Primary Care Pain Support Service
Persistent pain and chronic musculoskeletal (MSK) conditions present significant challenges in primary care. Due to the long-term nature of persistent pain, patients may not experience a complete resolution of their discomfort, pain, or disability. Instead, the focus is on helping them manage their symptoms effectively and improving their quality of life through personalized treatment and support strategies.
Historically, pain management has been rooted in physiotherapy and orthopaedics, rather than relying on medication. However, for patients who have not seen significant improvement through these traditional approaches, pain clinics have been established nationwide to offer additional support for persistent and chronic pain management.
Long-term analysis of these secondary care pain clinics has shown limited benefits in driving lasting behavioral changes and symptom relief for most patients. Recognizing this gap, First Contact Physiotherapy has developed a primary care-focused persistent pain service, designed to intervene earlier and address key risk factors before they escalate.
With extensive experience in first contact musculoskeletal (MSK) support, we assist thousands of patients monthly, approximately 50% of whom present with persistent pain and chronic MSK conditions. Our comprehensive modular pain service is tailored to individual patient needs, promoting long-term, meaningful change.
The Pain Challenge
Chronic pain affects up to 50% of the UK population (BMJ 2019), with persistent musculoskeletal (MSK) pain accounting for 30% of GP caseloads (HEE 2020). At First Contact Physiotherapy, our data from primary care partners aligns with these national trends, highlighting the significant burden of persistent pain on primary care services.
With rising waiting times for secondary care pain services and limited NHS resources, many patients with chronic pain rely heavily on primary care. These individuals often become frequent users of GP services, yet due to the complexity of persistent pain, general practice is often unable to provide comprehensive support within the limited time available. As a result, patients may struggle to reduce their reliance on medications, interventions, and repeat visits.
Key Challenges in Primary Care Pain Management:
- Limited GP consultation time to provide adequate support for persistent pain patients.
- Long waiting lists and inconsistent outcomes for long-term condition (LTC) pathways.
- Frequent front-line visits, with patients requiring 7-10 appointments per year on average.
- Broader health implications, including mental health concerns, obesity, metabolic health challenges, and increased lifestyle-related risks.
At First Contact Physiotherapy, we address these challenges by offering specialized primary care pain services, providing early intervention, structured pain management, and tailored patient support to reduce dependence on GP services and improve long-term outcomes.
Our Long-term Pain Service
People living with persistent pain often face significant challenges, including difficulty securing stable employment, multiple comorbidities, social isolation, mental health struggles (such as depression and anxiety), and obesity-related health risks. Due to the long-term nature of their condition, their behaviors and beliefs are deeply ingrained, making effective intervention more complex.
At First Contact Physiotherapy, we have developed a specialized team of health and wellbeing coaches to deliver personalized pain management programs. By working collaboratively with patients, our expert team helps challenge negative beliefs, promote positive behavior change, and foster sustainable improvements that have a lasting impact on both short-term recovery and long-term well-being.
Flexible Service
Each PCN or organization benefits from its own specialist primary care pain management team, allowing for a deeper understanding of local factors such as geography, socioeconomic differences, and environmental challenges. At First Contact Physiotherapy, we recognize that tailoring support to the unique needs of each community enhances the effectiveness of our pain management services, ensuring better patient outcomes and more impactful care.
Integrated Approach
At First Contact Physiotherapy, we integrate seamlessly with ARRS roles, local health teams, and community services to strengthen primary care networks. While our service is not strictly a social prescribing service, there is significant overlap in supporting long-term behavior change through quality coaching.
To ensure holistic patient care, we collaborate with primary and community care services, helping patients access appropriate, ongoing support beyond traditional NHS and medical interventions. This integrated approach enhances patient outcomes, promotes self-management, and ensures a more sustainable model of care.
Improve Wellbeing
At First Contact Physiotherapy, our priority is to enhance well-being and quality of life for our patients. Our ultimate goal is to empower individuals with effective self-management strategies, enabling them to take control of their health.
We actively collect data and feedback from every service user to measure our impact and continuously refine our approach. By doing so, we ensure that our service delivers maximum benefit to both our primary care partners and the patients we support.
A Fully Integrated Service
At First Contact Physiotherapy, we collaborate with and enhance existing healthcare roles, working alongside social prescribers, mental health practitioners, community link workers, and clinical pharmacists to provide holistic patient care.
