Making the Case for Health and Work Champions Using Health and Work Champions to ask about Work 13th June 2018 Genevieve Smyth @RCOT_Gen

Topics covered in today’s session: What are Health and Work Champions? What is the evidence for their impact? How can you develop Health and Work Champions locally?

Health and Work Champions Partnership with Public Health England. Lost opportunities to talk about the health benefits of good work Aims to create culture change in the NHS so it is routine practice for all clinicians to raise work issues In the past 18 months we have recruited and trained 60 occupational therapists across NHS Trusts in England to act as Health and Work Champions Policy drivers to embed work as a health outcome. Health and Work Champions is in both recent policy papers: Work, Health and Disability Green paper: Improving Lives (2016) https://www.gov.uk/government/consultations/work-health-and-disability-improving-lives/work-health-and-disability-green-paper-improving-lives Improving Lives. The Future of Work, Health and Disability (2017) Command paper https://www.gov.uk/government/publications/improving-lives- the-future-of-work-health-and-disability Evidence shows that being in the right work is good for health and that being out of work can have a detrimental effect on health We also know that the longer a person is out of work the more their health and well-being can start to deteriorate. Empowering health and care professionals to have an informed and supportive conversation with their patients about starting and maintaining meaningful work, as a key part of staying and keeping well. Making best use of Health and Work Champions to support this. Increasing use of the Allied Health Professionals Advisory Fitness for Work Report to relieve pressure on GPs signing Fit Notes, particularly for MSK and mental health. We want the health and welfare systems to work better together to improve the chances of those with disability or health conditions to be able to work, improving the population’s health overall.

What are the Health and Work Champions doing? Deliver a package of training about health and work to colleagues which aims to help staff: Understand the relationship between health and work Recognise the clinical potential of asking about work status Think about ways to discuss work in clinical settings Know how to refer and signpost patients for further support

Why employment? Employment is one of the most important determinants of physical and mental health Children growing up in workless households are almost twice as likely to fail at all stages of education compared with children growing up in working families PHE (2017) Health Profile for England

Why employment? Most people are in work The UK employment rate is at the highest it has been since records began. Nearly 75% of the working age population are in employment. 32% of disabled people with a mental health condition are in employment 46% of disabled people with musculoskeletal conditions are in employment

Asking, supporting, signposting: The five R’s Raise work issues with people early in the intervention pathway in a sensitive and acceptable manner Recognise the risk factors of being out of work Respond effectively to the straightforward work problems that people identify Refer people who have more complex difficulties to the appropriate specialist service Revisit work issues at intervals during the intervention

Key considerations What are some of the key considerations for remaining in or returning to work when people are… In work but their health is effecting their work? In work but on sick leave? Out of work?

Is it working? Project evaluation First phase by University of Salford: Use of pre and post training questionnaires to gauge change in knowledge, attitude and behaviour Between January and June 2017 487 NHS staff trained ; 40% AHPs; 25% doctors; 15% nurses Statistically significant improvements in attendees’ knowledge and confidence High positive impact on the Champions’ personal and professional development

Project evaluation Salford also found Health and Work Champions were doing a large amount of other promotional activities in addition to delivering the training. Barriers to the training resulting in changes in the organisations were: Trusts prioritising other tasks, time restraints, staff shortages, lack of management support If you would like copies of the Executive Summary – we have copies here and you can contact us for the full report. It is also on the RCOT website.

Project evaluation Second phase by ICF: Use of post training questionnaires to gauge change in knowledge, attitude and behaviour Site visits to Trusts to interview wide range of stakeholders about impact of project

In a three month period

Evaluation of the Health and Work Champions Programme, 2017/18 Healthcare professionals were overwhelmingly positive about the training they received from Champions, with over 80% of those responding to a post-training survey strongly agreeing or agreeing that the training was relevant to their role. Over 90% of respondents to the post-training survey felt they had come away with a stronger understanding of ‘health enhancing work’, the relationship between work and health and they felt more confident about engaging in conversations about work. Time is still a barrier.

How you can develop this locally? Project now moving to a regionally based “train the trainer” model. Will your manager support you in this new way of working? What back up and support have you got for this? What commitment could you make in terms of training others? Where would you host your training? Interested? Email cassie.fraser-shanley@rcot.co.uk by Friday 29th June. This will allow local networks to be strengthened, more responsive to local need and will make the obvious next stage for local leadership of the project.

Summary What the Health and Work Champions project is What the successful impact of the project has been How you might consider developing the project locally Genevieve.Smyth@rcot.co.uk 0207 450 5220