Could physiotherapy self-referral deliver economic benefits?

Enabling patients to refer themselves to physiotherapy could image-801797446-big
have profound economic benefits, a new report suggests.
Put together by the Primary Care Workforce Commission, the report was commissioned by Health Education England to identify new models of primary care that could meet the needs of both the NHS as an organisation and patients themselves.

It suggests that self-referral has the potential to reduce costs and provide better patient care, explaining that the move has the potential to be cheaper than first seeing a GP. However, the report also highlights that it is keen to see more research on exactly how self-referrals would impact GP workload.

Overall, the report suggests that an ‘upskilling’ of primary care teams may hold the key to improve primary care systems within the NHS, largely because it would empower each professional to do more for their patients without the need for referrals to colleagues.

In terms of physiotherapy, this could include physiotherapists acting as independent prescribers, as well as potentially moving to work alongside GPs as a first point of contact for musculoskeletal problems. Crucially, this would reduce the need for parallel GP appointments, thereby in theory reducing costs.

Economic benefits could also come in the form of a reduction in the amount of time patients’ need to take off work, with the report highlighting that, should there be any increase in cost for the NHS, this may be offset by improved productivity in the workplace.

These theories echo calls for self-referral elsewhere, such as those suggested by the Chartered Society of Physiotherapy (CSP). In April, the organisation found that, in England, over 100 million GP appointments could be freed up by self-referral to physios for issues such as back pain.

It noted that this could reduce the cost of patients receiving help for such problems by £33 per person, thereby having the potential to save the NHS millions.

It also noted that England is lagging behind other parts of the UK in terms of self-referral, highlighting that in Scotland 86 per cent of boards have full self-referral schemes, compared to just 31 per cent of clinical commissioning groups in England.

Furthermore, the organisation explained self-referral may be a crucial step for people with long-term conditions such as MS and arthritis, because it empowers them to manage their own health more effectively. As such, it could also reduce hospital admissions.

Mindful of the potential economic benefits of such moves, the CSP took chancellor George Osborne up on his recent request for money-saving ideas from health service professionals. The chancellor has given those working in public services until September 4th to send in their ideas for improving efficiency and reducing costs; in a public reply, the CSP stressed the advantages of self-referral.

Indeed, in addition to outlining how much could be saved per patient, the organisation also relayed that such changes could make great savings in terms of preventative care.

The models of improving primary care considered in the report by the Primary Care Workforce Commission included phone or face-to-face triage of musculoskeletal problems, and self-referral to physiotherapy.

Health Education England will provide a response to the report in the autumn.

Written by Mathew Horton