Sam, Advanced Clinical Practitioner
East Elmbridge Primary Care Network, employed by Kingston NHS Foundation Trust.
What are your main responsibilities in this role?
I conduct advanced assessments for musculoskeletal (MSK) conditions, manage red flags, organise investigations, make referrals, and provide patient education, injections, and independent prescribing. I also focus on personalised care and MSK coaching, and engage in shared decision-making with patients.
I supervise first contact practitioners (FCPs) and primary care staff, contribute to local education and training, and lead quality and service improvement initiatives. I also have involvement with clinical leadership, policy development, and supporting FCP competencies locally.
How did you start out in your role?
I started my career as a Physiotherapist in India in 2006 and later completed a Master’s in Musculoskeletal Physiotherapy in Sheffield. I gained experience in occupational health, NHS private providers, and secondary care, developing skills in musculoskeletal medicine and injection therapy.
During the pandemic, I transitioned to a First Contact Practitioner (FCP) role, earning a diploma in Musculoskeletal Medicine and a PG Dip in Non-Medical Prescribing. I also became a national trainer for FCP courses and currently work as a Primary Care Champion for the National Axial Spondyloarthropathy Society, aiming to reduce diagnostic delays.
I received the 2023 Changemaker Award for national contributions and received a commendation from the Chartered Society of Physiotherapy for my efforts in public awareness and peer support.
I recently completed a Multiprofessional Educator course and am working on my Advanced Practice portfolio, while encouraging others to explore ARRS roles in primary care for continued learning and growth.
What entry-level jobs should someone pursue if they are looking to follow a similar career trajectory?
Allied healthcare professionals, such as Physiotherapists, Occupational Therapists, Pharmacists, and others, can now pursue advanced practice roles within the Additional Role Reimbursement Scheme (ARRS) in primary care as part of the NHS improvement plan. These roles require at least 3 years of Band 6 experience.
The advanced clinical practice (ACP) model in primary care has expanded beyond clinical work to include research, management, leadership, and education. This approach ensures patients receive specialist care in their community, leading to better outcomes, fewer secondary care referrals, reduced over-imaging, and enhanced multidisciplinary collaboration and learning.
What skills are most important in your job?
The most important skills include active listening, personalised care, empathy, shared decision-making, strong clinical reasoning, knowledge of evidence-based care, resilience, collaborative working, networking, and a continuous hunger for knowledge.
These skills help you provide high-quality, patient-centred care, stay adaptable, and work effectively with others. The challenge lies in balancing these skills in a fast-paced, demanding healthcare environment.
What are the biggest challenges you face in your role?
The lack of a unified patient information system can result in important information being missed or miscommunicated, which can delay care and lead to errors.
It's challenging when different organisations or even departments within the same organisations have varying protocols. It can create confusion and inefficiencies, particularly when you're trying to streamline care for patients.
Balancing patient care with the need to attend meetings and maintain relationships with different stakeholders can be tough. It’s hard to prioritise everything when time is limited.
Long waiting lists and patient load can be overwhelming at times. The longer the wait, the worse the outcomes can be, and that’s always tough to manage.
What are the biggest rewards in your role?
The biggest rewards are a mix of patient-focused outcomes, collaboration with multidisciplinary teams, and ongoing learning.
There’s nothing quite as satisfying as knowing you've made a real difference in someone's health. That positive feedback can be such a powerful motivator. Identifying critical signs (red flags) and making life-saving referrals is incredibly rewarding.
Collaborating with a wide range of professionals allows me to learn from primary care colleagues and apply that knowledge to improve patient care.
I learn something new every day which keeps me on my toes. That kind of mindset not only makes you a better clinician but also contributes to your personal growth.
Top tips for others thinking about working as an Advanced Clinical Practitioner?
Jot down your SMART goals and work towards them. Always ask for help where you need it.
Most of all keep an open mind and enjoy learning. Never forego your curiosity.
Your next step on your career pathway?
I would like to become a professional educator to improve learning for ARRS roles and work towards pursuing AHP educational leadership role in future.