Patients must have direct access to physio, says CSP

The study by Keele University demonstrated that seeing a physiotherapist as a first point of contact instead of seeking a referral from a GP raised no safety concerns for patients.

There was also no increase in demand on a trial service when it was opened up to self-referral – busting a myth that is often cited as a reason to retain the GP role in managing who can access physiotherapy.

This was despite the option of direct access to physiotherapy being advertised to in excess of 8,000 people registered with general practices in the trial.

An FoI audit conducted last year by the CSP showed that patients could see a physiotherapist as the first point of contact – whether in a GP or surgery or through the ‘traditional’ self-referral route in an outpatient setting – in just over half of CCGs in England.

The levels are much higher in Wales and Scotland, but Northern Ireland this week cancelled a plan to rollout self-referral.

Prof Karen Middleton, chief executive of the CSP, said:

‘GPs are facing ever-increasing pressure yet out-dated rules mean they are still forced to see and refer patients who should instead be seeing a physiotherapist as the first point of contact.

‘It makes no sense to pile that extra workload on GPs, or the cost of an additional, unnecessary appointment onto the NHS.

‘More importantly, it is unnecessary for patients who are in pain to go through this extra step to access the expertise they need to get their recovery started.

‘The longer they wait, they greater the chance becomes that a minor problem develops into a longer-term issue that forces them out of work or everyday activities.

‘This is a vitally important piece of research that makes clear the case for change and the urgency with which it should take place.’

The study compared outcomes following the introduction of self-referral to physiotherapy to adult patients at two general practices with two others that had no self-referral for their patients.

Despite writing to every adult patient in the two self-referral practices, which totalled more than 8,000 patients, inviting them to self-refer if they felt they needed to, no increase in demand was found.

It did not increase waiting times and no safety issues were discovered. conditions that patients presented with were also no different between the arms of the trial.

Dr Annette Bishop, NIHR Research Fellow of Musculoskeletal Intervention Studies who led the study, said:

‘This research is the first randomised study anywhere in the world of patient direct access to physiotherapy.

‘It fits with national calls to investigate new models of care to better meet demand for health services for patients with pain conditions.’

The study was funded by the CSP Charitable Trust.

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