Implementing Self Referral for Allied Health Professions Scotland June 10 th 2010

Self Referral (SR) Self referral is a system of access that allows patients to refer themselves to a healthcare provider (AHP) directly, without having to see or be prompted by another Health Care Practitioner. This relates to telephone, electronic technology or face to face services

Objectives Understand the political, social and economic context of self referral for the AHPs Identify and discuss strategies to address practical issues, which influence the acceptance of self referral in the workplace Practice using a national performance tool that can demonstrate the value and impact of self referral Be confident in using referral management systems that challenge current service delivery and assess innovative ideas Identify key steps to implementation self referral in your area

SR Benefits for NHS patients present sooner high levels of patient satisfaction more backs and necks wait less more autonomous off work less more complete Rx same outcomes Holdsworth LK, Webster VS, McFadyen AK. Are Patients who Refer Themselves to Physiotherapy Different from those Referred by GPs?: Results of a National Trial Physiotherapy 92 PP March 2006 Self Referral pilots to musculoskeltal physiotherapy and the implications for improving access to other AHP services. DH Report 2008

SR Benefits - for service no floodgates fewer DNAs less prescribing, investigations and secondary referral time savings for GPs and patients cost effective

Implications and recommendations “GPs waste their time managing patients with low back pain.Self referral does not increase demand. Patients access services quickly and are more likely to complete their treatment. In the long term, self referral is more cost effective” Alan Johnson, CHPO Conference October 2008

Making the case for self referral Practice using a national tool that can support innovative ideas Be able to articulate how a national data collection tool can demonstrate the value and impact of self referral Identify your own key steps towards implementation

Value of self referral Valued by patients, GPs and therapists Is safe Is feasible in the NHS Is cheaper than other types of access Does not increase demand Values patients’ time Is supported by published work Does not attract patients from the private sector

.

Apply the seven dimensions of performance tool to self referral –If self referral is really successful, what would you expect to observe in the potential things to measure in clinical effectiveness, cost and patient centredness? –What data do you already have access to, or data that is easy and natural to obtain, which would support your observations?

Some observation/measurement to support the case –minimum: performance before and after implementation Be practical –Not aiming to publish a paper in a scientific journal –Trying to stretch thinking and make things better for people, carers and staff How does one produce evidence that self referral is better

Revisit challenges Top no. challenges

Implementation Tools Published literature Making the case -structures a dialogue with stakeholders. This plan includes being able to assess the new self referral service against key performance indicators. Are you ready for self referral checklist This sets out the key steps which services need to complete in order to implement self referral effectively.

Implementation tools (cont) Data collection tool PowerPoint presentation This presentation, with accompanying notes, focuses on the benefits of introducing self referral. Patient leaflet and poster iCSP and electronic networks