First Contact Practitioner’s (FCP) Challenges and Learning and Development Needs in Response to Managing Fitness for Work and Sickness Absence Certification for Primary Care Patients: Consensus Development

Abstract

Research Aim
Competent FCPs improve therapeutic outcomes in primary care (Stynes et al., 2010) and with further training and development, the expectation of improved work-related outcomes (Black, 2022). It is therefore important to define and articulate the health and work competencies FCPs need to consistently offer evidence-informed information to be effective and efficient in their roles and overcome the difficulties of the current context in primary care. Thus, the main aim of this project was to identify the competencies that underpin the FCP’s role in providing fitness for work recommendations and sickness absence certification within the primary care setting.

Methods
A pragmatic multi-phase consensus approach was used to generate work and health competencies needed for primary care practice. Two national nominal group techniques (studies 1 and 2) provided the first insight in the competencies needed in an expert group of FCPs and OH/ACPOHE physiotherapists with a consensus criterion of 60% adopted. Study 3 consisted of a national modified Delphi study to confirm a final list of knowledge and skill-based items needed for primary care practice. A priori consensus criterion of 70% threshold level of group agreement was adopted for this three-round questionnaire study. Items between 51% and 69% of agreement were included for the next round and those items with less than or equal to 50% of agreement were considered unnecessary and were excluded. In the third round, the occupational health (OH) specific contents for primary care were classified according to the degree of consensus as follows: strong (≥70% of agreement), moderate (51%–69% of agreement) and weak (50% of agreement) based on the maximum consensus reached.

Principal Findings
Of the 30 initial competencies, 20 (67%) reached a strong degree of consensus and 2 (7%) reached a moderate degree of consensus and 8 (27%) competencies were not recommended (≤50% of agreement). 20 OH specific competencies reached a priori consensus level of agreement to provide the final group list.

Importance and Relevance
This is the first project to identify health and work-education competencies for FCPs in UK primary care settings. The results from the three individual studies represent a new contribution to knowledge. It provides the first empirically derived list of occupational health (OH)-specific competencies for FCP education in primary care ‘first point of care’ physiotherapy with a high level of expert agreement and high retention rate between rounds. Also, it is the first study to involve both FCP and OH physiotherapy professionals in the UK.

Date of Award	2024
Original language	English
Awarding Institution	Glasgow Caledonian University
Supervisor	Sivaramkumar Shanmugam (Supervisor) & Lorna Paul (Supervisor)