Self-referral could save NHS millions

There is mounting evidence to support the case for self-referral in MSK care, says Ruth ten Hove.

At the end of 2014, the CSP conducted a UK-wide freedom of information (FoI) audit to find out if patients with musculoskeletal (MSK) conditions can refer themselves for physiotherapy. The results revealed that just 31 per cent of England’s 211 clinical commissioning groups said they offered self-referral to physiotherapy – a far cry from Scotland where 86 per cent of boards have full self-referral and the rest have partial schemes. Wales also offers self-referral more widely (63 per cent) and Northern Ireland recently agreed to its first pilot scheme.
Self-referral has been proven to create capacity, cut waiting times and costs £33 less for each patient compared to alternatives. See Widening access to self-referral could save the NHS hundreds of millions of pounds. 
Primary care is under enormous pressure, and up to three GP consultations in 10 are for an MSK condition, according to a recent British Orthopaedic Association study (visit and search for ‘girft’). It seems that the benefits of rolling-out self-referral 
are becoming clearer. 
Despite comments from the Royal College of General Practitioners questioning the CSP’s assertions, many time-poor GPs applauded the CSP’s call to utilise physiotherapy expertise more appropriately. Some remain sceptical and we must work to promote the benefits to all concerned, if we want change.
The CSP will use the FoI data to make the case for self-referral UK-wide at every opportunity; at events, through the media and at meetings with civil servants and other health professionals. We hope members will do the same.
Our new leaflet, Physiotherapy works for self-referral, is a great tool to start the discussion with your local decision makers. Download copies from  More information on the FoI results, including a map showing where self-referral is available and other useful resources, are also at the above link.  Take a look, read the evidence and help spread the word. 
Let’s ease the burden on primary care. Put physiotherapists on the frontline and let patients self-refer. 
  • Ruth ten Hove is head of research and development, CSP
Ruth ten Hove head of research and development, CSP

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