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I have not seen the detail report but the articles reads that the issue is about who is making the initial referral. So an orthopaedic surgeon who then arranges for physio isn't covered by this as probably there will be the pathway where the referral covers all care required within that referral so includes physio.

An alternative example which I think supports your point is where a GP refers a patient to their own service rather than to a community or hospital alternative as they are making the primary referral.

Given that the primary care service is typically cheaper than the hospital alternative and GPs will be responsible for the finances how will we know if patients are being given information about the full range of options available to them.

Hopefully not an issue...