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Southampton Primary Care Trust case study

In 1997 Southampton Community Health Service decided to fund a 9 month physiotherapy pilot for staff who had sustained MSD injuries. A private physiotherapy company were contracted to provide an initial assessment and 3 treatments. At the end of the pilot its success led to the Trust agreeing to continue the scheme. Following the formation of Primary Care Trusts in 2000, realising the benefits the service had provided, Southampton PCT agreed to fund a part-time in house physiotherapist as part of the Occupational Health team.

Why introduce a pilot?

Other effects related to increased workloads were stress and a higher risk of accidents.

Costs of the pilot

The pilot arrangement was budgeted at £110 for each referral. Some staff responded after two treatments and some needed longer, however, at the end of the Pilot the average costs worked out as £100 for each person. In the majority of cases the cost of the physiotherapy treatment was less than one fifth the cost of replacing a basic nurse for one week.

How the pilot worked

The service targeted those staff at an early stage of new MSD injury who would benefit from a course of physiotherapy treatment. When staff sustained an MSD injury they were referred to the OH Nurses who assessed them and requested a referral for physiotherapy. How the injury happened (home or work) was irrelevant as the effect of sickness absence or limited fitness would have the same effect on the organisation. Staff were offered an appointment and started treatment within 48/72 hours. The physiotherapy service had extended opening hours, which included evenings Monday to Friday and Saturday morning, which was a very attractive option for NHS staff who worked shifts.

Following the treatment

Following a course of treatment the Physiotherapist returned a feedback form to the OH Manager detailing the outcome of the treatment including ;

to enable the OH department to help the individual to return to work safely or to adjust the workplace or task. This form was copied to the relevant OH Nurse to assess the individual's fitness to work and recommend ergonomic, environmental or job adjustments in terms of tasks or hours in liaison and negotiation with Line Managers.

A Back Care Programme was also set up to support those staff in work with chronic back problems who needed help to cope with pain and disability. The programme was run by an OH Staff Counsellor and Back Care Adviser with support from a physiotherapist. It ran for 7 weeks, 2 hours per week, involving up to 8 individuals, and covered various topics to help and support them in life: ergonomics, relaxation, pain control and stress management. Individual Line Managers were approached and asked to give an extra hour over the lunch time period for their staff member to attend the group.

The groups bonded well and were happy to share experiences about coping. Tips were exchanged to make chores easier e.g. when peeling potatoes use two bowls, one face down in the sink and the other on top so that you don’t put yourself in a top heavy position. Feedback from these groups was very positive and helped to keep staff at work, contributing to reducing sickness absence.

The results of the pilot

Some comments from staff who had physiotherapy treatment:

“This is a vital service to maintain staff at work and reduce sickness absence.” (several made this comment).

“The service encourages a healthy life style, not just short term pain management.”

“The Trust should continue the service, the speed I was seen enabled me to stay at work.”

“The service helped by reducing my pain, lifting my spirits, and gave me confidence and education about back care.”

Updated 2012-12-28