Transcript Executive Meeting - Department of Health, Social Services

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
The Core Principles
EDUCATING AND CHALLENGING NEGATIVE
BELIEFS
WORK IS GOOD FOR YOU!!!!
Previous level
of function
Needed level
of function
Current level
of function
BIOPSYCHOSOCIAL MODEL
Pain level
Further exposure
Time
• From this …
• … to this.
ASSESSMENT
• Functional
assessment
MAKING CHANGES TO THE PROCESSES
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
BELFAST TRUST TRIAL
• 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 midpoint 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?
ANY QUESTIONS?