Delivering a first contact practitioner service in East London during a global pandemic

ABSTRACT

Keywords Utilised;Integrated;Challenging Purpose: First Contact Practitioners (FCPs) are being rolled out across the UK to help patients see the right person at the right time, first time. We have worked with all of our Primary Care Networks (PCNs), 8 in total, supplying 18 FCPs to deliver a Five day a week service. This service was provided by an NHS physio department. This was rolled out during COVID-19 pandemic and the team were successfully able to support patients at the start of their journey in GP practices while supporting an increasing workload for GPs. Our aim was to provide highly skilled professionals at the start of the patient journey. We have agreed specific KPI's, such as number of investigations performed, referral onwards to physio or secondary care to monitor performance. Should we then focus on the other aims which were to improve communication and liaison with GPs, to improve pathways for patients, to tailor services to local communities. Methods: We have used quantitative data collection for specific KPIs which includes monitoring waiting times, DNA rates, referral for investigation, diagnosis and a mixed quantitative and qualitative approach for patient feedback. A QI forum was set up for administrative staff and GPs within the PCNs to feedback alongside the FCPs themselves. Results: We have been able to demonstrate that the service is highly used across the vast majority of PCNs, 88% of referrals into the service are appropriate in-line with the ideals of a FCP service, onward requests to radiology are low, 1% for MRI and 4% for X-ray, and waiting times are low, 5 days but are increasing as the service grows in popularity. There have been some challenges with certain GP surgeries not engaging in the service, for example space to house the FCP service, being able to request imaging under the individual FCP name or even a pooled list, variability in demand leading to different waiting times. Conclusion(s) The service so far has delivered against all KPIs. However, the overall time required in setting up the FCP service properly, ensuring appropriate governance and support is in place for staff cannot be underestimated. The quality of training and support is reflected in the low referral for diagnostics and the satisfaction of patients within this particular service. GP engagement has been variable, with some fully embracing the role and being mentors to FCPs, whilst others do not wish to have the service and therefore do not utilize it. Longer term funding for permanent substantive roles will be critical in preventing loss of trained staff. Impact The roll out has the impact to transform our current pathway, as FCPs can support the patient at the start of their journey. Our clinicians work in primary and secondary care therefore can develop their skills across both areas, while developing the teams around them. This also strengthens existing links with our primary care colleagues, improving referral quality, patient experience and outcomes. Funding acknowledgements Not funded.