Caring for the carers

The government has promised more than £6 million to improve the health of NHS staff, as recommended in a major review. Joanna Lyall reports

The health of NHS professionals has come under increasing scrutiny in the past year resulting in calls for early intervention services to keep staff well and reduce sick leave.  In his NHS Health and Well-being Review, Dr Steven Boorman, chief medical adviser, Royal Mail, pointed out that the NHS lost 10 million working days a year due to sickness and called for occupational health to be given a much higher priority. ‘The health and well-being of staff should no longer be a secondary consideration, but needs to be at the heart of the NHS mission and operational approach,’ he said.  The report recommended that staff health should be included as a priority in the NHS Operating Framework and that The Care Quality Commission and Monitor should include targets on staff health. NHS commissioning organisations should only commission services from NHS providers that were demonstrably committed to improving staff health and this should be built into contracts, the report recommended. It called for national minimum service specifications for the staff health services to be provided by trusts. Reducing current levels of sickness absence across the NHS by a third would save £555 million a year and 3.4 million days – equivalent to 14,900 whole-time staff, the report pointed out.  But occupational health services were ‘inconsistent and in some cases inadequate’. ‘Many staff do not believe that senior managers or their employer take a positive interest in their health,’ the report noted.

Early intervention

The report called for all trusts to set up early intervention programmes. Health secretary Andy Burnham has accepted the report’s recommendations in full and the government has set aside £6.5 million for monitoring progress. ‘The business case for reducing sickness absence set out in your reports is unquestionable,’ he said.  The government’s response to Boorman’s recommendations states that trusts should consider ‘early access to physiotherapy and psychological counselling services’ for staff and ‘self-referral options for staff, if not already an option.’ In June the CSP will be launching a campaign to raise awareness of musculoskeletal disorders, which are the biggest health risks to physios.

Service pays for itself and saves £71,000

Worthing and Southlands hospital trust launched a physio service for NHS staff in 2005.  An analysis of the first six months shows sickness absence due to musculoskeletal disorders reduced 25 per cent and that the service not only paid for itself – saving 195 working days – but also saved £71,000. The service, provided at Worthing hospital, which is now part of  Western Sussex Hospitals trust, is run by Joyce Blundell, a band 6 physio working 18 hours a week.  ‘At the moment referrals come from occupational health, consultants and GPs but we are considering self referral, and thinking about expanding the service, which has been well received by staff, ‘ says Joyce Blundell. ‘There’s a high demand, with the largest group of users being nurses,  and we try to see emergencies within a week to 10 days.’  ‘I am often contacted  by physios who want to know how to make the business case for providing this sort of service,’ she adds. halving sickness absence for musculoskeletal disorders Gloucestershire County occupational health services introduced a physiotherapist to assess musculskeletal discorders in May 2006. The service, which costs £16,000 a year, consists of a band 7 physio working two days a week. The physio provides assessments and liaises with managers and other health care professionals but does not do hands-on treatment. The service was cited in the Boorman report for having cut average sick days for musculoskeletal problems from 13.6 to 6.8 days. Access is by referral from managers. We are reviewing services for staff and are considering self referral for physio,’ says Christopher Woon, service director for Gloucestershire county occupational health services.

Easy access

Doncaster and Bassetlaw trust piloted an open access physio service for its 6,500 staff in 2005. Staffed by Merrin Froggett, a full-time band 7 physio who has worked at the hospitals for more than 20 years, and Jim Phelan, a band 6 who works 10 hours a week, the service was made permanent in 2006, after an evaluation identified potential savings of more than £330,000.  The service operates from 8-4, Monday to Friday and 70 per cent of users refer themselves. The average waiting time for an appointment is 2.8 days and three-quarters of those treated need three or fewer sessions.  ‘Employees from all corners of the trust attend – from gardeners and laundry workers to executives and consultants – and the feedback is very positive,’ says Merrin Froggett. ‘The service is free and there are there are no exclusions, no screening and no limit on the number of treatments,’ she says. More than half the users say they would have taken time off work if the service were not available. ‘The staff who come for physiotherapy give a lot of themselves to the NHS and it’s good to give them a quality service which is convenient and accessible,’ she adds. fl

40% cut in lost days

West Suffolk hospital trust, Bury St Edmunds, was commended in the Boorman report for having achieved savings of £170,000  through a ‘system of priority referrals to a local physiotherapist for injured staff’. For a cost of £21,000 it had achieved a 40 per cent reduction in lost days through sickness absence and savings of £170,000 in the cost of musculoskeletal injuries, the report said. Originally the trust referred staff to a private physio provider but last December the service was brought inhouse, at a  cost of some £30,000 a  year. 

Further savings possible

A band 7 physio now works three days treating only NHS staff.  ‘Staff can usually get an appointment within a week and the service is very well appreciated,’ says Jenny Saunders, occupational health manager.  The new service arrangements may well provide greater savings than those quoted in the Boorman report from a 2006 audit, she believes.

Improving staff health

Boorman recommendations

  • Early intervention programmes should be available for staff in all trusts
  • All staff health services should have self referral
  • A national minimum service specification should be introduced for staff health services
  • Every NHS board should appoint an executive director to champion staff health
  • All NHS organisations should review their funding for staff health services
  • Services should only be commissioned from organisations demonstrably committed to staff health.

Further information

Dr Steven Boorman, chief medical adviser, Royal Mail, will be speaking at the ACPOHE conference in Glasgow on May 6, and at CSP Congress in Liverpool on October 15

Joanna Lyall

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