Add title here: ACP/APP/FCP/MSK/LOL!

I am feeling a touch of shame this morning. A friend asked me what I do. We have known each other for some time but we don’t talk about work really. I was sharing the news about my Winston Churchill Fellowship and the next questions came “so what do you actually do?”. I did my best, taking up as little time as necessary so as not to bore the dinner table but also shining light on the pioneering work being done by AHPs. But despite my monologue the response was “so you’re a nurse trying to be a Doctor”. Oh the shame!

First of all I’d like to say that my friend is very educated and doesn’t work or interact with the healthcare industry so could this be an educated public’s view of Advanced Clinical Practitioners and Advanced Physiotherapists?

This also highlights the view of nurses and their ANP counterparts. Their role seems to be understood and accepted but are they still seen in the shadown of their medic colleagues rather than in their own achievements and qualities. We have inherited a hierarchical healthcare system which was mostly occupied by consultants, junior doctors and nurses until AHPs came along and started occupying the bottom rung.

What can we learn from the nurses battle with public perception in our own route to equal status?

A systematic review in 2017 (Jakimowicz et al.) found that ANPs struggled to negotiate and clarify the scope of their roles in spite of a growing move for more ANPs in primary care. The BMJ published an article 13 years ago called “Nurse-led General Practice” calling for a change in the way we think about primary care and yet ANPs are still struggling with their identity as viewed by colleagues and the public.

I hope that I can learn more about how services, organisations and clinicians have tackled this problem through my Fellowship. Perhaps an accrediting body such as that proposed by HEE (The Academy) which would require advanced practitioners to prove their worth would improve our standing in the public’s eye. In the meantime though what do we call ourselves and how do we explain to our friends over dinner that we don’t massage people’s legs and we’re not trying to be Doctors.

4 thoughts on “Add title here: ACP/APP/FCP/MSK/LOL!

  1. Nice first blog Hannah.
    I must confess I use the title ‘MSK Practitioner’ but introduce myself as a physiotherapy specialist. Patients do not understand First Contact and appear to feel assured that you are a specialist. Respect however can only be earnt through demonstrating our knowledge & skills to both patients & colleagues. I now regularly get asked for a 2nd opinion from my GP colleagues but it’s taken over a year !


    1. Thanks Corinne. We are also finding that GPs book appointments with us after they have seen the patient. Trouble is this doesnt make us a First Contact service and that is where we add value so we have pushed back and asked GPs not to book with us if they have already seen the patient. This way we keep our limited capacity available for those first contacts.


      1. Hi Hannah
        In the early days I was being sent routine MSK patients from GPs, this has now stopped and they understand that if they feel a patient needs physio then a referral to community physio is appropriate. The second opinions are always the more complex patients that would have normally gone to orthopaedic triage, many of whom I am able to manage in house, which I feel is a good use of our skills and knowledge & saves the NHS and the patient a referral to secondary care. An example of being able to see the Right Patient at the Right Time in the Right Place


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