Case Study - Pilot of fast track physiotherapy service for NHS staff

Winchester and Eastleigh Healthcare NHS Trust

Amanda Hinkley, Head of Occupational Health and Safety

What we did

Piloted a Fast Track physiotherapy service for staff, collected data on cost benefits and made a case to the Trust Board to formalise the service

Background

NHS Staff who suffer from musculoskeletal symptoms are likely to consult with their GP and typically wait for 4 weeks to be assessed following the GP referral to Physiotherapy.

Access to early intervention for mental wellbeing and musculoskeletal services aims to keep staff at work and assist those who are at work but symptomatic to make a quick recovery to full capacity.

From Jan 2006 to January 2008 a Fast Track Physiotherapy Service (FTPS) for staff was provided within the Trust. Following a Trust review of Occupational Health and Safety, a decision was made to fund only core services and the staff FTPS was discontinued.

In July 2010, we decided to reinstate the service as a pilot with the expectation that data would be collated on the benefits (reduction in absence), costs of service provision, divisional utilisation and types of musculoskeletal symptoms treated. Therapy Services agreed to run the service and risk an over spend of the department. A report would then be submitted to the Trust Board.

The approach

We developed the following referral process:

  • Following attendance at Occupational Health Service (OHS) (appointments normally within 48 working hours), if the member of staff is referred to Physiotherapy (appointments normally within 10 working days)
  • Access to treatment is for acute or recent injuries. Chronic conditions are unlikely to benefit from this short term treatment facility, therefore, staff generally would be advised to see their own GP
  • The Back Care Advisory Team are involved if a need for work related ergonomic or back care assessment or advice was identified by the OH Adviser or Physiotherapist
  • OHS provide advice on fitness to work and staff sign to agree to the referral and to comply with the attendance criteria
  • Occupational Health or the Physiotherapist can refer staff for a 3 month subsidized membership at the onsite gym
  • A discharge form is sent from Physiotherapy to OHS and a client satisfaction questionnaire is given out at the last treatment session.

The outcome

We measured the recorded musculoskeletal absence on the electronic staff record (ESR) before the fast track service between July and December 2009 and then again after implementation of the fast track service between July and December 2010. The key results were as follows:

  • Reduction in Trust musculoskeletal absence recorded on ESR Comparison between July - Dec 09 (without FTPS) and July - Dec 10 (with FTPS) of 15.7%
  • 24 of the 86 staff who were referred by occupational Health to physiotherapy (between 1st July and 31st December 2010) reported access to the treatment prevented them taking absence
  • All staff contacting Occupational Health for assessment for referral to Physiotherapy were offered an appointment within 2 working Days.
  • 85 staff referred by Occupational Health to Physiotherapy were offered an appointment within 10 working Days.
  • The average wait for physiotherapy via the GP would be a minimum of 4 weeks and thus FTPS saved the Trust 4 weeks absence. Based on mid range salary + 20% on costs for these staff this equated to a minimum of £84K.
  • Reduction of indirect costs of absence and staff turnover through backfill with bank and agency.

The paper was presented to the Trust Executive Management Committee in February 2011 and the proposal for continuation of this service via Divisional funding was endorsed. 

The difference

Comments from the evaluation forms summarise the value of the service:

“A very useful service for staff. If it wasn’t available may have meant taking time off sick… A valuable service for staff, nice to feel that someone cares about NHS workers”

"Because of this service I have not had to take time off to travel to appointments in my local health area, Also due to advice given I have been able to continue working without taking time off”

“I am very grateful that we have this service. I had a bulging disc which was treated very quickly and effectively by the Physiotherapy department. Without this service I would have been off sick”

“It was very helpful to be able to access this at a convenient time, the service and staff were very pleasant and always caring”

For additional information please contact: amanda.hinkley@hhft.nhs.uk.

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