North London Partners in health and care

Barnet and Enfield set to make First Contact Practitioner pilot permanent

Barnet and Enfield set to make First Contact Practitioner pilot permanent

A successful six-month First Contact Practitioner (FCP) pilot aimed at managing patients with back pain in north central London is set to be made permanent in Barnet and Enfield as part of the new GP contract. Haringey is also considering a pilot of the FCP model.

FCP is a new model of primary care that involves placing specialists directly into GP practices to see patients that come into the clinic instead of following a traditional model where patients are seen by a GP first.

FCP’s can be from any profession but the pilot running in Barnet and Enfield between September 2018 and March 2019 have been in the musculoskeletal (MSK) field. For the purposes of this pilot, the FCP’s were from the Royal Free London Trust.

The NCL pilot involved placing MSK First Contact Practitioners in three GP practices in Barnet, Camden and Enfield to see patients who reported lower back pain problems.

Over the course of the six month pilot FCPs carried out 869 appointments with patients, of these, 68% were seen by the FCP once and then discharged with advice on how to self-manage their condition independently.

In the pilot, FCP’s generated an estimated saving between 85% and 89% in investigations and secondary referrals compared to GPs.

The savings made from reduced investigations (MRI and X-ray) and secondary care referrals (orthopaedic clinic, pain clinic and rheumatology clinic) are estimated at £487,471 a year, for 1.2 whole time equivalent FCPs, compared with seeing a GP.

Lisa Fuller, Integrated Care Development Manager and North London Partners MSK workstream lead, said: “The financial savings are just an estimate of the savings for investigations and secondary care referrals for one year. There are additional savings in freeing up GP appointments and de-prescribing.”

But the benefits are more than just financial, feedback from patients has been very positive.
Ninety-six per cent of patients say they would recommend the FCP service to their family and friends.

Patients that were interviewed as part telephone review of the service reported they were more confident in managing their back pain. “My pain has not changed but my understanding of it has and I have a good insight in how to take care of my back,” one patient reported.
Asked if they were doing anything differently to manage their condition following the FCP appointment, 92% said they were. One patient said: “I am now dieting and exercise regularly”, another reported “I am now exercising and didn’t do so before.”

In addition 33% of patients said they had stopped taking pain medication to manage their back pain following their appointment with FCPs.

For more information contact Nicola Akehurst, email