Developing a national musculoskeletal core capabilities framework for first point of contact practitioners

Abstract

Objective
We aimed to support service transformation by developing a core capabilities framework for first contact practitioners working with people who have musculoskeletal (MSK) conditions.

Methods
We conducted a modified three-round Delphi study with a multi-professional panel of 41 experts nominated through 18 national professional and patient organisations. Qualitative data from an open-ended question in round one was analysed using a thematic approach and combined with existing literature to shape a draft framework. Participants rated their agreement with each of the proposed 142 outcomes within 14 capabilities on a 10-point Likert scale in round two. The final round combined round two results with a wider online survey.

Results
Rounds two and three of the Delphi survey were completed by 37 and 27 participants respectively. 90 practitioners responded to the wider online survey. The final framework contains 105 outcomes within 14 capabilities, separated into 4 domains (Person-centred approaches; Assessment, investigation and diagnosis; Condition management, intervention and prevention; Service and professional development). Median agreement for all 105 outcomes was ≥ 9 on the 10-point Likert scale in the final round.

Conclusion
The framework outlines the core capabilities required for practitioners working as the first point of contact for people with MSK conditions. It provides a standard structure and language across professions; greater consistency and portability of MSK core capabilities. Agreement on each of the 105 outcomes was universally high amongst the expert panel and the framework is now being disseminated by Health Education England, NHS England and Skills for Health.