First contact practitioners

Q1: What is a First Contact Practitioner role in Primary Care?

A regulated healthcare professional who has undertaken additional training and experience within a specified scope of practice (MSK, Dietetics etc) to be able to safely provide the first point of contact and assessment for defined groups of patients and presentations as aligned to their area of experience and training. Practitioners in FCP roles support people to get faster access to the right care without necessarily needing a referral from a GP. Practitioners in these roles work as part of the multi-professional team with appropriate clinical supervision and governance in place.

Allied Health Professionals (AHPs) who typically work in FCP roles include Dietitians, Occupational Therapists, Paramedics, Physiotherapists and Podiatrists.

Q2: What are the FCP Roadmaps to Practice?

The FCP Roadmaps to Practice were written as guidance documents which set out nationally agreed education and training standards for AHPs moving into FCP roles in primary care. They described the educational supervision and governance to safely support practitioners through the process.

The first roadmap was developed in response to the 2018 Musculoskeletal (MSK) Core Capabilities Framework, which set out nationally agreed standards of practice for practitioners who were in a first point of contact role diagnosing and managing people with MSK conditions.

FCP Roadmaps were subsequently developed for specific professions – Dietetics, Occupational Therapy, Paramedics and Podiatry – which were aligned to relevant capability frameworks. These now underpin the commissioned education and training pathways, which have replaced the FCP Roadmaps to Practice.

Q3: Why should I complete a FCP education programme?

FCP education and training that has been nationally commissioned, meets agreed standards providing AHPs with the framework to demonstrate skills and knowledge needed to practice safely and effectively in a FCP role in primary care.

All registered healthcare professionals are accountable for their practice. The FCP programmes support AHPs moving into primary care to engage with relevant continuing professional development and supervisory activity, supporting them to maintain their skills and knowledge and to re-enforce their need to act within their scope of practice and governance framework.

As the independent regulator for health and social care in England, the Care Quality Commission (CQC) will look for evidence that employers have systems in place to recruit staff appropriately. For employers that recruit AHPs in FCP roles, the CQC expect to see evidence of completion or plans for completion of FCP education and training. 

Q4: What changes were made to the FCP Roadmap verification process in 2023?The governance and quality assurance of the FCP Roadmap verification process has been strengthened, with education providers offering educational routes to provide greater support to learners and their supervisors. NHS England’s Workforce, Training and Education Directorate (WT&E) has commissioned eight education providers in England to support these plans. The key changes include:- FCP Supported Portfolio route, where an education provider will work with a learner to assess their portfolio of evidence and, if required, oversee and deliver additional learning to support them to meet the requirements of Stage 1 – Regardless of whether a learner completes the FCP Supported Portfolio route or FCP Taught route, their supervisor will work in collaboration with an education provider throughout to support them to meet the appropriate level 7 learning outcomes. Once the supervisor has signed-off the learner’s evidence and the education provider assured itself that the learning outcomes have been met, the provider can issue a certificate or other form of evidence to the learner to indicate that they have completed the requirements of the applicable FCP training- Supervisors may be able to access funded refresher training, from the education providers commissioned by NHS England WT&E, to support them in their roleWe are also issuing clarity on other aspects of FCP education and training, in relation to recognition of FCP training and the route to advanced level practice:- Practitioners working in FCP roles that have successfully completed FCP Stages 1 and 2, and who want to train to become an advanced practitioner, are expected to complete the educational route to advanced level practice by successfully completing an Advanced Practice master’s programme accredited by the Centre. This is necessary to meet the requirements of the Multi-professional framework for advanced clinical practice in England

Q5: Why are these changes being made?

Since the roll out of the FCP Roadmaps, we have received feedback from across the FCP community that the process should be clearer and have stronger governance. In 2022, the Kings Fund’s research into the integration of additional roles in primary care also recommended that the former Health Education England (HEE – now NHS England WT&E) and the professional bodies consider how the roadmaps could be streamlined and made more accessible. The changes we are introducing are directly addressing this feedback, putting in place more robust governance and quality assurance measures into the process. This will support the delivery of safe and sustainable education and training for AHPs moving into FCP roles in primary care. 

We recognise that certain aspects of the FCP Roadmaps were not fully defined at the time the documents were published. We are now in a position to give further guidance on these specific sections, providing additional clarity to learners, supervisors and employers.

