Fit to work

Could physios have a future preventing work absences by providing care in the workplace? Louise Hunt reports

With musculoskeletal disorders accounting for over half of work absences, and the government’s drive to improve the fitness of employees, physiotherapists have a significant chance to improve the health and wealth of the nation. So says James Bowden, physiotherapist and managing director of occupational health provider COPE, who believes there should be ‘a whole army of trained occupational health physiotherapists able to go into the workplace’. Physiotherapists already working for independent occupational health services are paving the way for more to join their ranks. At Nottingham-based COPE, for example, physiotherapy is part of a range of services, including ergonomics consultancy and occupational psychology, offered to companies. James Bowden says occupational health physiotherapists need to have a good level of expertise and be effective at giving crisp diagnoses and advice on rehabilitation programmes. Other essentials include a team-based approach to bring together different groups of staff to devise good policies for prevention and rehabilitation. ‘This can’t be managed in a void,’ James Bowden says. OH physios may also be involved in training supervisors to use tools such as Rapid Upper Limb Assessment to identify if the work environment is causing a musculoskeletal disorder. A good understanding of employment law, and of how interventions can reduce the cost of absenteeism and avoid litigation, is also vital. This involves taking on substantial responsibility. ‘Physiotherapists need to be able to provide robust advice – it might be that they have to say that a person cannot be rehabilitated,’ James Bowden adds. ‘The key element is trust between employees and employers, and their advice must be totally impartial.’ 

Case for change

He believes there is scope for physiotherapists to push for further autonomy in the occupational health sector. They are the largest professional group able to make a diagnosis for musculoskeletal disorders, yet it is normally occupational health advisers or occupational physicians who make initial assessments of employees’ needs before possibly referring clients to a physiotherapist. This needs to change, he argues. ‘Physiotherapists should be given the chance to be the first point of contact in occupational health.’ For this step change to occur, a marked expansion is needed in the number of trained occupational health physiotherapists able to assess people in the workplace.  The Association of Chartered Physiotherapists in Occupational Health and Ergonomics runs short, CSP-validated courses to ensure that appropriate standards are met, but James Bowden says more are needed if physios are to capitalise on the demand for their services. Ultimately, physios working in the sector need to be ‘much more robust in articulating how physiotherapy can reduce costs for UK plc and the public sector’, with support from their professional body and special interest groups to lobby the government and employers on the role that physiotherapy can play. ‘Move for Health,’ he concludes, ‘should not only be about getting the public moving but also about creating the opportunities for physios to move into the workplace.’
Louise Hunt

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