Healthcare Commissioning Forum

Prompt treatment by a physiotherapist in the early phase of an injury can improve recovery; enabling a person to return to their 'normal life' as soon as possible. The self-referral pilots (see Contacts and resources) have shown that people who self-refer to physiotherapy take fewer days off work, and are half as likely to be off work for longer than a month, when compared with people who have been referred using more conventional routes.

Self-referral fits with the NHS choice and personal control agenda by encouraging personal responsibility for health-focused behaviour and providing convenient, responsive services (Department of health 2006, 2008a).

The initiative means that people can refer themselves directly to their local NHS physiotherapy practice, as long as they are 16 years or over and they do not have neurological, breathing or gynaecological problems. A person wanting physiotherapy completes a self-referral form (on paper, online or by telephone), which includes answering red flag symptom questions that may indicate a more serious underlying health condition requiring referral to a medical specialist. A physiotherapist assesses the form and, based on pre-determined clinical criteria, identifies whether the referral is classed as urgent, routine, or one requiring signposting to another service. Self referral is a 'step change' and could be included in all musculoskeletal physiotherapy services.

There is concern that introducing self-referral will increase demand for physiotherapy services beyond current capacities. However, it has been shown that provided the service is not historically under-referred to (referral rate of less than 50 per 1000), introducing self-referral does not lead to increased long term demand (Department of Health 2008b). During the first three months there may be some increase in demand as patients access the service more quickly, but levels revert to normal within this timeframe. Such observations have been seen in both studies (Holdsworth 2007, Department of Health 2008b) and from pilot services which have implemented self-referral.

For further information, go to :  https://arms.evidence.nhs.uk/resources/qipp/29492/attachment