May 2014 saw Obair welcoming a new member of staff – Ann Shearer, who has taken up the new role of Clinical Manager. Ann is based in Obair’s head Office at Trident House in Paisley and her role will include leading on the support and supervision of Obair’s Vocational Rehabilitation Evaluators who deliver the range of Obair products and to work with the Clinical Director to continue to maintain the quality of services to our customers. Ann will also retain her practitioner role providing high quality, innovative and evidence based Vocational Rehabilitation evaluations, services and interventions.
Ann, who is an occupational therapist who qualified in 2000, comes to Obair with considerable experience in Vocational Rehabilitation and Occupational Health. Her skills and knowledge extend to working in both the private and public sectors within the UK in the clinical specialties of musculoskeletal conditions, mental health and neurological conditions. Ann’s clinical skills include assessments in the work setting covering work site assessment, job demands analysis and ergonomics. Ann also has experience undertaking past and future care Medico-Legal assessments and is an accredited Matheson functional capacity evaluator.
Ann is committed to supporting the Obair Evaluators to further build a world class team using evidenced-based assessments and interventions with individuals, who due to injury, health condition or disability, are demonstrating restrictions in their functional or vocational capacity for work, enabling them to successfully retrain or return to work.
The BBC reported this week that the new Health and Work Service (HWS) being developed by the DWP will cover England, Scotland and Wales and will involve non-compulsory health assessments and treatment plans (BBC News on 9 February 2014). Owain Thomas today (11 February 2014) from Workplace Savings and Benefits reports however that, “Employer participation in the new Health and Work Service (HWS) could become mandatory if its initial voluntary structure is not a success, the government has admitted.” He goes onto quote Minister for welfare reform Lord Freud saying, “It is strictly a voluntary service, it is not a mandatory service as it could have been and it may become (as the OECD recommended), but we want to see how it works first on a voluntary basis.”
“It is in the end a voluntary service and we are hoping that it can remain a voluntary service. That is one factor that we will monitor very closely.”
A mandatory service would indeed create an entirely feel to employers, employees and GP’s and may alter referral, assessment and intervention processes and arguably require a complete redesign. Are we heading for a UK version of Workers Comp?
We have been aware of such a recommended service since the Black and Frost report (Health at work – an independent review of sickness absence) on 21 November 2011 and that it may become a reality following the Government’s response (response to the sickness absence review’s recommendations on 17 January 2013) just a year ago. Since then we at Obair have been following developments and in our different voluntary roles with professional organisations (College of Occupational Therapists Specialist Section – Work and Case Management Society UK) and engaging with our colleagues where we can regarding the design and delivery of such a service. At present we understand that the HWS will support people who have been on sick leave for more than four weeks, back into work. Referrals will be made by the GP (who is the gate keeper to claiming statutory sick pay) and or the employer but the uptake of the referral by the employee will be optional at this stage.
The GP is primarily duty-bound to protect the health of the individual and there is a big question as to whether GP’s will initiate a referral to HWS. The Work Foundation discussed this in October 2013 looking at the motivation of GP’s and their conclusion was “If GP’s do not see return to work as in their patients’ best interests or important for their wellbeing then they are unlikely to motivate them to take up an offer of the HWS or any other type of vocational support. The success of the WHS depends heavily on the patient’s motivation to take up an offer to attend but also on the GPs motivation to refer their patients into the service.”
Following referral, it is envisaged that the employee would undergo an assessment by an occupational health advisor who could come from any of the following professional healthcare groups Occupational Therapists, Occupational Health Nurses and Physicians and Physiotherapists. Taking a case management approach, the specialist will undertake an assessment either via the telephone or face to face and then be guided as to appropriate next steps. We have no details of how screening will be operationalised or how people will be chosen to have more or less intensive interventions but the use of tele-assessments is something the DWP have recently published evidence on in their report “Telephonic support to facilitate return to work: what works, how, and when?” Their results indicate robust evidence supporting telephonic triaging, case management and some return to work interventions (including monitoring) and adequate evidence supporting telephonic-based signposting and self-management techniques.
The Work Foundation and Macmillan held an event to look at the HWS and long term conditions and specifically to:
Following the event a report was produced that is helpful in considering important aspects about the new HWS in relation to long-term conditions, which echoes our own concerns here at Obair. These concerns for us are not just related to long-term conditions but resonate with most conditions and would be pertinent for a voluntary or mandatory service. Our broad recommendations would include:
Once we know more information regarding the details of how the HWS will be operationalised, which service providers will be prime deliverers and any further information, we will blog about this again. Your comments are most welcome.