Flex Health describes how self-referral for musculoskeletal and neurological physiotherapy can result in cost savings, shorter waiting times and benefits for patients and GPs in Hull and East Yorkshire.
Patient self-referral for physiotherapy
Patient self-referral to MSK physiotherapy is a system of access that allows patients to refer themselves directly to physiotherapy, without seeing or being prompted by another healthcare professional.
Patient self-referral to an MSK physiotherapist enables prompt treatment in the early phase of an injury or MSK problem. Musculoskeletal physiotherapists working within community outpatient settings can receive self-referrals directly from patients, and as recommended to them by GPs and other healthcare professionals. Physiotherapists can offer:
- assessment and screening for red flags
- good knowledge of biopsychosocial models of care
- expert knowledge of exercise and rehabilitation
- a commitment to supporting self-management and promoting healthy living behaviour
- a range of treatment techniques as part of a management plan (e.g. acupuncture, manipulation) X-ray/investigation requests and referrals to specialist services, e.g. Interface
- injections (with the ability to prescribe these independently in future).
This self-referral approach improves recovery, enabling a person to return to their ‘normal life’ as soon as possible; it also reduces the likelihood of a short-term problem becoming chronic. People in Hull and East Yorkshire who self-refer take fewer days off work and are almost half as likely to be off work for longer than 1 month compared with people who have been referred using more conventional routes.

Benefits to patients and carers
Patient self-referral fits with the NHS choices agenda. It encourages personal responsibility for health-focused behaviour. Patients who self-refer to physiotherapy are interested in strategies for self-care and self-management, in order to prevent future MSK problems. Self-referral enables individuals to build confidence in the management of their own condition. This is particularly important for people living with long-term conditions. Enabling patients to self-refer to the correct services and receive individual advice and education about their condition promotes better long-term, ongoing, and safe self-management in a supported environment.
Benefits to general practice
Twelve percent of GP consultations in England relate to musculoskeletal problems,10 and so permitting patients to self-refer for physiotherapy would free up substantial GP consultation time, reducing the administrative load and time taken to complete each referral (currently assessed as about 2 weeks). This would enable GPs to concentrate on those patients with more complex medical problems.
The feedback from GPs who have direct experience of patient self-referral to physiotherapy has been extremely positive (see Box 1, below), with the vast majority wishing to retain the self-referral facility. The main reasons cited for this were:
- savings associated with GP consultation and administrative time
- greater patient convenience
- encouragement of patient autonomy
- the potentially positive impact on waiting times.
If you’re looking to self-refer to physiotherapy with us, you can do this online here. Make sure to contact our friendly team here. Also, feel free to visit our state-of-the-art facilities in Hull and East Yorkshire.