Musculoskeletal conditions are the second biggest cause of absenteeism in the UK representing 28.2 million working days lost per annum. Current literature suggests that work issues are generally insufficiently addressed in primary healthcare and there is little evidence that evaluates any existing workplace interventions in this setting.
To address this issue locally, North West Boroughs Healthcare Physiotherapy Service is developing a new work and health pathway, 'Work Wise', to assist patients to remain in or return to work. An element of the pathway is the development of a website to provide accessible supportive resources and signposting material.
To inform website design and content we have undertaken extensive engagement with patients, public and employers and we wish to present our findings to assist the development of other initiatives in this important area.
A variety of platforms were used to collect a range of feedback including surveys, focus groups and individual interviews. Two separate surveys were launched and ran for 4 weeks, one aimed at patients and public, the second aimed at employers. Surveys were promoted on social media, local press and via local organisations.
To engage with employers, the local council business liaison manager publicised our survey to local employers. Focus groups, individual interviews and staff engagement added more in depth views, opinions and lived experience. This feedback was then triangulated and themed to inform website development.
In March 2019 we collated 200 patient and public surveys, 14 employer surveys, carried out 2 focus groups and 1 in-depth interview with a patient insight partner. The results were analysed and collated into 6 main themes. These were; advice on workplace assessment and equipment; discussion of MSK conditions with managers and colleagues; work based exercises and self-help guidance to remain in work or return to work; reasonable adjustments in work; managing stress and the emotional impact of pain and signposting to other services and organisations. These themes were used as the topic areas for the website content.
Digital resources are an essential component in healthcare. Collaborating with patients is vital in development of such resources to ensure they are an effective adjunct to patient care. Work Wise supports the NHS long term plan to improve digital health tools. The feedback demonstrates that patients, staff and employers view this as a valuable resource to assist in the management of musculoskeletal conditions that are affecting people at work and that they would be happy to access this information digitally.
Extensive patient engagement has informed the content of the website and will help with other websites designed to assist people with musculoskeletal conditions who are having work related issues. Engagement is important to ensure the website content is relevant to users and that information is delivered in a way that maximises its impact on the people accessing it. By accessing this resource early it is possible that patients will be more likely to stay in work, or make a more timely return to work with a musculoskeletal condition.
Top three learning points
Work Wise is one of 19 initiatives across the UK selected to receive funding from the Work and Health Challenge Fund. The Work and Health Challenge Fund aims to test potential solutions which help people with disabilities and health conditions to remain in work. The Work and Health Challenge Fund is part of a wider Innovation Fund managed by the Work and Health Unit.
The joint Work and Health Unit was set up by the Department for Work and Pensions (DWP) and the Department for Health and Social Care (DHSC).
This work was presented at Physiotherapy UK 2019
For further information about this work please contact Ruth Sephton.
(1) Office of National Statistics (2017) Sickness absence in the UK Labour Market. https://www.ons.gov.uk
(2) Bishop, A., Wynne-Jones, G., Lawton, S.A., Van der Windt, D., main, C., Sowden,G., Burton, A,K., Lewis, M., Jowett, S., Sanders, T., Hay, E.M. and Foster, N.E (2014) ‘Rationale, design and methods of the Study of Work and Pain (SWAP): a cluster randomised controlled trail testing the addition of a vocational advice service to best current primary care for patients with musculoskeletal pain (ISRCTN 52269669)’ BMC Musculoskeletal Disorders, 15: 232
(3) Hutting, N., Oswald, W., Staal, J.B., Engels, J.A., Nouwens, E., Sanden, M. and Heerkens, Y.F. (2017) ‘Physical therapists and importance of work participation in patients with musculoskeletal disorders: a focus group study. BMC Musculoskeletal Disorders, 18:196 DOI 10.1186/s12891-017-1546-9.