Brendan McConaghyLead Physiotherapist Occupational Health

Belfast Trust

EARLY INTERVENTION PHYSIOTHERAPY

• Sickness absence rates at April 2013 = 5.5%

• Costing the Belfast Trust £4.1million for MSK absence alone

A LOOK AT THE SIZE OF THE PROBLEM

WHATS THE EVIDENCE FOR A SOLUTION?

• Black Report 2008

• Boorman review 2009

• Frost- Black report 2011

• York Teaching Hospital- Savings of £1.2million/ year

• Staffordshire County Council- Savings of £100,000/ month

• Orthopaedic hospital Trust in Oswestry- 1200 employees saved £250,000

• Accessing and influencing the right people

• Chief Executive

• Directors

• Senior HR managers

• Union Reps

• Employees

SECURING THE FUNDING

The Core Principles

EDUCATING AND CHALLENGING NEGATIVE BELIEFS

WORK IS GOOD FOR YOU!!!!

Current level of function

Previous level of function

Needed level of function

BIOPSYCHOSOCIAL MODEL

Pain level

Time

Further exposure

• From this … • … to this.

• Functional assessment

ASSESSMENT

MAKING CHANGES TO THE PROCESSES

• Emailed referrals

• Rapid assessment

• Clinician typed reports

• Emailed reports in under 48hrs

• Rapid access to treatment

PROCESS OPTIMISATION

• Immediate emailed referral on commencement of sick leave

• Appointment in 5 working days

• Emailed report within 48hours

NIAS TRIAL • 12 week trial of Early Intervention Physiotherapy.

• Resulted in reductions in average time on sick leave by 48%

• Saving £3.58 for every £1 spent

• Led to NIAS funding of 1WTE Physiotherapist to provide service for 1200 employees

BELFAST TRUST TRIAL

• Some funding challenges were overcome

• SPCS selected as they had the most costly MSK sickness absence £1.14million

• 275 individuals were referred over the 6 month period

• 31% were on sick leave

• 35% compliance

• Average time to referral of 16 days

• Average waiting time of 6 days

• The process sped by 12 days

OUTCOMES

• Reduction in number of episodes of MSK sick leave of 12%

• Acute directorate fell by 0.5%

• Reduction in MSK days lost of 14.8%

• 17% rise in MSK absence in Acute Services

• 3.6% reduction in total days lost within SPCS for all conditions

Reduction in cost of MSK sickness of an estimated £49,928 during trial period £99,856 per year

ROLL OUT

• Calculations based on analysis of SPCS trial data indicates that a ratio of 1 Physiotherapist: 3000 employees is needed

• 6.5 Physiotherapists would be needed for the Belfast Trust (currently have 5wte)

• Secured the opportunity to present at the Executive Team meeting

• Gained agreement for £136,684 funding to recruit 3.25 wte mid- point Band 6 physiotherapists and 1.0 mid- point Band 3 clerical officer.

• If reductions in days lost made in SPCS trial can be replicated across the Trust there would be a saving of £615,000 per year.

• If NIAS saving can be replicated there is the potential for savings of £1.96million…

CHALLENGES AHEAD

• In March 2014 the OH physios were pulled from OH into core.

• On-going funding issues hindering recruitment of full quota of physiotherapists.

WHERE ARE WE NOW?

• Rolling out in the Belfast Trust

• Monthly monitoring and service improvement

• Region wide roll out?

ANY QUESTIONS?