Self referral
Self referral has been made a priority for the NHS in England.
The Operating Framework for the NHS 2009/10 sets out that from the middle of 2009, PCTs will be commissioning self referral services. The government is clear about the benefits of self referral when Health Secretary Alan Johnson endorsed its recommendations in the DH Report Self referral to musculoskeletal physiotherapy (and the implications for other Allied Health Professions).
Background
'Patients are able to refer themselves to a therapist without having to see anyone else first, or without being told to refer themselves by a health professional. This can relate to telephone, IT or face-to-face services.'
Self-referral to physiotherapy and other AHP services is not a new idea. Physiotherapists (and other AHPs) have been able to act as first-contact practitioners since 1978.
Self-referral is of course well established in the independent sector and has been used successfully for several years within the NHS in Scotland: see CSP publication Scottish physiotherapists delivering for health
What does self-referral mean for patients?
The short answer is, a return to normal life as soon as possible.
For instance, the self-referral pilots have shown that people who self-refer to physiotherapy take fewer days off work and are 50% less likely to be off work for more than one month when compared with people referred via the more conventional route. Early intervention for low back pain enables a return work up to five weeks earlier and gives a 40% reduction in the recurrence of low back pain in the following year.
Dame Carol Black’s Review of the health of Britain’s working age population, Working for a Healthier Tomorrow, was published in March 2008. It identifies three principal objectives:- prevention of illness and promotion of health and wellbeing
- early intervention for those who develop a health condition and
- an improvement in the health of those who are out of work, so that everyone with the potential to work has the support they need to do so
Choice and Personal Control
Self-referral fits with the NHS choice and personal control agenda by encouraging personal responsibility for health-focused behaviour. This is of significant importance in assisting 15 million people living with long-term conditions - enabling timely, easy, direct access to the correct services and receiving individual advice and education about living successfully with the issues their condition may raise, so providing ongoing safe self-management in a supported environment.
The feedback from GPs in the pilot was extremely positive, with 91% wanting the self-referral facility to continue. Primary reasons cited for this included the potentially positive impact on waiting times; one pilot site saw a reduction in waiting times from 20 weeks to 3 weeks, with urgent cases being seen within two days. This enables GPs to concentrate on those with more complex medical problems.
The evidence shows that introducing self-referral, providing that a service is already adequately resourced, does not lead to an increase in demand for physiotherapy. People who would normally have seen their GP first, simply opt for a more direct route to solve their problem.
Further details
Please contact Ruth ten Hove, Professional Adviser by phone on 020 7306 6666 or email tenhover@csp.org.uk.Login or register
