Salus Return to Work Services (SRtWS)

1. Salus Return to Work Services (SRtWS) • Les Brockie, Case Manager • Salus Case management • NHS Lanarkshire • Tel: 01698 206367 • Email: Les.Brockie@lanarkshire.scot.nhs.uk

2. Salus Return to Work Services (SRtWS) • SRtWS provide case management services for both the working and workless populations across the UK. • 6000 clients annually • Work closely with established employability services and additional support services across the public, private and voluntary sectors. • The focus of SRtWS is to support individuals to Gain and Maintain Employment (GAME).

3. Definition of Case Management • A collaborative process with the client • Assesses, plans, implements, co-ordinates and evaluates options and services • Required to meet clients health care, educational and employment needs

4. Case Management is..... • A non clinical model • Telephone based bio-psychosocial model • In-depth, collaborative telephone assessment • This process is facilitated with the use of validated assessment tools • This culminates with the signing off of the their own Action Plan • Self-assessment process encourages clients to take control and resolve their health and work issues

5. Role of Case Manager

6. Case Management Process

7. Measuring Effective Support • Every call has a clear focus • Ensuring timely engagement in any treatments • Supporting client to maximise benefits of available support • Assessing pace of progression and capacity to advance • Post treatment assessment tools to evidence success

8. Return To Work Process • If client is reporting progress, the services / interventions continue and a ‘Return to work’ programme is agreed and put in place • If client is reporting no progress (or deteriorates) the Action Plan is reviewed and services / interventions adjusted • Signpost when appropriate

9. Case Management Interventions • Health: Physiotherapy, Occupational Therapy, Counselling, Occupational Health Nurse….. • Social Services: Drugs, alcohol, family support services, housing… • Employment: Routes to work, Careers advice, Training providers, Education… • Other Services: Childcare, Debt management, Citizens advice, Womens Aid • Diet, Health and fitness

10. Salus MCN Stroke Programme • Partnership working with NHS Lanarkshire's MCN Stroke service • Target of 50 referrals per year • Referrals received from the young stroke nurses & young stroke support workers • 78% of clients who engaged with the service last year, did so with a positive outcome (e.g. Return to Work &/ or health improved)

11. Case Study 1 – Client Background • Clientaged 51 years, lives with her husband and two teenage daughters. • Worked for 9 years in the banking industry as an Administrator. Previously worked as a Cashier, Book Keeper. • Suffered a stroke, then another one 6 years later while working as an Administrative Assistant. Paid off from there after nine months of service, “Services no longer required”. • Left leg felt heavy, weak arms, very tired and also suffered constant headaches. Did not do much, had to pace herself, lacked confidence. Forgetful and also some memory loss due to stroke.

12. Case Study 1 – Action Plan • Get help with her mobility, headaches and energy levels. Become more active. • Agreed to Bowen Therapy. • Get more involved in Voluntary Work. Contacting Voluntary Action, North Lanarkshire and Volunteers Stroke Service in Wishaw. • Get a job, join and employability programme. • Referred to Remploy.

13. Case Study 1 - Outcome • After 4 sessions of Bowen Therapy, the client revealed that after her TIA she had lost all of her memory. She could not remember her husband, children, brother and any other details prior to her stroke. As one of the other Bowen Practitioners specialises in Mind/Body Bowen (helping clients reach back to their memory banks) a request was made to extend her treatment and explore this issue. • Further sessions were granted. Since completion of her treatment, and due to the very positive results, the Bowen Therapists have been continuing engagement the client once a month, as a Bowen Case Study. • Outcomes: Mainly due to the excellent results with the Bowen Therapy, and the positive action of the client, she feels much more confident and is actively looking for employment. Her confidence levels have risen and her mobility has increased. Attached to this report is an unsolicited statement written by the client as a testament as to how she feels the Bowen Therapy has helped her move forward. She has applied for several jobs and has received one interview so far. She is willing to consider any job vacancy and is still looking at suitable voluntary work through Voluntary Action. She has engaged with Airdrie Business Centre and is hoping for a placement at Wester Moffat Hospital. • Now in full-time employment as a Home Carer having completed a training course with the company. At the same time she was also offered a short term post with a Citizen Advice Bureau which she had to decline. • Scores- PRE POST • EQ5D – 11122 VAS-70% 11112 VAS85% • COPM – 5.2 5.1 COPM – 7.2 8.4

