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HEALTH MATTERS: A day in the life of a first contact physiotherapist with NHS Highland

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Ciaran McManus.
Ciaran McManus.

NHS Highland wants to share stories of some of its thousands of workers to showing the range of careers available. First up is Ciaran McManus, clinical lead for first contact physiotherapists in general practice

I am a first contact physiotherapist (FCP), which is an advanced physiotherapy practitioner who is based within a GP practice.

Our role is to deliver first contact musculoskeletal physiotherapy assessment, diagnosis, treatment and sign posting for communities, supporting their musculoskeletal health and wellbeing.

As part of the primary care modernisation improvement plan, we aim to reduce GP workload by providing fast access to expert physiotherapy musculoskeletal assessment and opinion.

As clinical lead for the south and mid FCP team, I co-ordinate the service provided by 20 clinicians spread over 28 practices, as well as providing clinics at three practice sites.

Here’s a look a day in my life...


I usually log on the network early to check for actions that need dealt with more urgently and complete management activity from the previous day.

With technology to enable working from home, supported by the e-health team, I can access documentation much more readily – usually this is accompanied by an early strong coffee.


On clinical days I see my first patient about now. Although as a team we have spent the past year providing a mixture of telephone, NearMe (video) and face-to-face consultations, my clinics have now returned to overwhelmingly face-to-face.

We offer patients and general practices a variety of appointment types that best accommodate their needs with patient choice being foremost in our minds.

I aim to devote all my attention to my patient when in clinic but my mobile is on hand for urgent queries from the team, for clinical or technical support.


When possible I join the practice team for my second and last strong coffee to catch up for clinical and non-clinical discussion.

This is an invaluable chance to connect with the general practice team (GPs, pharmacist, advanced nurse practitioner, admin team) for clinical discussion, patient specific or practice process sharing and for valuable biking/hiking/running area highlights.


One of my clinical days is at two separate GP locations so I finish up clinical administration and get on the road. I am experimenting with intermittent fasting so travel and podcasting usually takes my mind off food while I get to the next practice.

If traffic is light (never in summer in the Highlands) I might squeeze in a brisk walk to clear the mind.

I will usually check my email for anything that needs immediate attention and then start my afternoon clinic. Many of the Highland practices are small so being on site provides an excellent opportunity for the practice population to access physiotherapy input, even if it is once a week.

I am an independent prescriber and injection therapist, additional skills which help to draw as much activity as possible from increasingly pressured GPs.


I usually finish up patient and administration activity and then think about what activity I can squeeze in – running, golf, cycling, swimming – in that order. Practice what you preach.

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