Consensus summary: challenges and learning and development needs of FCPs when managing occupational health and sickness absence in primary care

Purpose: A key impetus for this study, there is a lacuna of empirical research that explores whether and to what extent FCPs feel they have the sufficient skills to assess, manage and influence the specific occupational health aspects pertinent to MSK conditions in primary care, including sickness absence management. Main aim: was to identify the challenges and key learning and development needs in response to providing fitness for work recommendations and sickness certification for patients with MSK conditions within primary care. Objectives: Conduct a Nominal Group Technique meeting to scope, identify, rank and rate critical problem dimensions and explore the major parameters of the problem area (fitness for work and sickness absence) as perceived by NGT FCP experts, and gain consensus. 
Methods: A pragmatic, non-random purposeful sampling approach was utilised to allow for an in-depth and appropriate exploration of the research topic and FCP/ACPOHE experts provided an exclusive body of knowledge of professional practice in their own FCP model of care. Recruitment involved non-probability sampling using clinical networks (iCSP), snowballing and social media. Nominal Group Technique's generated data about participants and generated and gained consensus on the challenges and learning and development needs on the specific Occupational Health topic.
Results: In total, 42 participated across the 4 NGT groups for ACPOHE and FCPs, that had an average 14.5 years (mean) working professionally as a Physiotherapist. The participants recruited to this study had a mean age of thirty-seven (range 31-49). There were 7 male and 14 female participants. All had been working in an FCP role for less than 1 year. Of these participants, 100% (n=21) identified as first contact practitioners, most were based in England (86%, n=18); 10% (n=2) were based in Scotland and 4% (n=1) in Wales. FCP experts gained consensus on four items with regards to the challenges faced in delivering occupational health specific advice, with ‘Educational requirements and professional liability aspects of fit note requirements’ deemed the most important item. FCP experts gained consensus on five items with regards to the learning and development needs when considering occupational health specific advice, with ‘Training on legal and legislative aspects of the fit note’ deemed the most important item.
Conclusion(s): To our knowledge, this is new evidence regarding the challenges and learning and development needs identified by a group of FCP clinicians working within primary care and OH with regards to the occupational health specific topic. Both challenges and learning and development needs are highlighted that provides evidence to complement the FCP roadmap to practice capabilities and influence future online and professional training in this area. Future work (later in 2021) will involve national consensus across UK based FCPs on the same topic through a Delphi Study.
Impact: Submit, publish and disseminate both studies in a peer reviewed journal. After this, we hope to work with ACPOHE, FCP and GP stakeholders to help design further education, training and courses specific to the topic. Develop and evolve advanced practice and first contact practitioner (physiotherapist) roles and help guide educational pathways at M-level.