AQP Adult Direct Access MSK Physiotherapy service and First Contact Practitioner (FCP) MSK Assessment Service

Description

NHS Frimley ICB ("the Commissioner") sought to commission Premier Physical Healthcare Limited to provide an AQP Adult Direct Access MSK Physiotherapy service and First Contact Practitioner (FCP) MSK Assessment Service, for patients in the North-East Hampshire & Farnham geographical locality of Frimley ICB.
AQP Adult Direct Access MSK Physiotherapy service: Patient population covered is North-East Hamsphire and Farnham place. Referrals are via GP. The referring GPs prioritise patients as either routine or urgent. The provider carries out an initial face-to-face clinical assessment with the patient, during which a treatment plan is discussed and agreed. For referrals accepted into the service, a package of care is provided consisting of the necessary treatment required to meet the individual clinical needs of the patient. This may include but is not limited to: advice & education, provision of literature, acupuncture, manual therapy, electrotherapy, exercise programmes, soft tissue mobilisation or back care advice. Follow-ups are provided. Group exercise programmes are permitted as part of the treatment. 
First Contact Practitioner (FCP) MSK Assessment Clinic: A community-based physiotherapy service benefitting patients with musculoskeletal conditions, who are able to be assessed and treated by a physiotherapist without an initial GP appointment. The service is delivered from participating GP Practice locations within the North-East Hampshire and Farnham locality of Frimley ICB. Patients with musculoskeletal conditions will be seen and assessed by the extended scope practitioner (ESP) who will make good use of pre-existing services such as exercises courses.
Patients would expect to be seen within five days, preferably within one to two days of them first contacting the practice.  Following assessment the ESP will, as appropriate:      • Treat or advise on the day and provide a suitable exercise sheet and management plan
• Recommend a locally available exercise course
• Refer on to the existing AQP Provider for an appropriate course of treatment. 
• Perform a joint injection (knee, shoulder, hand or wrist) working under a protocol agreed with Salus.
• Refer for imaging (x-ray, ultrasound, MRI) subject to countersignature by a GP
• Refer to a secondary care orthopaedic consultant subject to countersignature by a GP
• Identify problems that are more likely to have a cause which comes under the heading of rheumatology and request appropriate blood  tests using a locally agreed protocol.  These cases will be discussed with a GP
• Identify any "red flag" symptoms, and discuss with the duty doctor on the day.