NHS Quality Improvement Scotland Allied Health Professions Clinical Effectiveness Lead / Trust Clinical Effectiveness Co-ordinator Forth Valley Primary Care Trust, Trust Headquarters Royal Scottish National Hospital

Background: Patient direct access to physiotherapy (self-referral), is not the routine mechanism in use within the NHS although more recently it has become a topic of considerable UK and international interest. Aim: To develop, implement, investigate and report on a direct access primary care based physiotherapy service Design of Study: Experimental and qualitative Setting: A general practice in a health district of Scotland. Method: The service was introduced and compared to the existing system of open access over a twelve-month period. Demographic and clinical data were collected relating to two samples: Control Year Group: All general practitioner referrals in the year prior to the study year. Study Year Group: general practitioner and direct access referrals. All patients were followed up one-month after discharge, and the number of associated general practitioner consultations collated together with clinician views of physiotherapy generally and direct access specifically. Results: The Control and Study Year Groups were homogenous with regard to numbe