How Arla Foods has cut absences with an early referral system

Early physiotherapy treatment for musculoskeletal injuries has cut absence rates at Arla Foods. Mark Fletcher reports.

Medical evidence shows that early physiotherapy intervention on musculoskeletal injuries can prevent acute conditions becoming chronic and promote ­swifter recovery, a speedier return to the workplace and improved productivity levels.

In an industry that employs people across a wide spectrum of both manual and office-based jobs, Arla Foods was keen to establish a solution to help its employees recover more quickly and safely from injuries and conditions that required treatment, and so turned to Physio Med to provide a robust physiotherapy intervention service.

Arla Foods employs 2,800 staff across 10 sites in a wide range of office-based and manual-handling roles. Many of these jobs are quite physically demanding, including operating machinery, doing repetitive production line work, moving heavy loads in distribution centres and driving HGV ­delivery vehicles.

With the access to NHS physiotherapy treatment taking many weeks or months,

Arla Foods needed to establish a cost-effective service that provided faster access to physiotherapy in order to:

• reduce employee discomfort due to musculoskeletal disorders;
• minimise associated absence;
• improve productivity/work efficiency;
• facilitate early return to work;
• reduce the risk of further absence due to injury recurrence;
• provide education on injuries, at the time and on a continuous basis; and
• to provide all of the above in the most cost-effective manner.

Solution

In 2011, Physio Med, in conjunction with the OH department at Arla, implemented its physiotherapy advice line (PAL) – a physiotherapy intervention providing access to a telephone-based service, backed by a network of physiotherapy practices for face-to-face intervention if required.

Employees reporting a musculoskeletal condition were screened by Arla Foods’ OH department before being referred for an immediate telephone triage to ensure they were clinically appropriate for treatment.

Within 48 hours, the employee received a 45-minute telephone assessment from a chartered physiotherapist, incorporating a series of evidence-based clinical questions and movements to facilitate diagnosis.

The employee was then advised on the best way to self-manage the condition, including advice regarding their workstation, lifestyle, medication, posture and methods of symptomatic relief, plus an individually tailored exercise programme available online in video format.

Arla Foods’ OH team received an initial report summarising the employee’s functional capability, prognosis and likely outcome, allowing it to devise a return-to-work plan or help the employee to remain at work in a safe, sustainable manner. Physio Med followed each employee for 10 days to assess progress, offer advice or further intervention or discharge them.

Speedy return

With the average access time for NHS physiotherapy standing at more than 14 weeks (national survey, July 2010), one of the key drivers for Arla Foods was increasing the speed at which employees ­returned to work or improved productivity.

In the first 12 months, 126 referrals were received, with 120 progressed through the PAL system. Some 24% of these employees were absent from work at the point of referral and 59% of employees had reported themselves at work with pain, leading to average productivity of just 64% – highlighting the hidden cost of presenteeism.

By ensuring employees were referred and treated quickly, the majority of employees reduced their pain levels, increased their productivity and returned to work.

The service also had a financial benefit through improved productivity and savings in travel time for those accessing the remote service rather than face-to-face appointments. It delivered an overall return on investment of almost 10:1, equating to a 36.5% saving on the cost of delivery of the original face-to-face service with equal clinical impact.

Outcomes

• Of those employees off sick at the point of referral 86% returned to work.
• Increase of 28% in productivity and function – equating to 1.4 days per person per week (based on a five-day week).
• Average reported reduction in pain of 55% (6.4 on the pain intensity scale reducing to 2.9).
• Only 30% of employees went on to ­require hands-on intervention.

Physio Med reported back to Arla Foods on a host of other criteria – including the anatomical site of the injury, geographical locations, job roles and further breakdown of the impact of the service on employees’ pain levels and productivity – identifying trends to help Arla Foods put practices and measures in place to reduce future injuries and issues.

Robin Dearden, group environment, health and safety manager at Arla Foods, said: “Despite some initial scepticism that this new approach was a lesser service, the feedback from colleagues and unions has been good. Faster access to specialist advice, exercises and, if necessary, face-to-face consultation and treatment, is a great benefit both to our colleagues and our business through reduced absence rates and quicker return to work.”

Mark Fletcher is clinical director at Physio Med. The PAL service won the Chartered Society of Physiotherapy Service Excellence Award for Self Management in 2012.