First Contact Practitioners (FCPs) are highly skilled, autonomous clinicians who provide expert assessment, diagnosis, and treatment at the very first point of contact in primary care.
Other Clinical / FCP
Expert care, right at the start.
Right person, right place, right time
First Contact Practitioners (FCPs) are autonomous allied health professionals—including dieticians, occupational therapists, paramedics, physiotherapists, and podiatrists—who assess, diagnose, treat, and manage a wide range of conditions directly within primary care. Established initially with FCP physiotherapists in 2014 to alleviate GP workload, the role has expanded to encompass multiple professions, offering patients timely access to specialist care and reducing demand on GPs
FCPs complete accredited education and training, either via a taught HEI-led route or supported portfolio, to safely manage undifferentiated presentations and ensure high standards of governance. Funded by NHS England, these programmes support consistent capability across the workforce. Supervision by trained professionals is mandatory, maintaining quality and patient safety in line with CQC expectations.
Dieticians
First Contact Dieticians are specialist clinicians who offer direct access to nutritional care within primary care settings. They work with patients of all ages to assess, diagnose and manage a wide range of nutrition-related concerns. By supporting disease prevention, long-term condition management and hospital discharge transitions, they play a vital role in improving population health and reducing pressure on GPs.
Key Roles and Responsibilities
- Provide specialist nutrition and dietetic advice tailored to patient needs
- Support patients with diet-related disorders to adopt healthier habits
- Deliver dietary support across a variety of settings, including post-discharge care
- Collaborate as part of a multi-disciplinary team within the PCN
- Recommend medication changes for nutritional management based on
clinical data - Contribute to audits, evaluations, and continuous quality improvement
- Ensure effective clinical governance, including supervision and training
Training and Education
Dieticians interested in FCP roles should complete the FCP Roadmap to Practice for Dieticians, which supports the development of advanced-level capability and ensures they are able to operate autonomously in primary care. Access to clinical supervision and a named PCN contact is essential for day-to-day support.
Education and Training Requirements
- BSc or pre-reg MSc in Dietetics (approved by the British Dietetic Association)
- Registration with the Health and Care Professions Council (HCPC)
- Ability to operate at an advanced level of practice
- Completion of the FCP Roadmap to Practice for Dieticians
Occupational Therapists
First Contact Occupational Therapists (OTs) work with people facing physical, mental, or social challenges that affect their ability to perform daily activities. Positioned in primary care, they offer early intervention and person-centred care that empowers patients and reduces reliance on emergency or specialist services.
Key Roles and Responsibilities
- Assess, plan and deliver rehabilitation and reablement treatment plans
- Collaborate with patients to set meaningful, outcomes-focused goals
- Use communication strategies suitable for patients with additional needs
- Advise on adaptations, assistive equipment, and access to services
- Support with returning to work, managing long-term conditions, or coping with anxiety and depression
- Regularly review and adapt plans to support patient progress
- Work closely with multi-disciplinary teams across PCNs and other services
Training and Education
OTs working in FCP roles must complete the FCP Roadmap to Practice for Occupational Therapists, which prepares them to practise at an advanced level. Supervision, peer networking, and engagement in shared learning are integral
to the role.
Education and Training Requirements
- BSc or pre-reg MSc in Occupational Therapy (approved by the Royal College of Occupational Therapists)
- Registration with the HCPC
- Ability to operate at an advanced level of practice
- Completion of the FCP Roadmap to Practice for Occupational Therapists
Paramedics
First Contact Paramedics (FCPs) are highly trained clinicians delivering advanced care in primary care settings. They manage a wide range of presentations, from common illnesses to complex or undifferentiated cases, providing timely care and reducing the burden on GPs.
Key Roles and Responsibilities
- Act as the first clinical point of contact for a wide range of health issues
- Assess, triage and manage patients, providing treatment or referral as needed
- Support anticipatory care planning and deliver community-based interventions
- Offer a home visit alternative for urgent, same-day needs
- Promote patient self-care and provide general health advice
- Work collaboratively across multi-disciplinary teams within the PCN
- Communicate effectively with patients, families, carers and healthcare colleagues
Training and Education
FCP paramedics must complete the FCP Roadmap to Practice for Paramedics, ensuring they develop or demonstrate master’s level capability in clinical assessment, diagnosis, and treatment. Those not yet practising at this level must work within a rotational model under appropriate supervision.
Education and Training Requirements
- Degree or diploma in Paramedicine
- HCPC registration
- 5+ years post-qualification experience, including:
- Completion of a two-year “Consolidation of Learning” period
- Three additional years at Band 6 (or equivalent)
- Completion of the FCP Roadmap for Paramedics
Physiotherapists
First Contact Physiotherapists (FCPs) are MSK specialists who assess, diagnose and manage musculoskeletal conditions at the first point of contact in primary care. Patients can access their expertise directly—without needing to see a GP—leading to quicker support, reduced waiting times, and improved outcomes.
Key Roles and Responsibilities
- Independently assess, diagnose and treat a wide range of MSK conditions
- Create integrated care plans in collaboration with patients
- Offer first-line treatments, including self-management and referrals
- Conduct investigations and interpret diagnostic results
- Make use of advanced skills such as prescribing, injection therapy and
referral pathways - Take full responsibility for their practice, clinical decisions, and patient outcomes
- Collaborate with PCN teams to deliver joined-up care
Training and Education
FCP physiotherapists must complete the Musculoskeletal FCP Roadmap to Practice, which includes supervised practice, education modules, and demonstration of advanced capabilities. Ongoing professional development is supported through audits, peer review and training.
Education and Training Requirements
- BSc in Physiotherapy
- HCPC registration and appropriate insurance
- Master’s-level qualification or equivalent advanced practice capability
- Demonstrated Level 7 (advanced) skills in MSK practice
- Completion of the MSK FCP Roadmap to Practice
Podiatrists
First Contact Podiatrists specialise in foot and lower limb health, managing a wide range of conditions directly within primary care. Their expertise ensures patients receive the right support early—avoiding complications and reducing GP appointments.
Key Roles and Responsibilities
- Assess and treat patients of all ages with lower limb and foot pathologies
- Prescribe, produce, and fit orthotics and appliances
- Deliver therapeutic and surgical interventions for high-risk patients
- Educate patients about foot health and prevention strategies
- Liaise with wider health teams for referrals and pathway planning
- Maintain robust clinical governance through audits and evaluations
- Develop and deliver integrated podiatry services across PCNs
Training and Education
Podiatrists in FCP roles complete the FCP Roadmap to Practice for Podiatrists, which supports safe, autonomous decision-making in primary care. They must work under structured supervision and have access to a named individual within the PCN.
Education and Training Requirements
- BSc or pre-reg MSc in Podiatry (approved by the College of Podiatry)
- HCPC registration
- Advanced level of practice capability
- Completion of the FCP Roadmap to Practice for Podiatrists