14. Case Study 1 –Written Statement by Client 003Y 07/06/2010 • I would like to thank the Stroke Nurses and Leslie Brockie for this opportunity of receiving Bowen Therapy. I was given this treatment after having a second stroke event and I feel it has been very beneficial. • My therapies began on the 1st of March and I can say I feeling the benefit if it within hours. The benefits have been quite amazing and they have enabled me greater power in my left arm. Before I had very little movement, even to hold a hair dryer was quite painful and now I can say that drying my own hair is not quite as difficult as before. I have gained power in both arms after doing exercises. I also received Bowen Treatment in my left leg which has produced similar results. I can now walk without my leg feeling like a dead weight which is a welcome change. I was given six weeks of treatment and the difference it has made to my quality of life is excellent. • After a treatment one day I speaking to my Bowen Therapist about my memory loss and she was very interested in this. She then began to explain about a Bowen memory treatment which one of the other therapists specialised in and asked me if I would be willing to speak to her about it. I thought I would give it a go as I had nothing to lose and everything to gain. • I had the most amazing experience of my entire life. I gained a lot of memories and received mind blowing results. I could remember my early days when my mum left me with my child minder when she went to work and from what I can recall this was a pleasant experience. I could also remember living in my first home with my mum, dad and two brothers and all the details of the inside of our house, which one of my brothers verified for me. I felt lost after my mum died and left me, not being able to see her two grand-daughters grow up. I know she would be very proud of them just like me and their dad. Family members have told me to just to forget the past and concentrate on the future, but I feel I needed to know where i come from and most importantly my history my husband and my daughters.

15. Case Study 1 –Written Statement by Client 003Y 07/06/2010 • I wrote a letter to mum a couple of days after my treatment and to say it had made a difference is an understatement. The emotions I had were incredible and the tears were flowing like a river. My whole relationship with my mum was there with me when I was writing that letter and I could not understand at the time why, but after burning the letter a sense of peace and calm that I now have is overwhelming. I can remember that my relationship with my mum was real and I do not need my brothers to tell me so. From this experience I can, for some reason, feel that my relationship with my mum was special and this has given me great peace with my pat, memories of my own family and with my entire family.

16. Case Study 2 - Background • Hugh is a 43 year old male, who lives at home with his partner and teenage stepson. He also has two adult children. • Hugh had been working for the last 25 years as a Labourer with the local Council until 17 months ago, when he suffered a stroke.. This meant he was off sick, unable to work. He used to go walking, fly fishing and cycling with his son. • He was very positive about his situation and keen to explore and avenues which would help him. • Hugh stopped smoking (10-a-day) after his stroke.

17. Case Study 2 – Action Plan • Generally the aim was to improve his memory, strengthen his right side, become fitter and be more active. • Possibly get back to work • Presently only on medication and no other treatment is in place. Hugh had already received Physiotherapy and Occupational Therapy since being treated at hospital for his condition. • He agreed to Bowen therapy to improve the strength in his right side and possibly help also with cognitive thinking. • Continued with self help by using computer memory games and the WII to aid in his memory and responsive thinking. • Continues to keep fit by regular walking and exercise. To consider more activities or alternative work, explore Voluntary Work.

18. Case Study 2 - Outcome • Hugh made a phased return to work, coping and feeling good about it. • Continued with Bowen Therapy which was really helping with his movement, mobility and positive thinking. Feedback from his Bowen Therapist said “ Client had responded well treatment. He has regained full mobility to his shoulder” • Continues to keep fit by taking the family dog for regular walks and taking regular exercise. Still uses his computer to improve his computer to improve his cognitive thinking. • Hugh has returned to work full-time. He thinks his health has improved by 30% due to the Bowen Therapy. The strength on his right side, mainly arm and leg, have greatly improved. Mentally feeling much more capable. • When asked is he would recommend our service to others he said “Yes. If they want they could phone me and Iwill tell them all about it. If anyone had a stroke, go for it. People should get help early on, possibly 2 to 3 weeks after stroke. No use later. • Scores Pre Post • EQ5D – 22221 VAS 50% 21221 VAS 85% • COPM – 5.25 4.75 7.25 8.25