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Independents' Day

Self-referral for physiotherapy slashes costs

Getting patients to refer themselves to physiotherapy slashed care costs by almost a third compared with referral through a GP, a study by one NHS primary care service has found.

The musculoskeletal screening service in Barnsley introduced a self-referral system – with telephone triage from senior physiotherapists – in parallel with existing GP referrals, and then compared costs, attendances and patients’ experience between the two groups over nine months.

Compared with GP-referral, the self-referral route cut the cost of care by 32%, with an average saving of £36.42 per patient per episode of care. This was mainly down to reductions in missed appointments and the overall number of contacts with clinicians, according to the study authors, from Sheffield Hallam University.

Waiting times were also cut significantly by self-referral, with an average time to first assessment of 3.5 days compared with 31 for GP referral, while patients reported similar satisfaction overall with their care.

The researchers estimated that introducing self-referral across the service could save around one clinical staff post and about £100,000 a year.

They concluded: ‘Introduction of the described self-referral pathway was feasible, cost-effective and offered comparable care.’

Musculoskelet Care 2014; available online 26 May

Readers' comments (5)

  • Interesting and confirming my thoughts. I believe it is long overdue that we incorporate allied, and often considerably cheaper, health professionals in our patient facing frontline so patients can book directly into these services. of course all underpinned by appropriate streaming pathways and clinical governance arrangements

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  • A great idea. I believe this is what is done in Australia. I've never understood why a GP needs to intervene between a patient and a quality MSK physio.

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  • Brilliant idea, a real healthy option saving GP consult and referral time . It was available in my area, so successful they had to withdraw the self referral service as it was too popular! Where's the logic in promoting self care or being thankful patients keen to self manage msk problems then making it difficult for them to access physio?

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  • Vinci Ho

    One can argue the same arrangement can apply to counselling and talking therapy...

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  • Most Physio departments (as with many AHP departments) already take self-referral and have done for years. The main difference I have noticed with self-referral is it likely to result on advice over the phone rather than an actual contact. I have seen some pretty shoddy advice in some of these cases sadly, where presumptions were made on the basis of patient description and a lack of knowledge of any existence of undiagnosed co-pathologies.
    I am really fed up of the fall-out from telephone treatments

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