Q6: Who has NHS England WT&E engaged with about the changes?

We have engaged with our partners, such as the AHP professional bodies, and the FCP community at national, regional, and local level during the development of the FCP Supported Portfolio route and in socialising the additional clarity to the FCP education and training process. 

Q7: How do you complete the requirements of FCP education and training?

Learners can access one of two educational routes to complete the specific requirements of a FCP education and training:

– FCP Supported Portfolio route – the practitioner works with a supervisor and education provider to create a portfolio of evidence to meet the knowledge, skills and attributes outlined in a FCP Roadmap and to demonstrate they have applied these in clinical practice

– FCP Taught route – the practitioner undertakes a level 7 master’s level module(s) at an education provider, which is mapped to the knowledge, skills and attributes in a FCP Roadmap. Stage 2 is completed as part of a level 7 module delivered in clinical practice

Q8: How does the FCP Supported Portfolio route differ to the previous FCP Portfolio route?

The key difference is that an education provider will now support a learner and their supervisor through the process. Whilst the knowledge, skills and attributes for Stage 1 and 2 as outlined in a FCP Roadmap remain unchanged, the introduction of more academic oversight will strengthen governance, provide another layer of quality assurance, and create a more efficient process for learners.

An education provider will work with the learner to conduct a Learning Needs Analysis – to assess whether their knowledge, skills and attributes meet the requirements of Stage 1 and 2. The education provider will either confirm that these requirements have been completed or, if there are any gaps in the learner’s knowledge or evidence, set a learning plan. For the latter, the education provider will oversee and manage the education process, including to deliver the additional learning. The supervisor will continue to review a learner’s portfolio of evidence and be responsible for final sign-off once completed.

During Stage 2, the education provider will collaborate with the supervisor to ensure that the level 7 learning outcomes are met by the learner as they work through the process. On successful completion the supervisor will be responsible for signing-off the learner’s portfolio of evidence, with the education provider confirming that the learning outcomes have been met.

The learner’s employer will also be invited to acknowledge that the process has been completed. The education provider can then issue a certificate or other form of evidence to the learner to indicate that they have successfully completed the requirements of the applicable FCP education and training.

Q9: Have there been any changes to the FCP Taught route?

As with the FCP Supported Portfolio route, during Stage 2 an education provider will oversee the education process and work with the supervisor to support the learner to meet the level 7 learning outcomes. Stage 2 continues to be delivered in clinical practice, with the learner undertaking workplace-based learning under a supervisor that is responsible for signing-off the portfolio of evidence on successful completion. The education provider can also issue a certificate or other form of evidence to the learner to indicate successful completion under the Taught route.

All eight education providers who have been commissioned by NHS England WT&E to deliver FCP Taught modules have completed the FCP Self-Declaration process to affirm that their module(s) map to the standards of an applicable FCP Roadmap(s).

Q10: Which FCP route should we complete?

If you started FCP education and training after 1 November 2023 it is recommended that you complete either the FCP Supported Portfolio route or FCP Taught route. These are the only routes supported by NHS England WT&E from this date.

Any learner who undertakes either of the new routes will be expected to undertake a Learning Needs Analysis so that they can be provided with the most appropriate support and advised on the route that best suits their circumstances. The FCP Supported Portfolio route is designed primarily for practitioners who are already working in a FCP role in primary care and have started their portfolio of evidence.

Q11: Are we able to complete the previous FCP Portfolio route if we had already started it?

We recognise that there are likely to be learners who had started the FCP Portfolio route but may not have completed all the requirements of a FCP Roadmap. To support these individuals during the transition to the new educational routes, we have agreed to have a grace period until the 30 April 2024 to allow those learners to complete Stage 1 and 2 via this route. After this period, we expect practitioners to complete either the FCP Supported Portfolio route or FCP Taught route.

If you are confident that you will complete both Stages 1 and 2 by the end of April 2024, then you can continue with your current supervision arrangements. Once your supervisor has signed-off your portfolio of evidence, you can show this to your employer to demonstrate your educational achievement.

If you have just started the process or feel that you and your supervisor would benefit from additional support, then you can apply for a Learning Needs Analysis through an education provider commissioned by NHS England WT&E and be supported through the remainder of the process (subject to availability).

Q12: Which education providers have been funded by NHS England WT&E?

