Schemes for helping workers return to work

Early access to advice

This service could be used for workers with back symptoms who are still at work or any who are on sick leave:

• Occupational health professionals with experience of back problems and workplace situations (occupational physiotherapists, occupational therapists or other appropriate health professionals) are able to give advice through telephone contact.
• The system should include assessment of clinical priority. Severe conditions linked to back pain are rare. A caller with very serious symptoms would be directed to seek medical attention as appropriate as they may need urgent treatment from the NHS.
• Other callers can be reassured and given appropriate advice with a follow up contact arranged if necessary. The occupational health professionals must follow best clinical practice including clinical guidelines on back pain.
• The occupational health professional will be able to highlight any work factors that are causing difficulty and should liaise with supervisors or managers if necessary in order to help the person stay at work or return to work.
• Some cases will require monitoring by occupational health professionals with a review of progress at regular intervals.
• Some individuals such as those with a serious condition or serious back injury may be under the care of their GP or hospital specialist. While they are absent from work long term, occupational health professionals will be in a position to liaise with the GP or specialist to gain further information on the diagnosis and the plans for medical management including time frames. This will enable you to plan your work and arrange for cover as needed.

Extra help in returning to work

If someone is off work or unable to work normally due to back pain or injury and they have continued to have problems for 4-6 weeks, you can invest in a particular type of scheme to help restore function to the worker. This is called a functional restoration programme.

• There is strong evidence from good quality research for the effectiveness of this process. Gradual strengthening takes place under the supervision of occupational physiotherapists or occupational therapists.
• These professionals are able to assist workers to overcome any barriers such as fear of further injury and get them to carry out work-oriented tasks with the aim of going back to the original job.
• You should be aware that an exercise programme is not the same as a functional restoration programme and will not give the same benefits to the worker. For those of you who want more detailed information see Advice for health professionals and http://www.hse.gov.uk/research/rrhtm/rr493.htm

This is a real life example of where functional restoration was used to help workers return to work:

Royal Mail paid occupational physiotherapists to run a programme that had a success rate of 67%. In this scheme, employees had a history of extensive problems, suffering e.g. a prolapsed disc or back injury, and had been off work for periods such as 14 months. They had many years of potential employment ahead of them and had physically-demanding jobs, including lifting heavy mail bags. Most of these employees were able to return to work after a programme lasting typically just 10 weeks. They returned to full duties and were able to go back to active leisure pursuits like football.

The evidence indicates that these special programmes can prevent long-term back pain and be highly cost-effective, especially when individuals are selected as needing this approach, for example, those who have been having problems for at least 4 weeks and are not optimistic about being able to resume their normal job in the future.

If you need help to quickly and effectively address the issue of employee health, minimise the impact of staff illness, and provide essential support to staff with physical or mental health issues you can contact:

• Health4Work The free Health for Work Adviceline for Small Business in England;
• Healthy Working Lives The free Health for Work Adviceline in Scotland;
• Healthy Working Wales The free Health for Work Adviceline for Small Business in Wales.