Implementing an occupational healthcare model

Purpose

Approximately 20,000 sick days (1500 staff members) at St. George's University Hospitals NHS Trust (SGUHT) are due to musculoskeletal issues. This costs the trust approximately £3.4 million per year. Despite this it is the only trust within inner London that, currently, does not have a physiotherapy service within their Occupational Health (OH) offering. The argument for delivering the service is clear, supported by previous research, service evaluations and local data analysis.

4470 sick days saved
through fast access to physiotherapy.
87% of service users
reported confidence in self-managing similar issues in the future.

Approach

Data was collected from March 2017 - the end of January 2018. The service was opened to all permanent members of staff within the trust as long as they met the following criteria: Inclusion criteria: A musculoskeletal problem that they are either off work for, at risk of going off work from or affecting their ability to carry out their full duties. Exclusion criteria: Failed physiotherapy treatment, for the same problem, previously or are already receiving appropriate care for that problem. Staff could be referred into the OH physiotherapy service via direct referral by their manager or via an OH clinician.

Outcomes

A total of 298 members of staff were referred into the service. Only 20% of the average annual total.

Waiting times The average waiting time from time of referral until initial assessment was 3.4 working days, which is significantly faster than a referral into a local service.

Sick Leave 30% of staff members referred took sick leave due to MSK problems.

Staff Satisfaction 84% of the staff members who used the service rated their care as 'excellent'. Of the members of staff who used the service after/while on sick leave, 82% of them reported that physiotherapy had helped them return to work. 84% of staff members who accessed the service without taking sick leave reported physiotherapy prevented them taking sick leave. 87% of staff members that accessed the service reported they were confident in self-managing similar issues in the future.

Cost and savings

Estimated sick leave for common MSK problems It can be estimated that 4470 sick days have been saved by the fast access to physiotherapy through OH, which would equate to a saving of approximately £759,900 to the trust.

Implications

The OH physiotherapy service has allowed fast access to physiotherapy assessment and treatment of staff members, which has enabled quick advice to managers about supporting their staff who suffer from MSK problems. Although it is difficult to prove, the feedback would suggest that speed of return to work has improved and the likely reduction in sick leave taken is significant. Staff members feel better supported by the trust (their employer) as a result of being able to access this service and managers are very positive about the service.

Proving the benefit of an already proven occupational healthcare model has been challenging. Despite demonstrating clear benefit to the service we didn´t get approval to keep the service running. This demonstrates the challenges of operating within a cash strapped NHS and highlights the difficulties of getting decision makers to understand the benefits.

Fund acknowledgements

This work was not funded. 

Additional notes

Presented at Physiotherapy UK 2018.