Report: Telephonic support to facilitate return to work: what works, how, and when?
By Kim Burton, Nick Kendall, Serena McCluskey, Pauline Dibben
Great Britain loses around 140 million working days due to sickness absence per year. This results in an estimated cost of £9bn to employers, £4bn to individuals and £2bn to Government. (The Department for Work and Pensions, 2011).
Long-term sickness absences of four weeks or longer make up almost half of the total number of working days lost. There is also an impact on the Department.
Research suggests that 51% of people claiming ESA were in paid work immediately before making their claim.
In 2011 Government commissioned Dame Carol Black and David Frost to conduct an independent review of sickness absence which made various recommendations. The Government response to the review, Fitness for Work, which was published in January 2013. One of the recommendations, which was agreed, is the creation of a ‘Health and Work Assessment and Advisory Service’ (now called the Health and Work Service, HWS).
The HWS will make independent expert health and work advice more widely available to GPs, employees, and employers. It will be introduced in 2014.
The intent is to give employees, employers and GPs better access to OH advice, help. employees who have been absent from work for around 4 weeks due to sickness to return to work; give GPs access to work-related health support for their patients; and support employers to better manage sickness absence.
Advice and assessment are the two aspects to the Service, the assessment will:
- Identify all the obstacles preventing a return to work, and any measures, steps or interventions that would facilitate a return to work.
- Obstacles can be health-related, work-related, or non-health/ non-work-related.
- Recommendations for these will be included within a ‘Return To Work Plan’ that will be shared with the employee, employer and GP for consideration.
- An Occupational Health professional will use a biopyschosocial approach to identify all the issues preventing a return to work and offer managed self-help and specialist advice; a further (face to face) assessment if needed.
- Case management.
There will be different levels of service available to the employee, dependent on the level of need. These will include, amongst other things: an initial (phone) assessment.
Telephonic contact is an attractive approach for the HWS with the potential to provide targeted delivery but there are still questions over its safety, effectiveness, acceptability and relative costs that this research explores. In particular, the findings of the research can inform the design approach to occupational health assessment and support in the planned new HWS.
Using a best evidence synthesis, high-level evidence statements were developed and linked to the supporting evidence, which was graded to indicate the level of support. The evidence statements were organised to cover four pertinent areas of telephonic support: assessment and triage; case management; information and advice; and return to work.
The evidence on important aspects of implementation were also explored (e.g. safety, acceptability, timing, cost-benefits and required skills).
Recognising that the academic literature on the topic was limited, documentary evidence was also sought from professional practice and grey literature sources.