LAUSR

Keywords: First Contact Practitioner Purpose: The First Contact Practitioner (FCP) role has seen a rapid increase within the last decade in order to meet the increasing demands of the GP workforce, whilst providing effective models of care and streamlined pathways for patients presenting in primary care. The FCP role delivers a direct point of access for patients, providing assessment, diagnosis and management of MSK conditions. However, to date there is a limited understanding of the current models of FCP clinical practice and how FCP clinicians view them. Objectives: To gain a greater understanding of the current models of FCP practice and how FCP clinicians perceive these clinics. Methods: A non-experimental, cross-sectional descriptive survey was distributed electronically to FCP clinicians working in primary care. Ethical approval was gained from Coventry University Ethics Committee. Recruitment of FCP's was conducted between March and April 2021 with a non-probability, snowballing sampling method. The survey firstly collected data regarding clinician demographics such as;professional qualifications;duration of clinical practice;duration of time as an FCP. Secondly, their clinical model including;appointment format and duration;administrative time;and other non-patient facing time such as supervision and professional development. Thirdly, FCP perceptions of their current model of practice with the use of the Oldenburg Burnout Inventory (OLBI) Likert scale. And finally, open ended questions were incorporate allowing more detailed response of what clinicians perceived currently worked well and not so well in their model of practice. Results: A total of 129 FCP's completed the questionnaire. The majority of respondents were chartered physiotherapists, with a mean qualification duration of 11-15 years. A large proportion 81.5% had been working within the FCP role for three years or less. The survey was conducted during the COVID 19 pandemic, 72% of respondents reported a clinical model alteration, utilising telephone or video consultation as a first point of triage, direct contact for clinical assessment only if deemed necessary. Face to face appointment durations of 20 min were reported by 52.75% of FCPs;however, 45.7% of clinicians felt appointments were too short. Regular supervision was reported by 31.8% of FCPs and regular CPD by 39.2%. Overall workload was considered too much by 58.9% of respondents. Analysis of the OLBI scale demonstrated all clinicians scored either moderate burnout (20.9%) or high burnout (79.1%), with no one scoring low. Conclusion(s): The FCP role presents the exciting opportunity for development of advanced practice skills, whilst providing excellent care pathways to patients presenting with MSK conditions. This study highlighted high levels of burnout and unsatisfactory workloads from FCP clinicians. This is concerning for the longevity and sustainability of the FCP role considering a large proportion of respondents had worked in the role less than 3 years. Impact: This research demonstrates the importance of the inclusion of administrative time, clinical supervision, professional development and consideration of appointment duration when developing FCP clinical models of practice. Further consideration of this may be advocated in clinicians who are less experienced and newer to the role. Funding acknowledgements: This work was not funded