How We Add Value:
✔ Expert Assessments & Individualized Care Plans – Our specialist musculoskeletal and pain physiotherapists develop personalized care plans with clinical oversight, aligned with GP contract requirements.
✔ Empowering Self-Management – We equip patients with the confidence and tools to manage their conditions independently.
✔ Complementing Existing Healthcare Services – Our service integrates seamlessly within primary care and community networks.
✔ Referral Pathways for Primary Care Partners – We accept internal referrals from all primary care providers, reducing workload for GPs and practice staff.
✔ Encouraging Self-Referral – Patients can access our services directly, ensuring faster support.
✔ Community Integration – We connect patients with local walking groups, social activities, and support networks to improve long-term well-being.
✔ Aligned with NICE 2021 Guidelines – Our approach helps reduce the burden of long-term conditions in primary and community care.
Hear from Our PCN and Patients
Read testimonials from PCN partners and patients who have experienced the benefits of our specialized pain management service.
Our Focus
At First Contact Physiotherapy, we support primary care deprescribing targets by helping reduce reliance on opioids and gabapentinoids through structured pain management strategies.
✔ Collaborative Approach – We integrate First Contact Physiotherapists (FCPs) with specialist health and wellbeing coaches, working alongside PCN staff and clinical pharmacists to provide holistic patient care.
✔ Aligned with NICE Guidelines – Our approach follows NICE recommendations, leveraging health coaching to manage long-term conditions effectively.
✔ Seamless Service Integration – By coordinating with social prescribers, wellbeing coaches, and clinical pharmacists, we enhance existing primary care services and demonstrate measurable patient outcomes to PCNs and practices.
Discover Real-World Impact
Read our Pain Case Studies to see how our integrated approach is transforming patient care.
Our Results
82.5%
of patients did not visit the GP during the pathway (less than 4% visited the GP more than once.
39%
average increase in PSEQ across the whole caseload entering the service (a change of 9-14% considered clinically significant for the individual)
49%
average increase in confidence managing without medications
Source: Initial findings from ongoing long-term outcomes audit in 4Doncaster PCN January 2024 – January 2025
87.8%
Average PSEQ increase 4 months following the programme for those that completed the programme
52%
patients had not attended the GP practice about their pain 4 months after being discharged
Source: Initial findings from ongoing long-term outcomes audit in 4Doncaster PCN January 2024 – January 2025
Cost Savings for Primary Care
Chronic pain patients on average attend GP practices 12 times per year with their chronic pain conditions. That is 12 visits per year taking time and recurring cost to GP’s. Our primary care pain service is proven to significantly reduce the total number of visits to GP’s.
Pure Unity Health Pain Service Cost
- One Health and Wellbeing Coach will see on average 300 patients over a 12-month period
- Each H&WB Coach cost is = £42,347 per year – fully ARRS reimbursable
GP Equivalent
- Assume same average 300 patients seen per year. Each frequent patient has on average 12 GP appointments per year and average cost of a GP appointment at £49 per appointment*
- Therefore, average annual cost for GP service is £49x12x300 = £176,000 cost per year to the practice
Cost saving purely on appointments saved = £133,000 pa
- Plus – cost saving from deprescribing
- Plus – cost saving from increasing overall general health, increasing patient activation and reducing modifiable risk factors
Source:
NHS: Key Facts And Figures | The King’s Fund
Unit Costs of Health and Social Care programme (2022 – 2027) | The new home for the Unit Costs of Health and Social Care report
Goal Related Outcomes
At First Contact Physiotherapy, we use a combination of patient-reported and validated outcome measures to track progress and demonstrate meaningful improvements aligned with each patient’s individual goals. Our assessment tools include:
✔ Patient-Specific Functional Scale (PSFS) – Evaluates functional improvement based on patient-defined activities.
✔ Pain Self-Efficacy Questionnaire (PSEQ) – Measures confidence in managing pain independently.
✔ Medication Review & Analysis – Assesses changes in medication use and deprescribing progress.
✔ Patient Interviews & Feedback – Gathers qualitative insights into patient experiences and satisfaction.
✔ GP Surgery Attendance Monitoring – Tracks reductions in GP visits to measure service impact.
By collecting reliable, data-driven outcomes, we support primary care networks (PCNs) in demonstrating the effectiveness of our pain management service. Many of our partner organizations leverage this data to build business cases for presentation to Integrated Care Boards (ICBs)—helping secure funding to improve and sustain patient care.