jonathan sheppard clinical specialist physiotherapist (oh) staff physiotherapy service reducing...
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Jonathan SheppardClinical Specialist Physiotherapist (OH)
Staff Physiotherapy Service
Reducing staff sickness at Ashford & St Peter’s NHS Foundation Trust
Employee’s
An important part of our responsibility to our employees is providing them with resources to
lead healthier lives.
“Good health is important to all of us”
Performance AND Health and well being
Think / Feel
Performance
Physiology
Behaviour
•Psychological
•Musculoskeletal
•Disease
•Sense of ‘wellbeing’
•Happy
•Supported
•Sound decision making
•Able to manage self
•Coping with changes
•Good morale
•Improved productivity
•Hitting targets
•Good patient experience
NHS loses 10 million working days a year to sickness:
• 46% Musculoskeletal disorders (MSDs) (Boorman 2009)
Staff off work for 6 months have 50% chance of returning
Staff off work for 12 months have a 30% chance of returning
(Waddell, 2000)
Work
‘work should be comfortable when we are well and accommodating when we are ill
or injured’
Norton Hadler (1997)
What is the good of treating a condition and then sending them back to the conditions that made them sick?
Prevention better than cure….
Vs
Reducing the risks to health
Physiotherapy
Assess and treat specific conditions
Devise rehabilitation programmes to address areas of underlying weakness
Help staff to self-mange long-term conditions• Employee• Employer
Give appropriate ergonomic advice
Assists Occupational Health Advisors with return to work advice
Physiotherapy
Physiotherapy can:
reduce sick leave by preventing and treating the source of pain
enable staff to work on full normal duties through rehabilitation
ensure alternative or modified duties are appropriate and time limited
deliver a cost-effective service.
Ashford & St Peters NHS Foundation Trust
Delivering our vision
Patients first Personal Responsibility Passion for Excellence Pride in our team
To be one of the best healthcare Trusts in the country
Objective 1:Highest quality
standards
Objective 2:High performing
workforce
Objective 3:Delivering our
clinical strategy
Objective 4:Improving productivity
and efficiency
Values
Vision
Four strategic objectives
1. Improving patient experience programme
2. Leadership development programme
3. Workforce redesign programme
4. Implementing the clinical strategy
programme
5. Improving quality & productivity programme
6. Building stronger clinical directorates programme
Delivered through six Trust wide programmes…
Local business plan priorities aligned to strategic objectives and delivery programmes
…and in Directorates through local business plans
To recruit, retain and develop a high performing workforce – Trust Objective 2
Align service improvement with workforce planning and job design
Ensure mandatory training and professional development activities meet patient experience and outcome priorities
Embed Living our Values and Leadership & Management Framework
Continue to improve staff loyalty and experience so that staff are inspired, proud ambassadors of our Foundation Trust
Continue to improve the health, safety and wellbeing of staff
Continue to improve the health, safety and wellbeing of staff
Provide a dedicated Occupational Health Service to support the management of illness and prompt rehabilitation to include a Physiotherapy service
Promote active and healthy lifestyles
Hold monthly focused health promotion events
Deliver a high uptake of the seasonal influenza vaccine
Occupational Health Physiotherapy Service
Background to the OH Physiotherapy Post
Historic Picture of Physiotherapy in OH• Previous pathway into main out-patients• Previous attempts to get Physio involved
‘Good to Great’ – Leadership programme
NHS Constitution & NICE Guidelines
Health & Well-being agenda 2007-Working for a Healthier Tomorrow (Dame Carol Black) 2008-Improving Health and Work –Changing Lives (DH) 2009-Review of NHS Staff Wellbeing (Steve Boorman)
Aims & Objectives
Assess the effect on staff sickness from MSD by the provision of an OH Physiotherapy service
Reduce the number of sick days and time lost due to MSD
Work with Occupational Health to fast-track return to work
To raise the awareness of the Health & Well-being agenda across the Trust
Outline of service
Additional funding provided by ASPH for one year trial
Managed by Occupational Health but professionally accountable to Physiotherapy manager
Cross-site clinics
Drop-in clinics
Usage of Physiotherapy equipment and rehabilitation and Hydrotherapy classes
Use of outcome measures• Visual Analogue Scale (VAS)• Discharge questionnaire
