Enabling Life Potential through Vocational Rehabilitation “a process that enables people with...

Enabling Life Potential through Vocational Rehabilitation

• “a process that enables people with functional, psychological, developmental, cognitive and emotional impairments or health conditions to overcome barriers to accessing, maintaining or returning to employment or other useful occupation."


Worklessness and not disease is the biggest

cause of health inequality, social exclusion,

deprivation , and mortality


• All services should be aimed at maximising functional capacity of the working age population – physical, mental, social, spiritual

• It is not their diagnosis that is important – its what they can do!

• AHP’s crucial in delivering vocational rehabilitation services in Scotland

Enabling Life Potential through Vocational Rehabilitation - Healthy Working Lives Policy Review

• promote the health, safety and well-being of employees in the workplace; to help employees who become ill or injured to retain work; to provide access to services to enable movement towards work for those out of work as a result of illness or injury; to promote the benefits that work has for most people; to encourage all stakeholders, including employers, employees, healthcare professionals, employability advisers and trades unions, to recognise the benefits of work for health and their role in maximising the ability of working age people to retain or gain paid or unpaid employment.

• AHP’s critical to its success!

Enabling Life Potential through Vocational Rehabilitation - Healthy Working Lives Policy Review

•Redesigning the Client Pathways’.

Mapping current services and client pathways to work;Recommend improvements in provision of, and links between, services that move people towards work;Identify gaps in provision of relevant services and recommend how these can be addressed.


Dame Carol Black - • prevention of illness and promotion of health and

well-being;• early intervention for those who develop a health

condition; and• an improvement in the health of those out of work

– so that everyone with the potential to work has the support they need to do so.


Only 3%-15% of companies in the UK have access to Occupational Health support services – inequalities in access

Access to general services which are too ‘downstream’ from the workplace - delayed loosing valuable time

SME Sector (where the majority of people work) – few have access to any kind of Occupational Health Support

Poor links between employers and primary care Sick-notes state what an employee cannot do work

rather than indicating what work tasks they can do


• 48% of work related problems in Scotland of MSK origin

• UK – 12.25 million work days lost due to MSK problems

• Costs £141 million just for GP consultations


• In Scotland there are over 275,000 Small & Medium sized Enterprises (SMEs) providing approximately 54% of all jobs. It is estimated that £10 billion is lost annually through working age ill health in terms of days lost and worklessness. It is known that 2.5%-3.5% of workers leave the workplace each year through ill health. Approximately 60,000 people make a new Employment Support Allowance claim each year in Scotland.

Developing a Vocational Rehabilitation Service

for Small and Medium Enterprises in a Health Board area

- launched 12 February 2008

Working Health Services Dundee

Hotline

01382-825100

Working Health Services Dundee - Referral process

Individual

Hotline 01382-825100 - Telephone interview conducted

Information passed to local Case Manager

Case Manager assesses information and directs individual onto a pathway of care and eventual discharge

Ergonomists

Physiotherapist

Occ TherapistCounsellor

H&S Practitioners

Occ Health Nurse/Adv

Occ Health Physician

Occ Hygienist•Access to local services e.g Relate, Debt Counselling

GPs

Line Managerraise awareness


Under the auspices of the NHS - free and confidential

Case management model Multidisciplinary team Early intervention Easy to access service 01382-825100 Aimed at Small and Medium Enterprises Occupational Health support, Health and

Safety, Health Promotion, support through the HWL Award programme


• A proposed new Fit for Work service, based on a case-managed, multidisciplinary approach, would provide treatment, advice and guidance for people in the early stages of sickness absence.

• Proposal for a Scottish Fit for Work National Service


• The pilot seeks to build upon the national Condition Management Programme structure whilst complimenting the strategic approach undertaken by the Scottish Centre for Healthy Working Lives.

• enhance it by providing an additional service aimed exclusively at providing personalised return to work support for sickness absentees.

• Incorporate the work of the 3 pilots.


• Add Vocational Rehabilitative Fit for Work Services to existing CMP teams

• Existing Vocational Rehabilitation pilots in East of Scotland continue, joined by CMP led FFWS providing full Scottish national coverage.

• Case Management CBT approach encompassing full bio-psychosocial model

• Focus on return to work tailored programmes to return sickness absentees.


• Scottish Centre for Healthy Working Lives (SCHWL) acting as hub and referral gateway.

• SCHWL expand support role via info/advice provision for both health professionals and “clients”

• SCHWL use network to roll out attendance management module to SMEs

•


• Pathway – GP onto orthopaedic waiting list. Many centres in Scotland patients screened by ESP’s within acute centres.

• National UK data identifies this pathway resulting in up to 70% not requiring surgical intervention.

• What does this mean for the patient? Sickness absence? Psychological problems? Reduction in functional capacity? No active management!


A Community Based Multi-professional Triage Team / Orthopaedic Assessment Service (OAS) – PT’s and GPwsi

A centralised referral management system – NHS 24 physiotherapy tele-health service?

All AHP musculoskeletal services to be delivered within a single system

All return clinic appointments following surgery seen by AHP MSK team

CommunityAHPMSK

Services

Integrated MSKTeam

PhysiotherapyPodiatry

OTDietician

ProstheticsRadiography

Specialist nurseGPwsi

Self Referral via NHS 24

Self management and advice through NHS 24 web base for rehabilitation

GP Referral

Walk in Self Referral

Electronic Referral

Vocational Rehabilitation

Services & Chronic Pain Services

Orthopaedicwaiting list

Rheumatologyservices

Other acute services

Electronic Referral

GP Referral Electronic Referral

NHS 24 – Enhancing the MSK pathway

Vocational Rehabilitation

join a collaboration to develop education and training relevant to this vocational rehabilitation agenda

Develop a vocational rehabilitation community of practice

Enabling Life Potential through Vocational Rehabilitation “a process that enables people with...

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