Fit4Work@OASIS - Portsmouth Hospitals NHS Trust

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case-study

06 / 03 / 2012

The organisation

What we did and why

How we did it

Results and next steps

Tips for other trusts

Contact details

 

The organisation

Treating 650,000 people, the state-of-the-art Queen Alexandra Hospital opened in 2009, after ten years of planning, offering patient facilities that are amongst the best in Europe. Whilst the acute services are located at the Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust continues to provide outpatient facilities on Portsea Island at St Mary’s Hospital and also at Gosport War Memorial Hospital, alongside other services provided by Primary Care Trust NHS partners.

What we did and why

The Fit4Work@OASIS program was developed following recommendations made as part of the Boorman Review. As a flagship NHS Plus innovation site, the trust wanted to approach the issue of long-term sickness absence and ill-heath prevention from a different perspective, enabling an earlier return to the workplace through the use of physical activity.

Maintaining contact with the workplace, and keeping to the routines that this can provide has been demonstrated to dramatically improve the long-term mental health of individuals undergoing rehabilitation.
As a responsible employer, Portsmouth Hospitals NHS Trust continually evaluates its sickness absence figures and looks at what can be done to support individuals going through this often difficult period. Referring staff with a musculoskeletal issue or stress immediately to the occupational health team was already in place.

Fit4Work was identified as a more proactive step to reduce absence and improve the well-being of staff. The program and its various elements were designed to meet the needs of the individual first, establishing the infrastructure and funding after the plan had been created.

Once statistically validated data is available, the trust plans to publish the findings, to enable other employers to follow an evidence-based program that has been created and evidenced to improve the long-term health and well-being of NHS staff and ultimately the patients they care for.

How we did it

Three trust clinical service centres that were striving to meet their sickness absence targets were identified as being suitable participants for the pilot. This maximised the potential benefit to the trust and employees, and provides significant data for the pilot.

For the purposes of this program, exercise referral is defined as 'the referral of a client by an occupational health practitioner, human resources representative, or manager, to this service for the purpose of providing an assessment and subsequent exercise rehabilitation program as part of the management of a return to work schedule to the mutual benefit of the employee and employer'.

The formal referral process identifies exercise as a key component for achieving a client’s long-term goals, whilst managing their ‘condition’ with the aim of improving or reducing the rate of its progression and achieving an independent and sustainable increase in physical activity. This may or may not include additional physical activity recommendations.

Clients entering the scheme are seen by a fast track assessment practitioner, normally within five working days, to carry out a full physical and functional assessment, issuing a report and feedback to both the client and the employer making the return to work much safer. The report includes a summary of current and / or long standing issues, advice on what changes may be required in the workplace and at home, in addition to prescribed exercises and rehabilitation advice.

The post assessment report may also include an advisory referral. This might involve treatment from one of our therapists, referral to a specialist, or referral into the Fit4Work@OASIS Program. A start date can be scheduled within the week (course dependent).

The program is designed to help build employees confidence and fitness, whilst removing many of the return to work barriers, allowing them to return to the workplace and to stay at work without further injury.

The progressive exercise and work conditioning programme includes aerobic exercise, medical exercise rehabilitation, body conditioning, ‘work hardening’ and education sessions. Training in optimal postures and body mechanics are essential parts of the programme. Attendees are constantly assessed throughout the classes to ensure progressive rehabilitation is achieved. Upon completion, an exit strategy is formulated, and fed back to the referring professional. This may include, for example, an agreed sustainable activity plan, or, if necessary, re-entry into the program.

Working in this manner ensures that the most suitable people are employed to carry out each element of this specialised care program, delivering a quick recovery through seamless teamwork, and close management. 

Additionally clients are offered the opportunity to use the OASIS Personal Training service.

Results and next steps

At present the program is in its pilot phase. Whilst it is too early to produce meaningful figures, the feedback from individuals taking part has been very positive, often accompanied by a dramatic improvement in their well-being.

Several mechanisms will be used to capture the data from the pilot. In addition to information on the Electronic Staff Record (ESR), continuous ongoing assessment by the trainers and entry and exit questionnaires covering both mental, physical and perceived health, will be used. This will allow effective comparison with data provided by occupational health.

Tips for other trusts

A purpose built gym is nice but not essential. A quiet period in a meeting room with some basic equipment can get you started.
  • The expertise to establish a program like this is already in most trusts, coordinating the right people together with the shared goal of improving the health and well-being of their staff can bring great rewards for all concerned.
  • Contact details

    Mr Marcus Nash

    Manager - OASIS & Trust Wellbeing Lead

    marcus.nash@porthosp.nhs.uk

    Mr Brian Griffiths

    Specialist Practitioner Occupational Health

    brian.griffiths@porthosp.nhs.uk 

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