We have commissioned eight education providers in England to deliver a limited number of FCP level 7 modules for learners undertaking the FCP Taught route and/or training places to support learners pursuing the FCP Supported Portfolio route. A full list of education providers that have been funded can be found on our website here.

Approximately 1,000 training places have been funded for delivery in 2023/24 financial year. Each provider has been allocated a proportion of the training places, which can be used flexibly for either supporting learners completing the FCP Taught route or FCP Supported Portfolio route. Some providers are offering training places that will be applicable to all the FCP Roadmaps, whilst others have designed their offer around a specific FCP Roadmap only.

Whilst places are limited in 2023/24, NHS England WT&E will continue to plan for future years and confirm its budgets each financial year.

Q13: Can we complete FCP education and training with an education provider that has not been funded by NHS England WT&E?

Yes, although you would need to self-fund the learning or seek alternative funding arrangements. If you choose to take this approach, we recommend that the FCP Supported Portfolio route or FCP Taught route is completed with an education provider that has been through our FCP Self-Declaration process.

Since Autumn 2022, education providers have been invited to self-declare that their FCP training meets the requirements of the profession specific FCP Roadmap that the training is related to. Self-declaration is part of NHS England WT&E’s aim to quality assure education and training, so learners undertake FCP training to a nationally agreed standard. A full list of education providers that have completed the FCP Self-Declaration process can be found on our website here.

Q14: How do we apply for a Learning Needs Analysis via an education provider?

Applications are made directly to education providers. Links to the providers’ websites, which include further details about how you can apply to their funded learning offers, can be found on our webpage here.

Q15: Can we apply to an education provider that is outside our region?

Yes, all the funded education providers are offering FCP training on a national basis.

For Stage 1, learning content will be largely delivered online or via blended learning to support learners who live outside the provider’s region. Stage 2 workplace-based learning will be undertaken in the learner’s normal place of work, provided that the appropriate supervision is available. The education provider will liaise with the Primary Care Training Hub in the learner’s region to support arrangements for appropriate supervision.

Some providers are offering training places that will be applicable to all the FCP Roadmaps, whilst others have designed their offer around a specific FCP Roadmap only.

Q16: How can we show our employer that we have completed Stage 1 and 2 of FCP education and training?

This will depend on which educational route you have undertaken.

If you have already completed the FCP Portfolio route or FCP Taught route before the changes to the FCP Roadmap process were introduced, you should retain the evidence you collated to show you completed Stage 1 and 2. This will include the completed portfolio of evidence that was signed-off by your supervisor and/or a certificate of completion issued to you by an education provider. A list of the evidence required can be found on our website here.

On successful completion of the FCP Supported Portfolio or FCP Taught routes under the new processes, an education provider can issue you with a certificate or other form of evidence to indicate that you have met the requirements of a FCP Roadmap.

If you are still unsure how to evidence your educational achievement with others, please contact your supervisor or education provider.

 Q17: Will NHS England WT&E provide confirmation that we have completed a FCP Roadmap?

NHS England WT&E will not be providing additional confirmation of completion. Once you have successfully completed your portfolio of evidence, it will be reviewed and signed off by your supervisor.

If you undertake the FCP Supported Portfolio route or FCP Taught route, your supervisor will also work with an education provider to ensure you have met the relevant learning outcomes. The education provider can then issue a certificate or other form of evidence to denote successful completion of the applicable FCP Roadmap. 

Q18: What is the role of supervision within FCP education and training?

Clinical and Education supervisors have an integral role to support learners through the process and to provide assurance that the practitioner has demonstrated the knowledge, skills and attributes required to work in a FCP role in primary care. One of their key roles is to review a learner’s portfolio of evidence and decide whether the individual has met the requirements of an appropriate FCP Roadmap.

For both the FCP Supported Portfolio and FCP Taught routes, Clinical and Education supervisors will work with an education provider, as part of the institution’s quality assurance processes, to support the learner to meet the appropriate level 7 learning outcomes of the applicable FCP Roadmap. Supervisors will sign-off the portfolio of evidence on successful completion.

South East – the HEI will provide educational supervision, whilst in clinical practice a clinical supervisor or mentor is required. This is the responsibility of the employer.

Q19: Who can be a FCP supervisor?

A regulated healthcare professional working in primary care who has been appropriately trained and approved to work as a supervisor in line with the quality standards set out in NHS England WT&E’s Quality Framework. NHS England Primary Care Deans and regional quality teams, supported by Primary Care Training Hubs, have been implementing at scale the approval of educators across all professional groups and learning environments.

