The UK challenge:
health, work and austerity
health, work and austerity
At a time when the NHS is serving a growing and ageing population, the UK government estimates the need for £22 billion in NHS savings by 2020/21(3). Yet public expectation remains that access to ever improving treatment should be available to all. So the drive to reduce the welfare bill and to have people in
productive work remains a government priority.(4) There is clearly a
pressing need for best value and productivity in healthcare.
Musculoskeletal disorders (MSDs), from short term
back pain to complex, long term conditions such as rheumatoid arthritis, are
the main reason for people being off work. These conditions can also link to
mental health conditions such as anxiety and depression, which are associated
with stress and are responsible for the most working days lost in the UK.
Psychosocial factors such as workplace culture can in turn impact on the
development of MSDs.(5)
Benefits of early referral to physiotherapy for work
§ Economic savings to the UK
§ Prevention of MSDs and work-related
exacerbation of other conditions
§ Clinical
effectiveness in the treatment of MSDs and other conditions affecting workers
§ High levels of staff satisfaction
§ 'Healthy
conversations' that support behaviour change
Early access to physiotherapy enables
people to work
SICKNESS ABSENCE FROM WORK
CURRENTLY COSTS THE UK
£14.3 BILLION
Physiotherapy can help. It is a regulated,
clinically and economically cost-effective profession.
Physiotherapists are autonomous practitioners, with
the skills to accept referrals directly.(6)
They assess, diagnose, advise and treat people in
many clinical and non-clinical settings, both inside and outside of the NHS.
They are experts in the prevention and treatment of MSDs and of other conditions
affecting people of working age, such as cancer, cardiac, respiratory and
neurological conditions.(8)
According to Macmillan, there are currently over
750,000 people of working age living with cancer and it is predicted that there
will be 17million people living with arthritis and 3 million with cancer by
2030.(9)
Work advice from physiotherapists
All physiotherapists can give advice to help people to prevent problems related to their work. They advise employees, enabling conversations with line managers, and liaise with other health care professionals, family and carers as needed. Where a problem or health condition already exists they work with people to achieve optimal function and mobility - with work an important treatment outcome.
Physiotherapists add further value in supporting
the public’s overall health. For instance, they can give specific advice about
physical activity levels based on an individual’s clinical physiotherapy
assessment. This can help people address concerns such as obesity, leading them
to better overall health and promoting self-management of their condition.
Within the workplace, physiotherapists specialising
in occupational health and ergonomics can provide targeted support in response
to the needs of staff and their roles, as well as the business needs of
employers.(10) They liaise with line managers and others to promote
workplace health and minimise sickness absence.
The NHS itself, the UK’s largest employer, has a
high rate of sickness absence due to MSDs, costing around £400m per year.(11)
Early access to physiotherapy is now included in government measures. For
instance, as part of the work generated by the Five Year Forward View aimed at
reducing sickness absence in NHS workers.(12)
41,000 working days
saved
John Lewis partners (staff)
reporting an injury receive a triage call from Physio Med within four hours,
and initial assessment from a chartered physiotherapist within three days.
2,324 partners engaged with the service over 12 months. JLP estimates it saved
41,010 working days, saving £2,676,000
93% improvement
The Royal Free London NHS Trust provides a
physio-led health and work centre for staff with self-referral to
physiotherapy, workplace and ergonomic assessments and health and wellbeing
advice. 89% were recommended fit to stay or return to work; data shows 93%
improvement in spinal, upper and lower limb disorders.
Worst to best
NHS Lanarkshire put in place a
‘self-referral to support’ service, including physiotherapy, from day one of
sickness absence. They moved from being the worst, to among the bestperforming
Health Boards in mainland Scotland.
Increased
confidence for managers
79% of staff using the Physio Plus self-referral
physiotherapy service at Sheffield NHS Hospitals Trust report it
prevented them having to take time off work. 69% of those off work said it
helped them return more quickly. Staff and managers said it increased their
confidence in dealing with sickness absence.
High return on
investment
100 London Fire Brigade staff with chronic
musculoskeletal conditions followed a programme provided by Crystal Palace
Physio Group including work-specific exercises. There was an 85% reduction in
time off work, and £27 return on every £1 spent.
Staff self-referral
Powys physiotherapy service responded to data from
the health and wellbeing team demonstrating MSK conditions were in the top
three reasons for sickness absence at Powys Teaching Health Board. Staff
now fast-track themselves into the service for assessment, self-help advice and
management of their condition.
Summary
Referral to physiotherapy can help people to work.
For those already in work, physiotherapists can help to prevent sickness
absence in the first place, and facilitate sustainable return to work following
sickness absence. For those not working, physiotherapy can enable individuals
to take opportunities to work. Early access to physiotherapy benefits
individuals, workplaces and the economy.
References
1. Waddell G, Burton
KA. Is work good for your health and well-being? Norwich: TSO; 2006. https://www.gov.uk/government/publications/is-work-good-for-your-health-...
2. Black C, Frost D.
Health at work: an independent review of sickness absence. Norwich: TSO;
https://www.gov.uk/government/publications/review-of-the-sickness-absenc...
https://www.gov.uk/government/publications/review-of-the-sickness-absenc...
3. HM Treasury.
Spending review and autumn statement 2015. Norwich: TSO; 2015.
https://www.gov.uk/government/publications/spending-review-and-autumn-st...
2015-documents
https://www.gov.uk/government/publications/spending-review-and-autumn-st...
2015-documents
4. Department of Work
and Pensions. Fitness for work: the Government response to ‘Health at work – an
independent review of sickness absence’. London: Department of Work and
Pensions; 2013. https://www.gov.uk/government/publications/government-response-to-
the-review-of-the-sickness-absence-system-in-great-britain
the-review-of-the-sickness-absence-system-in-great-britain
5. National Institute
for Health and Care Excellence. Workplace health: management practices London:
National Institute for Health and Care Excellence; 2015.
6. The Chartered
Society of Physiotherapy. Self referral. 2015. http://www.csp.org.uk/professional-union/practice/self-referral
7. Health and Safety
Executive. Work Related Musculoskeletal Disorder Statistics (WRMSDs) in Great
Britain 2014/15. London: Health and Safety Executive; 2015. http://www.hse.gov.uk/statistics/causdis/musculoskeletal/index.htm
8. The Chartered
Society of Physiotherapy. Physiotherapy works - the evidence. http://www.csp.org.uk/professional-union/practice/your-business/evidence...
9. The Kings Fund.
Disease and Disability. http://www.kingsfund.org.uk/time-to-think-differently/trends/disease-and...
10. The Chartered
Society of Physiotherapy. Association of Chartered Physiotherapists in
Occupational Health and Ergonomics. 2015. http://www.acpohe.org.uk/
11. The Royal College
of Physicians. Work and wellbeing in the NHS: why staff health matters to
patient care. London: Royal College of Physicians; 2015. https://www.rcplondon.ac.uk/guidelines-policy/work-and-wellbeing-nhs-why...
12. NHS England. Five
Year Forward View. London: NHS England; 2014. https://www.england.nhs.uk/ourwork/futurenhs/
13. The Kings Fund.
Long term conditions and multi morbidity. http://www.kingsfund.org.uk/time-to-think-differently/trends/disease-and...
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