Occupational Health Physiotherapy Service for Trust staff

Find out how Oxford Radcliffe NHS Trust built on its existing occupational health physiotherapy service and developed and trailed a face-to-face musculoskeletal triage service. The triage service has shown that a physiotherapist can work alongside the more traditional members of the occupational health team and provide a valuable service in relation to musculoskeletal disorders.

The organisation has benefited from having staff treated at the workplace, plus a reduction in sickness absence from early intervention. By identifying and targeting areas of high injury risk in the workplace, there is the potential to reduce litigation.

• The organisation
• SHA region
• Project dates
• Project context
• What we were trying to achieve and how
• What are the results
• Further information

The organisation

Oxford Radcliffe NHS Trust is one of the largest acute teaching hospital trusts in the UK. It provides a wide range of general and specialist services from three hospitals. At the end of 2006/7, the Trust employed 9,356 people, provided around 1,436 beds, and had a turnover of £484 million.

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SHA region

South Central

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Project dates

• The occupational health physiotherapy service was developed in 1996.
• The face-to-face musculoskeletal triage service was developed in September 2006 - to date.

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Project context

The government White Paper 'Choosing Health' identifies improving workplace health as priority. Sickness absence in the UK costs up to £30 billion per year. A government survey of 'self-reported work-related illness in 2001/02' estimated that over a million workers in Great Britain believed they were suffering from a musculoskeletal disorder that was caused or made worse by their work.

Musculoskeletal disorders account for 60 per cent of sickness absence and evidence shows that the longer people are off work with musculoskeletal injuries the less likely they are to make a successful return to the workplace.

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What we were trying to achieve and how

In 1996 an occupational health physiotherapy service was set up for Oxford Radcliffe NHS Trust staff. The service was developed to provide easy and rapid access to specialist occupational health physiotherapy. :

In 2006 the service was expanded and a face-to-face musculoskeletal triage service was developed and trialled. The aims of the occupational health physiotherapy (OHP) service are to:

• provide staff with fast, evidence-based advice
• provide staff with easy access to advice and treatment
• ensure staff can return to work as early as practicable
• ensure a safer return to work
• assess work of members of staff and look at the likely risks
• provide ergonomic advice and recommendations
• reduce serious injury
• reduce chance of injury recurrence
• reduce time off work
• reduce chance of litigation.

Advice is provided by physiotherapist who is familiar with the working practices of the hospital and who can arrange to make a workplace visit to help reduce any recurrence.

Staff self-refer and are given advice or exercises to self-manage their problem, they can also continue to access the treatment service if the problem persists.

Staffing for the service includes:

• 0.5 WTE Senior I Physiotherapist
• 1 WTE Senior II Physiotherapist

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What are the results

The triage service has shown that a physiotherapist can work alongside the more traditional members of the occupational health team and provide a valuable service in relation to musculoskeletal disorders. An audit of this service is currently being undertaken.

Cost savings come about because of reduced sickness absence; the service does this in several ways:

• by treating the problem, the reduction in sickness absence comes from treating the injury or condition early and keeping the staff in work or returning staff to work
• by treating the problem rapidly, research has shown that if treatment is delayed the patient is less likely to recover completely and take longer to return to work. There is a two-fold benefit from having a rapid, on-site response
• by being proactive, a monthly 'Positive Back Care' session uses the latest evidence to improve attitudes towards back pain, which is one of the biggest causes of sickness absence from work
• by working as a team, close liaison occurs between the manual handling advisors, risk management, health and safety, human resources and the occupational health physiotherapy service. Policies and procedures for the trust are discussed at regular meetings and strategies for tackling ill health at work are formed, and all parties are actively involved
• by improving the workplace, the occupational health physiotherapy service has one physiotherapist with ergonomics training. Recommendations are made to improve the working environment, thus helping prevent a recurrence of the problem and potentially prevent co-workers developing similar problems
• on-site physiotherapy eliminates travel time away from work, staff are seen on-site and can therefore return to work immediately
• by boosting staff morale, there is growing evidence to suggest that psychosocial factors play a significant role in both musculoskeletal problems and other causes of lost days. Fast access to treatment, reduced pain and feeling valued will reduce stress and encourage a feeling of well-being.

A patient satisfaction survey of the hands-on treatment service was carried out on staff that had accessed the service. The results showed that:

• 100 per cent of staff were satisfied with the waiting time for appointment.
• 48 per cent of staff were very satisfied and 43 per cent satisfied with the treatment received.
• 65 per cent of staff rated the results of their treatment between 75-100 per cent
• 71 per cent of staff that were off sick at the time of their appointment felt they had a quicker return to work due to use of the occupational health physiotherapy service
• 75 per cent of staff that were still in work at the time of their appointment felt that the OHP service had helped them stay in work.

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Further information

For further information about this project please contact:

• Julie Kelly, Senior Occupational Health Physiotherapist, Oxford Radcliffe Hospitals NHS Trust, Julie.Kelly@orh.nhs.uk