1. Brendan McConaghy Lead Physiotherapist Occupational Health Belfast Trust EARLY INTERVENTION PHYSIOTHERAPY

2. Sickness absence rates at April 2013 = 5.5% Costing the Belfast Trust £4.1million for MSK absence alone A LOOK AT THE SIZE OF THE PROBLEM

3. 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

4. Accessing and influencing the right people Chief Executive Directors Senior HR managers Union Reps Employees SECURING THE FUNDING

5. The Core Principles

6. EDUCATING AND CHALLENGING NEGATIVE BELIEFS

7. WORK IS GOOD FOR YOU!!!!

8. Current level of function Previous level of function Needed level of function

9. BIOPSYCHOSOCIAL MODEL

10. Pain level Time Further exposure

11. From this … … to this.

12. Functional assessment ASSESSMENT

13. MAKING CHANGES TO THE PROCESSES

14. Emailed referrals Rapid assessment Clinician typed reports Emailed reports in under 48hrs Rapid access to treatment PROCESS OPTIMISATION

15. Immediate emailed referral on commencement of sick leave Appointment in 5 working days Emailed report within 48hours

16. 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

17. BELFAST TRUST TRIAL

18. Some funding challenges were overcome SPCS selected as they had the most costly MSK sickness absence £1.14million

19. 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 OUTCOMES

20. 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

21. Reduction in cost of MSK sickness of an estimated £49,928 during trial period £99,856 per year

22. 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)

23. 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 mid- point 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…

24. 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.

25. WHERE ARE WE NOW? Rolling out in the Belfast Trust Monthly monitoring and service improvement Region wide roll out?

26. ANY QUESTIONS?