current study, five of the 13 participants had only seen the FCPP after first having a GP appointment, and one of the patients' surgeries required a GP appointment prior to FCPP input.…”

“…The interview topic guide was informed by the aim of the research as well as by the results of the scoping review and survey of access methods previously performed by the authors (Lamb et al, 2023a(Lamb et al, , 2023b. It was developed by discussion among the authors, and there were no patients involved due to time constraints.…”

Patient access to first contact practitioner physiotherapists in the UK: A national survey

“…The development of the survey questions was informed by a review of the research literature, which revealed a paucity of research on how patients access FCPP appointments, but which did provide some indication of potential access methods (Lamb et al, 2023). The questions were formulated to answer the primary and secondary research questions.…”

“…Different appointment booking processes such as 'triage at reception' and 'self-booking' were identified through a survey exploring FCPP provision across the UK (Halls et al, 2020), suggesting that there may be multiple and varied models in practice for accessing FCPP care; however, this was only one question in the survey and did not provide any further detail. A recent scoping review investigated the literature around how patients access FCPP appointments and found that there is little published evidence on this topic, and what evidence there is contains minimal description of the access routes and processes or their effectiveness (Lamb et al, 2023).…”