Continuing our profiles of winners of the 2020 Occupational Health & Wellbeing Awards, we look at physiotherapy provider Bespoke Wellbeing, which successfully rose to the challenge of Covid-19 lockdowns last year by embracing a virtual physiotherapy model, an adaptability that led to it, along with the charity The Advocacy Project, winning “Best musculoskeletal initiative” .
The forced experiment of pandemic-related home working may, for many of us, have meant some 18 months of no commuting and/or no need for a smart work wardrobe anymore. Less positively, it led to the tyranny of back-to-back Teams/Zoom calls, a blurring of home and work life and fuelled a sharp rise in musculoskeletal problems for many workers, especially those working from unsuitable workstations or in cramped home conditions.
Studies have suggested a rise in back, neck or shoulder problems during the pandemic as well as musculoskeletal problems generally. In turn, given the fact employers and employees alike have had no option but to engage digitally, we’ve also seen a sharp rise in demand for online physiotherapy services.
One physiotherapy provider that successfully adapted to this shift during the pandemic was Bespoke Wellbeing. How it rose to the challenge of managing this almost overnight transition, alongside the charity The Advocacy Project, meant they were named “Best musculoskeletal initiative” in the 2020 Occupational Health & Wellbeing Awards.
Bespoke Wellbeing was started by former NHS occupational physiotherapist Clare Henson-Bowen in 2014, initially working out of a rented room in London’s Covent Garden half a day a week. By the time the pandemic hit in March 2020 the service was operating out of four central London clinics and working with an array of employers, OH and HR teams and case management companies across the UK.
As Clare explains to OHW+: “Pre Covid, we were growing a national network of experienced, qualified physios with an interest in occupational health to help deliver work-specific help and treatment. We were also delivering DSE and ergonomics, physiotherapy and return-to-work plans. We’d go in and figure things out for clients, whether or not they have a plan, from a work perspective, equipment, ergonomics, a return-to-work programme and so on.”
But then, of course, Covid struck. “Because our hubs are in central London, they shut quite quickly, actually before the first lockdown. Our patients were just emptying out anyway. But we very quickly regrouped and thought, ‘what are we going to do?’,” says Clare.
“We switched to virtual consultations and were able to go back to our customers and explained how we were still going to be meet the needs. And it has grown from there; we actually doubled our team during Covid,” Clare outlines, with the service conducting as many as 250 virtual appointments a week now at its height.
Definitely, virtual physiotherapy is a different skill. You really have to adapt and you have to be open to adapting.” – Clare Henson-Bowen
“The growth has been quite incredible, actually. But we have realised that, definitely, virtual physiotherapy is a different skill. You really have to adapt and you have to be open to adapting,” Clare continues.
“Clearly, you’re not physically manipulating people’s limbs, but you can still do a lot virtually. Listening was always key anyway, reassurance, giving people advice, telling them what the diagnosis is. That reassurance is so powerful. That, say, it is simple back pain, it’s going to get better in four weeks; this is what I need you to do. Keep as mobile as you can, as long as it is not too sore, put some heat on it, go to your GP or pharmacist if you need,” Clare explains.
“We’ve also partnered with an exercise and rehab app, which people can have on their computer, tablet or phone. It is all video based and we can track them, their pain levels, they can send messages, it will alert us if their pain scores are too high. And that’s really helpful for clients, too. It has also helped people to take more ownership of their recovery; to do the exercises; it is not passive.
“We are seeing quite a lot of people who have developed spinal or limb issues because of working from home; their home and work life has merged far too much and perhaps they haven’t had the right kit or have been working in a sub-optimal position. As home-working has carried on for months at a time, it is has been ‘we’ve just got to sort this out’.
“On the ergonomics side you do need to get a baseline of everyone; so you need to go, just draw a line in the sand and you need to find out how is everyone doing and what kit have they got? Have they got the basic office kit and is anyone struggling? Are they super tall or super short? Have they got enough space to set a desk up – you see all sorts, people sitting in their kitchen cupboard,” Clare continues.
“We do video consults for physiotherapy and occupational health, video consults for ergonomics, DSE and home assessment, and with that they send in photographs before they come. It is all automated on our system.
“Someone sends a referral for a staff member, we send them a link to book themselves in, that automates a confirmation email with a link to the consent form, and then they send in pictures of their desk or working space. That comes through, we put it on the file. The physio has access to all of that beforehand; we ask them if there are any problems, and then we go through the DSE and ergonomic assessment. Our reporting then is exactly the same,” Clare explains.
A long-term model for the future?
So, despite the UK now gradually returning to to workplace ‘normality’ (or, at the very least, a hybrid mix of home and office-based working), is the virtual physiotherapy model likely to continue post pandemic?
Winning the award gave a real boost to morale, definitely. Also it has been valuable in terms of the recognition it has given us to other occupational health providers.” – Clare Henson-Bowen
“I hope so,” says Clare. “Virtual physiotherapy is more cost-effective; employees are often able to do it better, but also it is so rapid and much better for organisations where their employees are dispersed. People are becoming much more receptive to these models.”
To that end, just as hybrid working may become a more permanent transition, so a blended approach to physiotherapy could be a likely future model. “We really actually like virtual care; we believe in it and we believe it works really nicely, and so we are going to look at selling it more. There are so many benefits,” says Clare.
And being able to say she is now running an award-winning service has definitely helped, both during the pandemic and, hopefully, beyond. “The team worked incredibly hard during the pandemic; they were so flexible and positive. Always to win an award, it feels like that recognition is there, but especially when it is being judged by your peers,” says Clare.
“Winning the award gave a real boost to morale, definitely. Also it has been valuable in terms of the recognition it has given us to other occupational health providers, but also organisations and customers as well,” she adds.
The Bespoke Wellbeing and The Advocacy Project team
Technically, Bespoke Wellbeing operates four central London clinics but, of course, were out of action for much of 2020 because of Covid-19 restrictions.
The team comprises six physiotherapist and three administrative staff, and because of the increased demand from online physiotherapy has pretty much doubled in size since before the pandemic. “We all have an interest in occupational health; we all have experience or training in ACPOHE,” explains Clare Henson-Bowen.
Beyond the core team, the service operates a number of partnerships OH advisers, physicians and occupational therapists.
How Bespoke Wellbeing and The Advocacy Project became an OH&W winner
The charity The Advocacy Project and its physiotherapy supplier Bespoke Wellbeing had worked together to conduct workplace assessments and promote musculoskeletal wellbeing for more than two years, but it was how they responded to the pandemic that really caught the eyes of our judges and led to them being crowned “Best musculoskeletal initiative”.
When, with lockdown, The Advocacy Project’s staff began working from home at short notice, often without sufficient equipment, Bespoke Wellbeing quickly adapted its services (which has included treatment of existing conditions as well as preventative measures) to be able to reach employees regardless of their geographical location.
Solutions introduced included a digital home-working guide, remote display screen equipment assessments, webinars to discuss keeping well whilst working from home (including spinal exercises, good working practices and mental health) and regular emails to signpost support materials.
The feedback throughout has been extremely positive and Bespoke Wellbeing’s programme transformed the way at least one employee was able to work. Staff morale, performance and sickness absence rates have all improved since the interventions were brought in.
Praise from our judges included the fact Bespoke Wellbeing, “took a very proactive approach to addressing an important concern about remote working, including a wide variety of preventative and reactive interventions”.
Our judges added: “The use of follow-up emails to remind employees about the support on offer was also effective in keeping it front of mind.”