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Physiotherapy works: Occupational health

File 118891Physiotherapy is clinically and cost effective at keeping people at work or helping workers return quickly after sickness absence.

Size of the problem

  • Sickness absence costs the UK around £15 billion annually in lost economic output(1)
  • £13 billion is spent on health related state benefits(1)
  • In the NHS almost 40% of staff sickness absence is due to musculoskeletal conditions, e.g. back pain(6)
  • 5% of sickness absence becomes long term, lasts over four weeks and accounts for almost half of the total working days lost each year(1)
  • There is an 80% chance that if absent for six months an individual will be out of work for five years(6)

The Frost-Black report, a government sponsored review of avoidable sickness absence at work, promotes the idea of early access to occupational health,(1) this includes specialist physiotherapy services.

Building on previous independent reports,(2,3) the Frost-Black review discusses the human cost of worklessness and how the cost of ill health for employers in the public and private sector can be addressed.

A combination of work-focused healthcare, timely advice and an accommodating workplace is recognised as offering the best prospect of sustainable return to work.(1,3) Occupational health physiotherapy is recognised as having a key role in this process.


Employers have a legal duty to protect the health, including musculoskeletal disorders, mental health(6) and individuals who have undergone surgery.

Physiotherapists work within a strong clinical evidence base that is linked to measureable outcomes.

They support self management of common and complex health conditions and promote independence whilst considering all aspects of the patient’s life.

The benefits of work

Evidence shows that ‘good work’(7) is good for health.(8)

For most people including those with long term conditions, health can actually be improved by being in work.(1)

Occupational health physiotherapists have a role in proactively promoting health and wellbeing in the work environment.

This allows workers to avoid sickness and injury as well as the potential secondary health consequences of sickness absence or even unemployment.(7)

Case studies

York Teaching Hospital NHS Foundation Trust (1)

York Teaching Hospital Foundation Trust was losing 5.5% of total working time due to sickness absence. This amounted to an annual cost of £3.7 million.

The Trust started a project in 2008 to tackle this. By 2011 the Trust had invested £160,000 in a multidisciplinary team (MDT) including occupational health physiotherapists. This team worked in partnership with hospital managers and trade unions to help sick or injured  employees return to work.

By January 2011 absence rates were down to 3.8% and by November 2011 had reduced further to 3%. Long term absence has fallen by 72% for those off for four weeks or longer and 77% for those absent for three months.

Measured on a full-time equivalent basis there are now 54 more staff available to work with direct savings in pay costs of almost £1.2 million per year from a reduced need for bank and agency staff.

Staffordshire County Council (9)

In 2012, Staffordshire County Council contracted a private occupational health physiotherapy company to reduce their sickness absences.

This rapid access physiotherapy service begins with a telephone triage. This allows contact with the employee within 24 hours of being off work. During the call the nature of the problem is established with self management advice and exercises discussed. A face-to-face physiotherapy appointment can then arranged at a convenient time and location for the employee if necessary.

Since the start of this rapid access physiotherapy programme, Staffordshire County Council has found a reduction of 1,000 lost work days per month whichamounts to a saving of £100,000 per month.

A service to prevent sickness and injury is currently being piloted to reduce absences even further.


Work is good for the health of the working population, yet sickness absence due to common health related conditions remains significantly high in the UK.

This cost burden to individuals, employers and society can be avoided with rapid intervention.

Occupational health physiotherapists are able to provide preventative and reactive services for keeping people at work or helping workers return quickly after sickness absence.


1. Black C, Frost D. Health at work an independent review of sickness absence. . London: Department of Work and Pensions; 2011.

2. Black C, Working for a healthier tomorrow. London: Department of Work and Pensions; 2008.

3. Boorman S. NHS Health and Wellbeing Review. London: Department of Health; 2009.

4. Health and Safety Executive. Workers health and safety; employers responsibility. Health and Safety Executive 2012.

5. Association of Chartered Physiotherapists in Occupational Health and Ergonomics. What we do. ACPHOE 2013.

6. The Chartered Society of Physiotherapy. Fit enough for patients? An audit of workplace health and wellbeing services for NHS staff. The Chartered Society of Physiotherapy, 2013.

7. Marmot M. Fair society, healthy lives. (The Marmot review). Univeristy College London 2010.

8. Waddell G, Burton AK, Kendall NA. Vocational rehabilitation–what works, for whom, and when?(Report for the Vocational Rehabilitation Task Group). Norwich: TSO; 2008.

9. CTC Healthcare. CTC Healthcare Saves Council Over £300,000 in Sickness Absence Costs. CTC Healthcare 2012.

Further information

CSP Enquiry Handling Unit
Tel: 0207 306 6666


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