1. AHP Advisory Fitness for Work Report Training Welcome

2. Please complete the pre-training questionnaire. Please record your unique audit ID in your diary- you will need it again in 2, 6 and 12 months time. This project is supported by Clinical Effectiveness, R&D and the AHP Assistant Director. It is part of a research project looking at the experience of giving and receiving an AHP Advisory Fitness for Work Report.

3. Session Plan  Learning Outcomes  Aim of training.  What is Vocational Rehabilitation?  Background, Clinical and Professional Rationale.  The Equality Act.  Consent.  Advising on Fitness for Work and Signposting.  Impact.  Exploring Patient Reported Health-related Work Difficulties.  Making Recommendations and Goals.  Filling in the Report.  Creating a Digital Signature.  Storing and Data Protection.  Next steps.

4. Learning Outcomes 1.Know why and how you can perform vocational rehabilitation. 2.Understand and apply the training to your practice. 3.Be able to access, fill in and issue an AHP Advisory Fitness for Work Report. 4.Start a dialogue around training needs and service requirements.

5. Learning Activity 1: What do I want from this session? Please write down on the sticky note what you want from the session and place here....

6. E-KSF/CPD Communication Personal and People Development Keep up to date with CPD activities around vocational rehabilitation.

7. Aim of this training: To be confident in supporting a person to remain in, or return to work as part of usual intervention and correctly record this advice in the AHP Advisory Fitness for Work Report form.

8. Vocational Rehabilitation “ is whatever helps someone with a health problem to stay at, return to and remain in work. It is an idea and an approach as much as an intervention or a service” Waddell, Burton & Kendal (2008)

9. Background  Created by the AHP Federation www.ahpf.org.uk/home  Designed by 3 key partners -CSP, COT & SCP.  The AHP Report is a member only privilege.  Copyright© form.  Nationally recognised, electronic form.  Patient held.

10. NHS Grampian AHP Fitness for Work Survey 2014 (n=211)  43% had not heard about the AHP Fitness for Work Report.  75% did not know how to access it.  92% did not feel confident explaining the purpose of it.  93% did not feel confident using it in practice.

11. Survey outcomes 66% wanted a profession specific workshop on how and when to use it. 60% wanted clear guidance and protocol from NHS Grampian management team. 53% wanted dedicated time to access a learning module. 45% wanted buddying with an AHP colleague who is more confident in its use.

12. Drivers Clinical demand. 25% of adults over 16 report some form of long term illness/health problem or disability – accounting for 80% of all GP consultations. Professional accountability- if you don’t who will?

13. Political drivers & clinical improvement plans, guidelines, plus best practice. AHP National delivery plan Scottish Government’s 2020 Vision The Quality Strategy Long term conditions- specific mentions: stroke, cancer, MSK, pain, mental health. Making every opportunity count (MeOC)

14. Disabled and disadvantaged Disabled people are far less likely to be in work or hold qualifications than the national average. Currently, at every level of qualification, disabled people are up to three times more likely than other citizens to be without a job but want to work. Disabled graduates have a higher chance of being out of, but wanting, work than a non-disabled adult who has no qualifications at all.

15. Equality Act A person has a disability for the purposes of the Act if he or she has a physical or mental impairment and the impairment has a substantial and long-term adverse effect on his or her ability to carry out normal day to day activities.

16. Equality Act The person has an impairment that is either physical or mental. The impairment has adverse effects which are substantial. The substantial adverse effects must be long-term. The substantial, long term effects, adversely effect normal day to day activities. –4 yes’s...The equality act 2010 may apply. –1 or more no...The equality act 2010 may not apply.

17. Equality Act Some conditions are automatically covered HIV infection, MS and cancer.

18. Consent Explicit, informed consent must be gained. Sharing health information and treatment with non-health and social care staff. Confidentiality, privacy, dignity issues.

19. In what ways can the AHP Advisory Fitness for Work Report form be used by a patient? To provide clear written advice on fitness for work and how a return to work could be facilitated. To give to their employer to base part of a return to work discussion around. To provide evidence to their employer for sick pay purposes (although a fit note from a doctor* may still be required to pay sick pay).

20. In what ways can the AHP Advisory Fitness for Work Report form be used by an employer? To have a starting point for return to work discussion. To be kept informed. To have suggestions to consider. To agree appropriate modifications to an environment to enable work to continue.

21. In what way can the AHP Advisory Fitness for Work Report form be used by a doctor? As a report on which to base the provision of a fit note. As they want from you, your specialist knowledge. Your up to date comprehensive assessment and advice. Your knowledge of the functional impact.

22. Reminder.... The report is not sufficient on its own to claim ill health benefits. Your report is only advice to your patient and is not binding on their employer. The report complements and can be used in conjunction with a fit note.

24. Filling in the Report Go to the COT website. Under Professional Resources tab, second from the bottom ‘AHP Fitness Report’.

25. Advising on Fitness for Work

29. The most common return to work solutions.... Phased return to work Altered hours Amended duties Workplace assessment

30. Other options to consider... Advice on workplace adjustments, modifications and equipment Education and advice on the management of symptoms at work Education on safe and correct movement techniques and postures Support to develop effective coping strategies for work Follow-up with employee and employer to review and adjust the programme

31. Exploring health-related work difficulties Activity: Recall a case or construct a simple one. Write down 2 difficulties this person might experience and two pieces of advice (recommendation or goals) to address this.

34. Outcomes  Return to same job, same employer  Return to same job modified, same employer  Return to different job, same employer  Return to same job, different employer  Return to same job modified, different employer  On the job training  New skill training or retraining  Other educational/academic program (New Hampshire Department of Labor, USA website 2006, Holmes 2007)

35. How to do a digital signature for the first time.  Click on box 9  Click on: A new digital ID I want to create now.  Ensure the default first option is highlighted (NewPKCS#12 digital ID file)  Click Next  Enter your :  Name- as you want it to appear in a formal report.  Organisational Unit i.e Horizons or leave blank.  Organisational Name- NHS Grampian  Email Address- work one  Country/Region –scroll to find GB United Kingdom  Leave the Key algorithm default setting  Leave on digital signature and data encryption default setting

36. How to do a digital signature for the first time....continued.  Click on next  Click on browse  Choose a file location  Enter password twice- this is the password you will use from now on!!  Click on finish  Re-Enter your password  Click on lock document after signing  Enter name of report  Click save  Your signature will come up in the box and the form is locked.

37. How to do a digital signature for the second time  Click on box 9.  Enter your password.  Tick box Lock Document After Signing.  Click on Sign box.  The document is now signed and locked.

38. Just want your signature and date in the box?  Click on the appearance box  Scroll down to create new appearance  Go to Configure Text- remove all ticks except name and date  Click OK  This should hold for every time...

39. Storing and Data Protection Currently no electronic patient held record storing facilities if you are NHS. Work in your U Drive, print and store in your notes. Email to.nhs/.gsi.gov.uk/.gse.gov.uk/.gsx.gov.uk/.gcsx.gov.uk

40. Next steps Record HCPC number somewhere accessible. Create digital signature. Get access to the COT website page (member side). Save a blank report.....when the time comes, do one!

41. Further CPD... Look at the healthWorks webpage. Familiarise yourself with contents of z-card and local QuickGuide. Undertake the e-Learning for Health modules. Undertake the COT free-modules on workmatters

42. What happens now? Apply what you have learnt. Next questionnaire will come through in 2 months time. Invite to participate in a Focus Group. Subsequent questionnaires will come through at 6 months...and finally 12 months after your training.

43. Contact details: julietmcbean@nhs.net Mobile 07584386187 nhsg.healthworks@nhs.net