Nottinghamshire clinicians are the first in England to complete the Government’s new course for specialist staff working in GP surgeries.

In March 2022, Charlie Akiens (top left), Asha Gudibandi (top right), Laura Bryden (left) and Desi Gillespie (right) completed the course,  which was delivered by the University of Hertfordshire and is run by Health Education England. They are physiotherapists with the capability to work as diagnostic clinicians by assessing patients with soft tissue, muscle and joint pain to decide on the most appropriate care for them.

The team is based in local GP surgeries so that they can provide expert musculoskeletal (MSK) care quickly and close to home. Over half a million patients across South and Mid Nottinghamshire, including Beeston, Eastwood, Kimberley, Mansfield, Newark, Ashfield and Hucknall can access the service.

By 2024 the target is that all adults in the UK will be able to see a first contact practitioner (FCP). This means thousands of staff within primary care will need to follow in their footsteps to complete ‘Roadmap to Practice in Primary Care’ programme.

Despite the pandemic, GPs in Nottingham have worked tirelessly with Primary Integrated Community Services to accelerate the first contact practitioners (FCP) scheme in which NHS England funds specialist roles who work in community GP surgeries. As early adopters, the PICS team have worked with the University of Hertfordshire and Health Education England to develop the programme and provide templates and materials for other practitioners across England.

The FCP (MSK) roles have the potential to reduce pressures on GPs by upwards of 10 per cent, while enabling patients who need a hospital consultant to be seen as quickly as possible. It’s all part of the NHS Long Term Plan to ensure patients are seen by the right person at the right time.

The impact on improving patient care and reducing waiting times is immense. Musculoskeletal (MSK) problems account for approximately 30% of the overall GP caseload with one in four working adults reporting MSK issues.

PICS employ and supervise 28 FCP (MSK) staff across Nottinghamshire. The team have carried out nearly 12,000 appointments that would otherwise have fallen to a GP. Given the success of the programme, GPs plan to expand further and employ 45 by March 2024.

Charlie Akiens was the first FCP (MSK) in Nottingham to be recruited to this new type of role when she was employed by PICS on 5 April 2020. She is now clinical lead for one of the busiest FCP teams within primary care in the country. She says:

“I am pleased and proud to be part of a pioneering team as we’ve developed the FCP service, driving forward the health and well-being of our population at a local level through primary care.”


Dr Julian Barratt Regional Faculty Lead for Advancing Practice, a spokesperson from Health Education England said:

“Health Education England has been pleased to support the development of clinicians at the enhanced level of practice by progressing to First Contact Practitioner roles in primary care to speed up access to care for patients and improve their health outcomes.”

Mr Rishi Navsaria Consultant Physiotherapist and Senior Lecturer at the University of Hertfordshire who leads on the MSK First Contact Practitioner course says

“As a team of experienced musculoskeletal educators at the University, we are proud of this group of physiotherapists who rose to the challenge and became some of the first clinicians to successfully pass an HEE funded University Course and who are now eligible to be digitally recognised as First Contact Musculoskeletal Practitioners by Health Education England.

“These roles are vital in optimising patient care right from their first appointment. If we can get the right health care professional seeing the right patient earlier in their care, we can try to avoid patients developing long-term musculoskeletal problems.“

Read a patient case study and GP perspective here: New Physiotherapists improve agility of patients and Practice | (