As well as being a recognised supervisor, it is strongly recommended that the place of work that supervision is being undertaken in is also a recognised learning environment.

South East – at scale approval of educators is part of Domain 4 of the Quality Framework. Therefore, an NHS England WT&E South East approved Clinical Learning Environment will be evidence of this requirement.

Q20: How do we find a FCP supervisor?

The first step is to ask your employer if there is an appropriately trained supervisor employed in your place of work who can supervise you. If one is available, you should agree with them if they can be your supervisor for the purpose of the FCP Roadmap process. You should inform the education provider of your agreed named supervisor when applying to undertake the FCP Supported Portfolio or FCP Taught route with the institution. The education provider will liaise with the Primary Care Training Hub or the relevant NHSE WT&E regional team to confirm that the supervisor has been through our quality approval process. 

South East – Education providers can access the centrally held summary data of quality approved clinical learning environments. This provides evidence that the placement provider has met the requirements of Domain 4 the NHS England Quality Framework.

Q21: What happens if there are no supervisors available in my place of work?

We recommend that you contact the Primary Care Training Hub in your region, which can offer advice and support to you and your education provider.

Q22: How can you become a FCP supervisor?

The route to becoming a supervisor for FCP Roadmap education and training is integrated into NHS England WT&E’s process for the approval of multi-professional educators. This process is led by the Primary Care Training Hubs in NHS England’s regional teams and is aligned to NHS England WT&E’s Quality Framework, which sets out the multi-professional quality standards for all clinical learning environments.

Firstly, you should complete an NHS England WT&E approved training course relating to multi-professional supervision. You should contact your local Primary Care Training Hub who will advise which training course(s) you could complete. Once you have successfully completed the applicable training course, you will need to gain approval from NHS England WT&E to work as an educational supervisor. You may also wish to apply for your place of work to be approved as a learning environment if this is not yet recognised as one. This can be done at scale, such as across a Primary Care Network.  

The contact details for each Primary Care Training Hub can be found on our website here.

South East – further guidance is available below in Appendix 1 on the supervisor requirements for FCPs. The relevant HEI may also provide support for preparation of supervisors in clinical practice. NHSE England WT&E South East approval of educators is captured within the Clinical Learning Environment approval, and therefore if the learning environment is approved, the provider has the relevant governance in place to ensure their clinical supervisors are appropriately trained.

Q23: Why has the process to train as a FCP supervisor changed?

We have received feedback from across the FCP community about improvements which could be made to the supervision process. The Kings Fund’s research into the integration of additional roles in primary care also recommended that the FCP Roadmap process could be streamlined and made more accessible. Integrating FCP supervision within the robust quality approval processes led by the Primary Care Training Hubs addresses stakeholder feedback, ensuring there is a clear, consistent process and standard of quality for supervision across primary care.

Delivering our future FCP workforce is dependent on a sustainable educator workforce. We expect that aligning FCP supervision with existing quality approval processes will help to widen the available pool of educators who will be able to supervise learners completing a FCP Roadmap, creating long term sustainability for FCP education and training.

The presence of Primary Care Training Hubs and education providers within the FCP Roadmap process will also give supervisors additional support, providing them with opportunities to access funded refresher training if required.

Q24: Can we continue to be a FCP supervisor if we have only completed the two-day FCP Roadmap Supervisor training previously?

NHS England WT&E values the time and expertise that individuals have dedicated to the role of a FCP Roadmap Supervisor. This group will continue to be important to support the operation of the FCP Roadmap process and to provide a sustainable educator workforce to support FCP learners.

As FCP supervision aligns with our existing quality approval process, we request that evidence of your completion of the FCP Roadmap Supervisor training is submitted to your local Primary Care Training Hub. They will take this previous training into account as part of your application as a supervisor. The validity of the original course will be accepted, but as is required for all educators, the Training Hub will also need to see your up-to-date educator Professional Development Plan (PDP) and evidence of learner feedback. The Training Hub will also be able to advise if you would benefit from any refresher training.

South East – it is the employer’s responsibility to monitor and maintain educator records and therefore recognition of the clinical learning environment by NHS England WT&E South East confirms the appropriate educational governance is in place. Training Hubs are available to support and guide educators in sourcing appropriate CPD. In addition the HEI supporting the trainee may offer preparation for supervisors.

