A day with a First Contact Practitioner

It's All About People Musculoskeletal (MSK) Personalisation Project Manager, Matt Evans, recently spent time with Anna Krynicka, a First Contact Practitioner (FCP) working for Lincolnshire Community Health Services NHS Trust. He wanted to find out more about how personalised approaches are embedded in service delivery and the associated challenges. 

“How can I help you today?”

What resonated with me was Anna’s approach to every single person who came into her clinic. She asked each one how she could help them. It was reminiscent of my customer service days at a supermarket, but the question she asked was far more sincere and heartfelt. It essentially set the scene for Anna to begin to understand what each person needed to do to manage their own conditions, placing an onus firmly on them. What could Anna do to help them help themselves?

I was eager to observe a First Contact Practitioner to make sure I understood what a 20-minute appointment looked like. While I remain passionate about Patient Activation Measure (PAM) tool and process, decision support tools and ‘What matters to you’ conversations, it’s becoming evident that the system restricts the ability for colleagues to utilise these tools freely.

Time at the front end of a person’s journey is precious and limited, so it’s critical to use those 20 minutes in the most effective way possible.

I witnessed Anna flicking through tabs and boxes on her computer system desperately trying to keep her pace up enough to cover as many things as time allowed, yet unavoidably she began to run behind her allocated timeslots.

Everyone who came into clinic was seeking help. All left with exercises and their questions answered. The beauty of Anna’s work was how she helped people to understand what was happening in their body. She often referred to the body’s ‘mechanics’ and supported the understanding of pain, allowing people to leave her with increased knowledge and confidence.

At no point did she suggest anyone should stop doing something; instead she advised them to adapt because “Once you stop, it’s so much harder to get going again.”

I asked about whether printed information might be helpful, mindful of people being overwhelmed by verbal detail and description during an appointment, but Anna corrected me. She warned of how limiting a print-out can be when the exercises she used were tailored exactly to support issues identified with individual patients.

A personalised care approach is built into the work of an FCP, but whether it’s measurable and how effective it is, is unknown.

Anna clearly has the techniques mastered and is a highly knowledgeable person with a passion for helping people. Her experiences have undoubtedly helped her to embed the approaches within her normal practice, as a part of her routine conversations.

It was great to see. 

To get in touch with Matt, please contact him via matthew.evans34@nhs.net