Service Delivery
Post filled with a band 7 Clinical Specialist Physiotherapist
Referral Process• Self Referral• Occupational Health Adviser’s• GP / Consultants
Links with other departments• Physiotherapy• Moving and Handling
Number of Staff seen
449 staff seen in the year long trial
56% clinical, Non-clinical 44%
45% Nursing, Midwifery and Health Care Assistants
Average wait of 12 days compared with 85 days in the main department
Staff sickness
FTE Days off sick
Days lost per employee
No. of episodes
Average length of sickness
Without With
physio physio
5714 4030
1.73 1.23
781 697
7.3 5.7
Comparing Staff Sickness Levels
29% reduction comparing year on year
Specific conditions seen
0
20
40
60
80
100
120
140
160
180
Back Neck Upper Limb Lower Limb
No
. of
sta
ff
Cost Savings
Indirect costs of MSD sickness• Productivity• Turnover of staff• Staff morale
Reduced bank staff usage shows saving of £60,344
Return of £2 for every £1 spent
Outcome measures
Average reduction in pain of 80%
77% of staff seen did not have time off work
52% reported Physiotherapy intervention was the direct reason for not having time off
68% of staff indicated they saved time by not having to take time off to visit their GP for a referral
71% of staff more active following Physiotherapy treatment
Time saved by not visiting GP
MDT Working with OH Advisors
Timely referrals
Appropriate training
Return to work advice
Appropriate risk assessments
Health & Wellbeing
Prevention / Education • Back pain workshops• Desk-based exercises video
- http://trustnet/docsdata/occhealth/exercises.html#h
• Exercises on ‘Trustnet’• Information resource on common conditions on ‘Trustnet
Calendar of events• Workout at work (CSP) Gym Ball sessions• Chair Pilates
Top Tips
Self referral is key
Understand MSD sickness
Understand the ‘in-direct’ costs of MSD sickness
Embrace Health & Well-being with direct support from the Executive team & partnership working
Staff-side Reps
Does your Trust have a Health & wellbeing strategy?
Be proactive in discussing Health & wellbeing with your organisation
Have ‘Health & wellbeing’ as a regular agenda item on your meetings with management
Explain and understand the link between staff morale and improved Health & wellbeing
Work with Occupational Health not against them
Building a business case with OH
Compare your current levels of sickness with nationwide statistics
Use evidence to show the effect of a specific OH Physio
Explain the need for a specialised physio in occupational health and NOT just a ‘fast-track’ service
Finance directors are interested in potential savings only so focus on these
Take Home Message
OH Physiotherapy proven to reduce staff sickness
Staff are being asked to do more with less so need support
NICE's public health guidance – “The NHS should do more to improve the health and wellbeing of its workforce” (Jan, 2012)
‘The bigger picture’
30 minutes specific Physiotherapy treatment per week
Specific exercise 4 times a week for 1 hour Approximately 56 hours sleep per week
What about the other 107 ½ hours in the week??
I am happy to answer any questions or queries
Sheppard J: 2013: Trust Physiotherapy: Occupational Health at Work; (5): 25-28
Jonathan Sheppard – Clinical Specialist Physiotherapist (Occupational Health)
Further Information
Audit Commission (2011). Managing Sickness Absence in the NHS: Health Briefing from: www.audit-commission.gov.uk/SiteCollectionDocuments/AuditCommissionReports/NationalStudies/20110210managingsicknessabsence.pdf
Accessed: 26/01/12 Baker P (2011). Costs and benefits of managing musculoskeletal disorders and return to work.
Journal of Association of Chartered Physiotherapists in Occupational Health and Ergonomics. Vol 15.3. pp. 14-16
Boorman S. (2009).NHS Health and Well-being review: Final report. London, Department of Health.
Department of Health (2011). Healthy Staff, Better Care for Patients: Realignment of Occupational Health Services to the NHS in England. London, Department of Health.
Department of Health (2011). NHS Health & Well-being Improvement Framework. London, Department of Health.
Department of Health (2011). The Operating Framework for the NHS in England 2012/13. London, Department of Health.
Waddell G, Burton AK. Occupational health guidelines for the management of low back pain at work – evidence review. London: Faculty of Occupational Medicine, 2000
Zigenfus G.C., Yin J., Giang G.M. (2000). Effectiveness of early physical therapy in the treatment of acute low back musculoskeletal disorders. Journal of Occupational and Environmental Medicine, 42 (1), pp. 35-39, 1076-2752.