First Contact Practitioners – chiropractors relieving pressure on NHS in new role 

We’re all aware of the immense pressure on the NHS, particularly in primary care. Recently, think tank, The Nuffield Trust produced figures for the BBC which show the first sustained drop in GP numbers for 50 years. Musculoskeletal (MSK) problems are addressed in 1 in 8 GP appointments, and an estimated 29% of the UK population live with an MSK condition.

As MSK specialists, chiropractors have a key role to play in relieving some of this pressure, but still in a First Contact role, providing ease for access for patients. The current title for this role is: ‘First Contact Physiotherapists’, but the term is set to change to ‘First Contact Practitioner’ (FCP), next year, opening the door for more chiropractors to work in FCP roles. There are currently two chiropractors working as FCPs and we’re proud to say they are both BCA members. Here, our Director of Communications Lisa King, caught up with one of them to hear about her experience in this role.

Hannah Fairris is a champion for the profession just two years after graduation; finding herself in a GP practice was a “happy accident” as she explains; “I’m really keen for chiropractors to be better understood around mainstream healthcare, using our diagnosis skills”.

How did you get in to this First Contact role?Hannah Fairris

My first exposure to NHS triage was working with Dr Neil Osborne at Christchurch hospital when I was a student at AECC University College. When I became an associate after graduation, I realised that with the typical patient you see, the diagnosis skills we are taught aren’t always used as much as I would have liked.

Once I started my own private clinic, I thought that I’d use GP triage as a marketing opportunity but realised that as a patient recruitment initiative this wasn’t going to be successful as many of the NHS patients aren’t appropriate to refer to a private clinic for a variety of reasons. But because I was delivering a better service for MSK patients the GP surgery, I took this on in an FCP capacity. At present, the P stands for physiotherapist, but from April 2020 it will be Practitioner.”


And what’s your experience been like?

“I’m loving it! The variety of patients I see in the Back and Joint clinic (our name for the service), is different to those in private practice work, and it presents options for career diversity which I hadn’t anticipated.”


How have your NHS colleagues reacted to you/the service?

“Because I’m able to relieve some pressure in the system and the patients have fed back high levels of satisfaction, GPs and Advanced Nurse Practitioners are happy. As you can imagine when there is a new skillset available within the team, there was some trepidation to start with. Of course, because NHS colleagues tend to have more experience of physiotherapists, some do think I am a physio or an osteopath, but by being here and working in this role I can champion the chiropractic profession. To be honest, I haven’t had any negative feedback about being a chiropractor, just apprehension due to a lack of understanding of our skillset. My NHS colleagues are impressed that our training is to such a high standard, and most importantly, I can help MSK patients to feel better quicker. To bring our skillset to the table benefits everyone all round.” 


What has the been the biggest benefit?

“As a chiropractor in a GP practice, MSK patients only wait 1-2 days to see me, versus the 1-2 week wait time for a GP appointment and a 4 month wait to see a physiotherapist. I get only positive comments about how this integration works well for everyone, obviously it was a step change to go into to GP practice, but this experience has shown myself and my colleagues that chiropractors are more confident than GPs in MSK diagnosis, so actually the level of reassurance for them as Drs is huge.
For me, the structure of the GP practice provides lots of opportunities to treat and refer,, with all of the appropriate ‘safety nets’ in place because I’m working as part of a wider team. I will take history and do an examination and if the issue is an MSK one, I will diagnose. If the issue is not an MSK issues, I arrange referral.

And the best bit for me personally, is that it has transformed my day to day experience of work. Because I’m able to use my diagnosis skills much more than I do in private practice, I meet lots of different people and I feel really supported by the support network around me.”


With 80% of people in the UK suffering neck or back pain in their lifetime, 32% of them visiting their GP as a first action FCPs in GP practices is a great first step to recognising chiropractors as First Contact support. Raising greater awareness about the support services available will help people move away from automatically choosing GPs as the first port of call and having two of our members leading the way in this will further that conversation. Find out more about First Contact Practitioners in the NHS.