Preparing Allied Health Professionals for First Contact Practice roles in primary care: a mixed-methods study exploring the experiences of students and their clinical mentors

Abstract

Background
The First Contact Practitioner role have been established in England to expand multidisciplinary working in primary care. First Contact Practitioners, including podiatrists, paramedics, physiotherapists, dietitians, and occupational therapists, undergo less foundational training than General Practitioners. Health Education England commissioned The University of Central Lancashire to deliver a module for First Contact Practitioners to support the development of the knowledge, skills, and attitudes required to provide safe and effective care in primary care. This study investigated the utility of the module as perceived by First Contact Practitioners who had completed the module and their clinical mentors, and their perceptions about how the First Contact Practitioner role meets the clinical realities of primary care.

Methods
Using a qualitatively driven mixed-methods approach, we collected data via online surveys and semi-structured interviews. We explored the empirical material using a reflexive and creative method, and used Lipsky’s theories on street-level bureaucracy as a theoretical frame of reference.

Results
Twenty-one students and six clinical mentors completed the survey, six students and two clinical mentors were interviewed. We found that perceptions about the utility of the module is influenced by personal circumstances, professional identity, and mentoring experience, and that profession-specific competence typically fall short of the capabilities required for the primary care gatekeeper role. The participants indicated that a clear definition of the First Contact Practitioner role is missing, which might sit in contrast to policymakers’ perception that there is a clear blueprint for the implementation of the role.

Conclusions
Our findings can inform and guide postgraduate training for healthcare professionals wanting to pursue a career in primary care, as well as employers that implement public policy at the street level. Our study can guide policymakers, who in their endeavour to improve public services must allow autonomous practitioners to interpret and show discretion in their meetings with patients, but also offer clear guidelines, job descriptions, and roadmaps.