Allowing employees to refer themselves into workplace physiotherapy schemes, before they become too sick to work, can significantly reduce sickness absence, writes Claire Glynn.
Musculoskeletal (MSK) issues continue to undermine the health of the workforce. One in 10 employees are now affected by an MSK issue and extensive NHS waiting lists mean hundreds of thousands of employees are not getting the support they need to recover or manage their condition.
Employers and the government have responded by increasing access to occupational health solutions. However, a new study shows access to OH alone isn’t enough to solve the problem. According to Nipping it in the bud, an analysis of the recovery outcomes of over 1,600 people referred into occupational health due to an MSK issue, timing also matters.
Not only could 60% of employees be prevented from going absent with an MSK issue, if referred into physiotherapy while still in work, but 97% were still expected to be at work a month later. This compares to just one in two (56%) employees referred between one to two months of absence and less than one in five (18%) of those who had been off work for over six months before being referred.
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Most worryingly of all, even when managers had access to specialist physiotherapy support, more than one in four (28%) wait until the employee has gone absent from work before referring them. Alarmingly, six out of 10 managers are waiting until an absent employee has been unable to work for at least a month before raising a referral.
By this time, the likelihood of the employee being able to return to work with reasonable adjustments is dramatically reduced. Although 60% of employees could be made fit for work with reasonable adjustments – if referred into physiotherapy while still in work – just 23% could be brought back with reasonable adjustments once absent.
How can self-referral help?
Critical to ensuring both individuals and the business can benefit from early intervention is educating managers to refer employees into physiotherapy at the slightest niggle. However, employers such as Marks & Spencer are going one step further by allowing employees to self-refer themselves for occupational health physiotherapy.
Under the scheme, any of the 60,000 people employed by M&S who are affected by an MSK issue, such as back pain or muscle sprain, can self-refer themselves for advice and up to six free physiotherapy sessions.
Although M&S had a physiotherapy service in place beforehand, employees could only access it if referred by their manager. The new approach has unlocked access to physiotherapy and improved the employee experience, by allowing employees to get an appointment within just one to four days of them contacting the provider, PAM Physio Solutions.
As a result, there has been a four-fold increase in the number of people reaching out for physiotherapy support, but calls are triaged to ensure employees are only being given the support they actually need.
Forty-nine per cent of employees struggling with an MSK issue at work are affected by back pain, while almost a third of absent employees are also struggling with back pain.”
In some cases, that might just be some advice about self-management or a couple of face-to-face physio sessions to help the employee understand their condition or symptoms. In other cases, they might need all six sessions to learn how to correct poor posture leading to pain.
Describing the rationale behind the approach, Simon Croker, service manager for colleague services at M&S, said: “At a time when NHS waiting times and rising costs are making it difficult for employees to access physiotherapy, the scheme is enabling us to empower our people to look after themselves. Early intervention matters because, the sooner employees can be helped to recover from a joint or muscle issue, the more likely they are to be able to remain in work, which is also good for their financial and mental health.”
What’s driving MSK absence?
Of course, prevention remains better than cure, so it’s also important to educate people how to boost their MSK health. The Nipping it in the bud report also found that back problems are the main issue undermining the MSK health of employees. Forty-nine per cent of employees struggling with an MSK issue at work are affected by back pain, while almost a third of absent employees are also struggling with back pain.
Fortunately, the number of people affected by serious medical conditions, such as inflammation of the spine, is rare. Instead, one in 10 (11%) of those off work, and one in four (27%) of those struggling to perform at work, have backache. That is to say: strained muscles and spinal ligaments, typically resulting in lower back pain.
There is no reason why individuals struggling with backache cannot be quickly rehabilitated and supported to stay in work. However, the prevalence of backache referrals shows that far too many employees are struggling to maintain good back health.
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As well as unlocking access to physiotherapy, one element that is essential to addressing this is looking at the underlying issues putting pressure on backs. These can include factors such as a sedentary lifestyle, poor posture and weight gain.
By educating employees about ergonomic risks, and the importance of staying active and eating well, employers can go a long way towards reducing preventable MSK issues.
