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Physiotherapists’ call for patient self-referral shot down by RCGP

The RCGP has urged caution against a call from physiotherapists for patients to be given the power to self-refer for their services.

The call, contained in a report from the Chartered Society of Physiotherapy (CSP) published today, claimed that making physiotherapists the first point of contact for many musculoskeletal problems would free up ‘more than 100m GP appointments a year’ in England.

The report highlighted FOI data showing a disparity across the UK, with just 31% of CCGs in England saying patients in their area could refer themselves directly for treatment, compared with 86% of patients in Scotland and 63% in Wales. Meanwhile, in Northern Ireland the first pilot scheme was recently approved.

But the RCGP warned that making self-referrals the standard for physiotherapy treatment could have the unintended consequence of swamping physiotherapy services and putting patients at risk.

Dr Helen Stokes-Lampard, RCGP honourary treasurer, said the work of GPs and physiotherapists should ‘complement each other’ and pointed to problems with a previous self-referral pilot.

She said: ‘[W]e are concerned that this scheme would fall short in meeting patient expectations if implemented without due regard for local needs – and in some cases, compromise patient safety if non-musculoskeletal issues are overlooked.

‘A similar scheme in the Midlands previously offered patients open access to physiotherapy, but it was totally swamped with inappropriate self- referrals and eventually shut down, leaving patients bitterly disappointed and GPs to pick up the pieces.’

But CSP chief executive Professor Karen Middleton said: ‘It makes little sense for patients to see a GP when the physiotherapist they are likely to be referred to could assess and diagnose them in the first instance.

‘Offering that direct access allows for an earlier assessment and ensures patients with the most urgent needs are treated sooner and more effectively. In the current climate, there is simply no clinical or financial case to be made for patients taking up a GP appointment when the help they need is available elsewhere.’

A report from a recent pilot study in Barnsley in England reached a similar conclusion to the CSP report – that self-referral reduced costs for the NHS compared with going via a GP.