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Physiotherapy provision helps Trust save £491,504
Background
As the NHS Trust responsible for overseeing the care of one of the largest counties in England, the Lancashire Care NHS Foundation Trust (LCFT) provides vital health and wellbeing services to a population of approximately 1.5million people across more than 400 sites.
In addition to providing a wide variety of services, including community nursing and children and young people’s wellbeing, the Trust specialises in delivering secure, inpatient and community mental health services.
With many vulnerable patients in their care, it is vital that LCFT’s employees remain as fit and healthy as possible in order to deliver its high-quality services without delay. Because numerous roles within the Trust require its employees to carry out physically-demanding tasks, and with the most recent data published by the British Medical Journal (BMJ) indicating that 22% of all sickness absence within the NHS is due to musculoskeletal conditions, minimising the risk of musculoskeletal disorders (MSDs) among its employees was of particular importance.
LCFT already provided its employees with access to a range of services designed to safeguard their health and wellbeing but wanted to increase this provision to include fast access to an effective physiotherapy service in order to protect staff against the risk of MSDs.
As a result, LCFT entered into a partnership with occupational physiotherapy provider Physio Med, a company with a proven history of helping employees of large organisations including a number of NHS Trusts. Physio Med was employed to provide its blended physiotherapy service to encourage quicker recovery, quicker return to the workplace and improved productivity levels among LCFT’s employees.
Brief
LCFT is one of the largest employers in the region, with approximately 7,000 staff. Its dedicated Health and Wellbeing service is made available to all its employees to encourage and support them to improve their physical and mental health, with services on offer including access to physical and occupational health support and an employee assistance programme offering access to confidential telephone counselling.
A consequence of the number of physically demanding jobs within the Trust is that employees within certain roles are at risk of suffering musculoskeletal disorders (MSDs). Nursing and healthcare workers, for example, are particularly prone to suffering MSDs as a result of, or exacerbated by, moving and handling tasks.
With access to NHS physiotherapy via GP referral taking up to 14 weeks (National Survey, 2015), those suffering from MSDs were often forced to work at reduced levels of productivity while waiting to access treatment or absent from work entirely for prolonged periods. As a result, and because medical evidence has proved that early physiotherapy intervention on musculoskeletal injuries can prevent acute conditions becoming chronic, the Trust decided it needed to find a way to support its employees in quickly accessing quality physiotherapy treatment in order to:
- Reduce MSD-related employee discomfort and pain levels
- Minimise associated absence and facilitate an early return to work
- Improve productivity
- Reduce the risk of further absence due to the recurrence of MSDs
With LCFT employees working at more than 400 sites across Lancashire, the provision also needed to be flexible enough to meet their needs regardless of their geographical location.
Solution
In April 2017, Physio Med began working with the LCFT to implement its award-winning blended model of physiotherapy services. The Physio Med service provides fast-track access to treatment, supporting staff health and wellbeing, improving productivity and reducing sickness absence.
Any employee that suffers a musculoskeletal injury or disorder is referred to Physio Med by their manager before being contacted by a member of the Physio Med team for a telephone triage, within as little as two hours and a maximum of four, to ensure they are appropriate for treatment.
All appropriate referrals then receive an initial assessment within a maximum of three days, with acute conditions going through Physio Med’s award-winning Physiotherapy Advice Line (PAL) service and chronic injuries being referred directly to the face-to-face (F2F) service via Physio Med’s handpicked network of 780 clinics.
The PAL initial assessments are carried out over the phone by a Senior Chartered Physiotherapist and comprise a series of evidence-based clinical questions and a series of movements designed to facilitate diagnosis. The employee is then advised on the best way to self-manage the condition and assist the physical healing process. This includes:
- A bespoke exercise programme created for the individual by the physiotherapist to speed up healing, communicated via comprehensive video exercise files so they can be easily accessed via a computer, smartphone or tablet at their convenience
- Relevant advice regarding their work station, lifestyle, medication, posture and methods of symptomatic relief
- Realistic advice on modifying the working day to accommodate the injury.
Employees referred directly for F2F treatment receive an appointment within an average of 2.7 days at one of Physio Med’s practices. With a vast number of practices to choose from, employees can select the one most convenient for them, enabling LCFT to increase productivity while also allowing its employees to use their time more effectively.
Outcome
In the 12-month period between April 2017 and March 2018, a total of 226 cases were progressed by Physio Med, with 50% being referred direct for face-to-face (F2F) service, 49% being referred into the blended PAL and F2F service, and 1% being referred for an ergonomic assessment.
Initial PAL assessment appointments were offered in just 1.5 working days, while initial F2F assessment appointments were offered in 2.7 working days.
33 employees referred were absent from work due to their condition at the point of referral, while the remaining 193 were at work with pain and therefore operating at reduced productivity levels, highlighting the hidden cost of presenteeism.
Employees discharged from the F2F service received an average of 4.4 sessions each, including the initial assessment.
Of the 208 employees discharged from the service, only 12 (5.7%) remained off work following treatment and there was a reported average pain reduction of 56.5% (from 6.9/10 to 3/10). Additionally, there was a reported improvement in productivity and function in real terms of 33.5% (from 51.5% to 85%), equating to 1.7 days pp/pw working a five-day week and resulting in an overall increase of 65%.
196 (or 94%) of the 208 employees were successfully rehabilitated back into the workplace.
In financial terms and based on the average daily cost of a Trust employee being £100.00, the Physio Med service has delivered significant returns to the LCFT:
- The improved productivity and function multiplied by the days saved in not waiting to access NHS treatment delivered a total estimated saving of £491,504 over the 12-month period
- This equates to an ROI figure of 13.8:1
Physio Med also reports back to the Trust on a host of additional criteria, such as anatomical injury site, referring locations and job roles, identifying trends to help the Trust put practices and measures in place to reduce future injuries and issues.
An LCFT spokesperson said: “The health and wellbeing of our staff is of utmost importance, so we wanted to give them the best possible chance of recovering more quickly and safely from MSDs. By working with Physio Med, we’ve supplied our employees with access to a physiotherapy service which is effective and flexible enough to meet their needs, regardless of where they live; they can now receive advice over the phone incredibly quickly and get exercise plans and videos sent direct to their smartphones and computers, or visit a practice of their choice if face to face treatment is necessary. As a result, we’ve seen a significant reduction in MSD-related sickness absence and we’ve also been able to help staff return to full health – and return to work – much more quickly.
“The Physio Med service has also enabled us to make fantastic cost savings which, in turn, have allowed us to do more with the money available to us. Needless to say, we’ve been very impressed with the results it has delivered and would recommend the service to other NHS Trusts.”
