Management of Sickness Absence in NHS Lanarkshire

Transcription

1 Management of Sickness Absence in NHS Lanarkshire Mark Kennedy Dr Dravendranath Reetoo

2 Salus Services to NHS Lanarkshire Salus Occupational Health, Safety and Return to Work Absence Management Health and Safety Occupational Health EASY Management Referral OH Referral Case Management Physiotherapy / Mental Health Support Health Surveillance Onward Referral - eg OT / Physio / Case Management Immunisation Positive Health Promotion

3 Clinical Governance Systems ISO9001:2015 accreditation one of first 3 in UK SEQOHS Standard Accreditation 2015 version RISQS Registration NHS Lanarkshire Information Governance Policies Clinical Audit Clinical Governance / Clinical Team Meetings Multidisciplinary Team Meetings

4 Focus Early on Absence Significant evidence to demonstrate early intervention is best for RTW. EASY day 1-10 now policy Advice and opportunity to self refer into OH & Case management early offer of interventions (counselling/physio) Management Referral (day 28)- triaged to Medic or OHA depending on complexity. Assessment turned around within 15 days

5 NHSL Absence Excellent Short Term absence rates (best in Scotland Long Term absence above national average (ageing workforce, growth in mental ill-health, management of policy, generous employee terms). Salus job to determine Fitness for Work and where possible earliest RTW date.

6 Therapeutic intervention MSK - Triage to Physio (funded via Salus commercial activity). MH Access to counselling from day 1 of absence (voluntary) Recent introduction of Case Management (for work AND non work related issues) (funded via Salus commercial activity

7 Audit / Survey Results Review of consistency of OH Advice Peer review of report content Medical Manager feedback Service Manager feedback Attendee evaluation Clinical Record review Activity / KPI tracking and reporting

8 Review Consistency of OH Advice 64 cases all clinicians / all locations Main conditions MH / MSK / Cardiovascular Return to work timeframe : RTW by 8 weeks : 17/21 MH;17/24 MSK; 11/19 CVS MSK x1 : 3-4 months ( RTA & fracture Tib. & Fib. ) CVS x 1 : 4-6 months ( Cardiac Arrest x2 & ICD ) No time frame :4/21 MH; 6/24 MSK; 7/19 CVS) Phased return recommendations 48 No Phased return recommended 14 < 4 weeks ; 2 (CVS) : 4-8 weeks No unspecified timeframe

9 Managers Feedback Medical Managers - 8/26 9/13 - Service Managers 7/8 OH Support helpful most / some of time 9/9 6/8 OH Advice helpful most / some of time 9/9 6/7 Comfortable with Management Referral Process 9/9 4/7 No specific areas for support 5/8 Minority Comfortable with role and understanding legislation Majority 7/8 Would benefit from Training / Support from OH 3/9 8/8 Prefer group support sessions 5/6 Additional useful free text comments and feedback provided

10 An Audit of OH MR Records of 41 Mental Health Cases 13 Fit, 8 Specified RTW dates, 28 Not Fit 22 (13 initial + 9 reviews) given time frame RTW 11 Fit Note: only 4 specified RTW date Barriers to RTW: 60% reasons non medical Work related issues, Personal issues, Shift pattern, Moving ward, Medication change, Waiting specialist report, Cognitive function problems Diagnoses: 60% Stress and Anxiety Interventions: EASY + OH + CM together for more appropriate support

11 Future Developments Engage more closely to support managers & increase awareness of OH role in supporting the employee and managing absence. Target clinical governance and audit more on Mental Health cases. Further develop Mental Health support for sickness absence (evaluate whether other support (occupational psychology, CBT etc would have a potential role)