Q25: Do we need to complete refresher training to continue to be a FCP supervisor?

All recognised supervisors are responsible for their professional development and to remain up to date whilst acting in a supervisory capacity or role. This includes completing an educator PDP each year and to continue to meet all supervisory requirements as detailed in the Quality Framework.

The majority of the education providers who have been commissioned by NHS England WT&E are offering funded refresher training for FCP supervisors who may need this. These individuals can contact their local Primary Care Training Hub for further information. 

Q26: Is there an educational route for enabling progression from first contact practice to advanced practice?

Practitioners working in FCP roles, who that have successfully completed FCP Stages 1 and 2, and, who want to train to become an advanced practitioner, are expected to complete the educational route to advanced level practice by successfully completing an Advanced Practice master’s programme accredited by the Centre. This is necessary to meet the requirements of the multi-professional framework for advanced clinical practice in England.  

Whilst many FCP modules have been designed to fit in with existing Advanced Practice master’s programmes, recognition of prior learning is at the discretion of the education provider. Those who wish to pursue this route are encouraged to contact their local Primary Care Training Hub or education providers who are offering master’s advanced practice programmes for further information.

Looking beyond first contact practice toward advanced practice, for existing, experienced advanced practitioners the Centre’s ePortfolio (supported) Route offers the opportunity for those advanced practitioners working in advanced practice roles to have the quality assurance of their prior educational and experiential preparation as advanced practitioners to be recognised by the Centre on a standardised basis.

Completed the original roadmap supervisor and verification training (two days) or if not:

Be a minimum of 3 years post registration in their professional speciality area of practice and include one year working in primary care

Be in good standing with the HCPC

Be practising in the area they are supervising

Consultant Practitioner or Advanced practitioner or completed First Contact Practitioner stage 2 or existing roadmap supervisor trainer (2-day course)

Choose from the following e-learning to support your development as an educator:

– NHSE SE AHP Practice Educator programme

– Work-based place assessments – as required by the relevant HEI (CBDs, COTs, CEX, VLOGs)

– The Learning Hub Clinical and Educational Supervision

Be working in (or working towards) an NHSE WT&E PCN approved clinical learning environment PCN level approved learning environment

Optional Roadmap Supervision ELfH video

Be 2 years post CCT

Be in good standing with the GMC and NHS England

Complete a GP Clinical Supervisors course (Wessex) or ‘Training for non – Trainers’ (Thames Valley):

– Please note this is the same course GPs attend to supervise some doctors in training and you will therefore be screened on application for some pre-requisite information. If you do not meet these pre-requisites, you will still be invited to attend the course and may supervise the wider workforce as appropriate, but will not be invited to accredit with Thames Valley Wessex GP school to supervise doctors in training. For further details please contact:

– Thames Valley – Head of GP School (manjiri.bodhe@nhs.net) or Education Programme Officer Carolyn Puliti Picchi (c.pulitipicchi@nhs.net) for further information and signposting

– Wessex – Associate Dean for Train the Trainers (ranjan.dass@nhs.net) or Professional Development Unit (england.pdu.wx@nhs.net)

Be working in (or working towards) an NHSE WT&E PCN level approved learning environment

Top up Training Video for GP’s Supervising AHPs

Completed the original roadmap supervisor and verification training (two days) or if not:

Be 3 years post-registration and 1 year in Primary Care

Be in good standing with the NMC

Relevant post-registration Level 7 enhanced study or Consultant practitioner or Advanced Practitioner

Have completed an NMC practice assessor preparation programme and have prior experience as a practice supervisor, mentor/sign off mentor or practice teacher. More information available via Primary Care School to source local practice assessor offer, or choose from the following e-learning to suit your development as an educator:

– eLfH NMC Standards for Student Supervision and Assessment (SSSA) update

– Open University (free course) Practice supervision and assessment in nursing

– Work-based place assessments – as required by the relevant HEI (CBDs, COTs, CEX, VLOGs)

– The Learning Hub Clinical and Educational Supervision

Have advanced equivalent knowledge and experience for the learner’s field of practice and meeting the requirements of the relevant HEI

Be working in (or working towards) an NHSE WT&E PCN level approved learning environment

Optional Roadmap Supervision ELfH video

Wednesday 22 May 2024

Wednesday 19 June 2024

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