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Early Intervention Physiotherapy. Brendan McConaghy Lead Physiotherapist Occupational Health Belfast Trust. A look at the Size of the problem. Sickness absence rates at April 2013 = 5.5% Costing the Belfast Trust £4.1million for MSK absence alone. Whats the evidence for a solution?.
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Early Intervention Physiotherapy Brendan McConaghy Lead Physiotherapist Occupational Health Belfast Trust
A look at the Size of the problem • Sickness absence rates at April 2013 = 5.5% • Costing the Belfast Trust £4.1million for MSK absence alone
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
Securing the funding • Accessing and influencing the right people • Chief Executive • Directors • Senior HR managers • Union Reps • Employees
Previous level of function Needed level of function Current level of function
Pain level Further exposure Time
From this … • … to this.
Assessment • Functional assessment
Process optimisation • Emailed referrals • Rapid assessment • Clinician typed reports • Emailed reports in under 48hrs • Rapid access to treatment
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
Some funding challenges were overcome • SPCS selected as they had the most costly MSK sickness absence £1.14million
Outcomes • 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
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?