First Contact Practitioner – Musculoskeletal (MSK) Physiotherapist


MSK First Contact Practitioners are regulated, advanced and autonomous healthcare professionals trained to provide expert MSK assessment, diagnosis and first-line treatment, self-care advice and if required and appropriate, discharge a person without medical or onward referral.

The development of First Contact Practitioner MSK (FCP) services across the UK allows people with musculoskeletal (MSK) conditions to access MSK physiotherapy expertise at the start of the pathway, ensuring timely access to diagnosis, early management and onward referral if necessary. This benefits patients, primary care and the wider MSK system.

Scope of Practice

Role Responsibilities

  • 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).

Link for more information on MSK First Contact Practitioner: NHS England: MSK First Contact Practitioner

Entry Requirements

  • BSc in Physiotherapy
  • At least 3 years post graduate experience in MSK and 5 years post graduate study
  • Health and Care Professions Council (HPCP) Registered
  • Usually working at an Agenda for Change Band 7
  • Advanced MSK practitioners (AP’s) may work at a Band 8a (the role is evaluated and will be determined by the complexity of the clinical workload and the scope of the role)

Training and Development

Mandatory Training

See above ‘Entry Requirements’

Standard Training (on entry to Primary Care)

First Contact Practitioner (FCP) Recognition

FCP roles began with the development of the FCP Physiotherapist in 2014, in response to the shortage of GPs in Primary Care. FCP roles are designed to support GPs as part of an integrated care team and to optimise the patient care pathway by seeing the right person in the right place at the right time.

To create sustainability for multi-professional FCP roles, there is a need to build a clear national Primary Care training pathway for clinicians moving into FCP roles and then onto Advanced Practitioner roles.  Therefore the NHSE ‘Roadmaps to Practice’ were published to support educational pathways for clinicians.

Please find below links to the Roadmap to Practice which will help service providers, managers and Physiotherapists themselves to identify what training, qualifications and competencies they should have to safely and effectively practice at first contact practitioner levels.

First contact Practitioners and Advanced Practitioners in Primary care: (Musculoskeletal) A Roadmap to Practice

The Musculoskeletal Core Capabilities Framework (2018)

Working alongside the ‘First Contact Practitioners AND Advanced Practitioners in Primary care (Musculoskeletal); Roadmap to practice (link above), FCPs must have completed both stage 1 and Stage 2 of the Roadmap to gain recognised First Contact Practitioner MSK status.

  • The Physiotherapist can be seen as a ‘trainee FCP’ until full FCP recognition is gained.
  • At present there are 2 main educational pathways by which one can train to be a First Contact Physiotherapist;
    • 1. Via an FCP portfolio completely
    • 2. Via portfolio with taught routes via HEI’s.
  • There are two stages to First Contract Practitioner recognition;
  • Stage 1: Preferably, must be completed with a portfolio of evidence and verified before employment in Primary Care. The KSA must be completed prior to employment as a FCP or AP in Primary Care to assure patient safety. For MSK clinicians already working in primary care this can be completed retrospectively. 
  • Stage 2:  Is completed with a portfolio of evidence and verified in Primary Care. This is the recognition process of the application of the KSA in Stage 1 to clinical practice in Primary Care. Best practice is that this should be completed within 6 – 12 months for a full-time member of staff but this can be longer provided a completion date is agreed with the employer.
  • ‘Trainee’ FCP’s are advised to keep a folder of evidence ready to submit in the final stages of their pathway.

Education providers

There are education providers across the UK that are successfully running MSK FCP taught modules.  NHSE has also provided funding support for applicants to attend these modules.  All the providers have committed to taking learners from outside the region that they are based.

Please see information and links below to each provider for further information.  If you are looking to enquire about an FCP taught module, please contact the education provider directly to discuss your individual requirements.

Additional Training

  • Advanced Practice Recognition – Please see link to the SNEE TH Advanced Practice page for full information on Advanced Practice

Supervision Requirements

Supervision is a process of professional learning and development that enables individuals to reflect on and develop their knowledge, skills and competence, through regular support from another professional.

Supervision can have different forms and functions and a number of terms are used to describe these. For this guidance we use the below terms and define them as follows:

  • Clinic/practice supervision: day-to-day support provided by a named/duty senior/more experienced clinician for issues arising in the practice.
  • Clinical/professional supervision: regular support from a named senior/experienced clinician/practitioner to promote high clinical standards and develop professional expertise.
  • Educational supervision: supports learning and enables learners to achieve proficiency.

Supervision Guidance for primary care network multidisciplinary teams (NHSE, 2023): NHS England » Supervision guidance for primary care network multidisciplinary teams

Clinical and Education supervisors have an integral role to support learners through the FCP Recognition process and to provide assurance that the practitioner has demonstrated the knowledge, skills and attributes required to work in a FCP role in primary care. One of their key roles is to review a learner’s portfolio of evidence and decide whether the individual has met the requirements of an appropriate FCP Roadmap.

For both the FCP Supported Portfolio and FCP Taught routes, Clinical and Education supervisors will work with an education provider, as part of the institution’s quality assurance processes, to support the learner to meet the appropriate level 7 learning outcomes of the applicable FCP Roadmap. Supervisors will sign-off the portfolio of evidence on successful completion.

The route to becoming a supervisor for FCP recognition and training has recently been updated.  Please see the NHSE ‘First Contact Practice FAQ’s’ page here for the latest updates on the process:  First Contact Practice FAQs | Health Education England ( further information regarding the FCP Roadmap pathway and processes, please visit: Roadmaps to Practice | Health Education England (


AFC Band 7/8a

100% of actual salary plus defined on costs covered via ARRS Scheme.

Training and development funding

FCP Physiotherapists may be entitled to wider NHSE commissioned funding to support their training and development requirements.  Please contact the training hub for more information on this.

Recruitment Information

Where a PCN employs or engages a First Contact Physiotherapist under the Additional Roles Reimbursement Scheme, the PCN must ensure that the First Contact Practitioner Physiotherapist meets the ‘Minimum Role Requirements’ stipulated in Annex B of the Network DES: Network Contract DES (

Please find various resources in this section to assist in the recruitment and embedding of the First Contact Practitioner Physiotherapist role in General Practice.

Additional Resources

FCP Skills Event 15th April

A collaborative learning event between ESNEFT MSK services and General Practice FCPS.