Developing programme theories to understand 'First Contact Physiotherapy' in Primary Care: A rapid realist review (FRONTIER)
First Contact Physiotherapy (FCP) is a new primary healthcare model in which a specialist physiotherapist in Musculoskeletal Disorders (MSKDs) located within general practice, undertakes the first patient assessment, diagnosis and management without the requirement for prior GP consultation. It is intended to provide additional capacity and diversify the primary care workforce to meet the high demand for MSKD appointments and the challenges of recruiting and retaining GP staff. Initial audits of the service propose the FCP model may free up GP appointments, reduce secondary care referrals and scan requests, improve patient satisfaction, and produce cost savings. However, there is a lack of robust research evidence, and limited understanding of how best to implement FCP given contextual variation in general practices across the UK. This rapid realist synthesis generated and refined programme theories to develop insight into “What it is about FCP in Primary Care that works, for whom, in what circumstances, how and why?”. This was the second stage of a four-part project exploring the FCP role.