Self-referral: key considerations for GPs
Up to 30% of GP consultations are for people with musculoskeletal problems. Patient self-referral to physiotherapy frees up GP time
Self-referral reduces associated administration costs and gives patients faster access
GP-suggested self referral allows patients to make their own choices. Patients like it
Self-referral: key considerations for employers
- Self-referral returns employees to work quickly
- People who self-refer to physiotherapy take fewer days off and are 50% less likely to be off for more than a month compared to conventional GP referral
- Quick access is key. Evidence shows that early intervention for low back pain returns employees to work up to five weeks earlier, with a 40% reduction in recurrence the following year
Self-referral: delivering value to patients
- Self-referral puts individuals in control of their care, promoting self-management and health-focused behaviour. It champions the service ethos of 'treat to manage, not treat for life'
- People with complex and long-term conditions have a simple route in and out of services. It gives patients an easy route back into the service
- Evidence shows better treatment outcomes
Patient self-referral: saving time and saving money
The Quality, Innovation, Productivity and Prevention (QIPP) programme in England has endorsed self-referral for musculoskeletal disorders (MSDs) to give patients easier access to treatment. Nationwide, GPs can be heard supporting self-referral.
'Allowing patients to self-refer reduces the overall musculoskeletal workload for GP practices,' says Dr Lenden in Plymouth. 'This frees up appointment slots in busy clinics.'
Research on the cost savings of self-referral in Scotland showed an average saving of approximately £2 million each year, considering the costs of patient self-referral were calculated as £66.31 per episode compared to GP referral at £88.99.
Self-referral saves money
The QIPP process updated these costs in accordance with Department of Health (2011), showing savings of £25,207 per 100,000 people as a result of reducing GP contact, unnecessary prescribing and diagnostic imaging. It also highlighted that the demand for physiotherapy did not increase in the long term.
QIPP also showed that an episode of GP-suggested self-referral costs 10% less and an episode of patient self-referral costs 25% less than traditional GP referral.
The English pilot showed 41% of MSD physiotherapy referrals came from the traditional GP route, 35.4% came from GP-prompted self-referral and 23.6% full self-referrals (patient refers themselves to physiotherapy without being told or prompted by a health care professional).
This evidence shows the potential for even greater cost savings in the management of patients with MSDs if full self referral were more widely implemented.
Self-referral: building the national picture
Results from national self-referral projects in England and Scotland have shown that it's a less expensive model of physiotherapy care than the GP referral route. Self-referral increases user satisfaction and reduces the number of other healthcare interventions such as MRI and x-rays.
Self-referral also reduces sickness absence and time off work. It's cost-effective in terms of patient time and commitments, and helps to streamline other care pathways.
By promoting autonomous decision-making about personal health needs, self-referral can enhance motivation for recovery, enabling speedier return to previous health status.
It also has the potential to provide opportunities for targeting particular groups with health needs, such as farmers or minority populations.