Kissing it Better: Rehabilitation

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Kissing it Better Rehabilitation
Michael Benton Chief Executive Officer
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What is Rehabilitation?

•  

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What is Rehabilitation?

• Provision of
• Clinical and vocational intervention
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What is Rehabilitation?

• Provision of
• Clinical and vocational intervention
• Via an initial assessment process
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What is Rehabilitation?

• Provision of
• Clinical and vocational intervention
• Via an initial assessment process
• Followed by an appropriate managed treatment
  programme
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What is Rehabilitation?

• Provision of
• Clinical and vocational intervention
• Via an initial assessment process
• Followed by an appropriate managed treatment
  programme
•  
• To

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What is Rehabilitation?

• Provision of
• Clinical and vocational intervention
• Via an initial assessment process
• Followed by an appropriate managed treatment
  programme
•  
• To
• A willing participant with a suitable physical or
  mental trauma

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What is Rehabilitation?

• Using a managed service
• And appropriate treatment methods such as
• Triage
• Physiotherapy
• Osteopathy other treatments
• Cognitive Behavioural Therapy (CBT)
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What is Rehabilitation?

• Giving
• Cost efficiencies and a reduction in claims cost
  to insurers
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What is Rehabilitation?

• Giving
• Cost efficiencies and a reduction in claims cost
  to insurers
• Reduced absenteeism to employers
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What is Rehabilitation?

• Giving
• Cost efficiencies and a reduction in claims cost
  to insurers
• Reduced absenteeism to employers
• Less pain and suffering to the claimant
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What is Rehabilitation?

• Giving
• Cost efficiencies and a reduction in claims cost
  to insurers
• Reduced absenteeism to employers
• Less pain and suffering to the claimant
• Increased and faster probability of return to
  normal
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What is Rehabilitation?

• Giving
• Cost efficiencies and a reduction in claims cost
  to insurers
• Reduced absenteeism to employers
• Less pain and suffering to the claimant
• Increased and faster probability of return to
  normal
•  

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What is Rehabilitation?

• Giving
• Cost efficiencies and a reduction in claims cost
  to insurers
• Reduced absenteeism to employers
• Less pain and suffering to the claimant
• Increased and faster probability of return to
  normal
• Reduced Insurance premiums for employers
•  

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What is Rehabilitation?

• Giving
• Cost efficiencies and a reduction in claims cost
  to insurers
• Reduced absenteeism to employers
• Less pain and suffering to the claimant
• Increased and faster probability of return to
  normal
• Reduced Insurance premiums for employers
• Reduced claims spend 

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What is Rehabilitation?

• Giving
• Cost efficiencies and a reduction in claims cost
  to insurers
• Reduced absenteeism to employers
• Less pain and suffering to the claimant
• Increased and faster probability of return to
  normal
• Reduced Insurance premiums for employers
• Reduced claims spend
• A caring brand image
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What is Rehabilitation?

• Giving
• Cost efficiencies and a reduction in claims cost
  to insurers
• Reduced absenteeism to employers
• Less pain and suffering to the claimant
• Increased and faster probability of return to
  normal
• Reduced Insurance premiums for employers
• Reduced claims spend
• A caring brand image
• High perceived employee benefits
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Approaches to Rehabilitation
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Approaches to Rehabilitation

• No Action
• Lip Service

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Approaches to Rehabilitation

• No Action
• Lip Service
• Reaction
• A Peck on the Cheek

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Approaches to Rehabilitation

• No Action
• Lip Service
• Reaction
• A Peck on the Cheek
• Shotgun Action
• Kissing Anything that Moves

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Approaches to Rehabilitation

• No Action
• Lip Service
• Reaction
• A Peck on the Cheek
• Shotgun Action
• Kissing Anything that Moves
• Proactive
• A Full on, Mutually Satisfying Kiss

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Why Bother?

• The Facts
• Employee absenteeism costs British Industry more
  than 12billion per year

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Why Bother?

• The Facts
• Employee absenteeism costs British Industry more
  than 12billion per year
• Only 10 of people return to work after serious
  injury in the UK compared to 30 in the US and
  50 in Scandinavia

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Why Bother?

• The Facts
• Employee absenteeism costs British Industry more
  than 12billion per year
• Only 10 of people return to work after serious
  injury in the UK compared to 30 in the US and
  50 in Scandinavia
• AIG Europes review of 30,000 cases (06/04)
  highlighted a reduction in claims costs of 20
  when rehabilitation was applied compared to cases
  when it was not provided

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Why Bother?

• The Facts
• Employee absenteeism costs British Industry more
  than 12billion per year
• Only 10 of people return to work after serious
  injury in the UK compared to 30 in the US and
  50 in Scandinavia
• AIG Europes review of 30,000 cases (06/04)
  highlighted a reduction in claims costs of 20
  when rehabilitation was applied compared to cases
  when it was not provided
• QBE reported that where rehabilitation was
  provided claims settled for 1/3 less
• Insurance Times September 2007
• Confederation of British Industry (CBI) 2005

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Why Bother?

• The Facts
• The Government Sick Note Initiative Driving
  Occupational Health assessments

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Why Bother?

• The Facts
• The Government Sick Note Initiative Driving
  Occupational Health assessments
• Can the NHS cope

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Why Bother?

• The Facts
• The Government Sick Note Initiative Driving
  Occupational Health assessments
• Can the NHS cope
• Employment Employers will be encouraged to
  offer a RTW programme

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Why Bother?

• The Facts
• The Government Sick Note Initiative Driving
  Occupational Health assessments
• Can the NHS cope
• Employment Employers will be encouraged to
  offer a RTW programme
• Legislation Rehabilitation Code

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Why Bother?

• The Facts
• The Government Sick Note Initiative Driving
  Occupational Health assessments
• Can the NHS cope
• Employment Employers will be encouraged to
  offer a RTW programme
• Legislation Rehabilitation Code
• Culture Attitude Change

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Why Bother?

• There are two major conditions requiring
  rehabilitation
• Stress
• As a result of trauma, accident or anxiety
• Injury
• As a result of a physical accident

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Why Bother?
The Stress Factor

• 1 in 5 workers find their work very or extremely
  stressful
• (HSE figures)

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Why Bother?
The Stress Factor

• WORK/TRAUMA related stress accounts for 1/3 of
  all new incidences of
• ill-health.
  (HSE figures)

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Why Bother?
The Stress Factor

• EACH case of stress-related illness leads to an
  AVERAGE of 30.2 working days LOST (HSE
  figures)

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Why Bother?
The Stress Factor

• A total of 13.8 million WORKING days were lost in
  2006/7 to STRESS, DEPRESSION and ANXIETY
• (HSE figures)

13,800,000
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Why Bother?

• The Physical Factor
• Nearly 5 million working days
• were lost as a result of back pain
• in 2003-04. This means that on
• any one day 1 of the working
• population are on sickness leave
• due to a back problem
• Source HSE 2005

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Why Bother?

• The Physical Factor
• Nearly 12.3 million working days
• were lost as a result of work
• related musculoskeletal pain
• in 2001-02.
• Source HSE

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Why Bother?

• The Physical Factor
• The Health and Safety Executive
• estimates that musculoskeletal
• disorders, which includes back
• pain, costs UK employers
• over 590 million

590,000,000
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Stakeholder Objectives Before Rehabilitation
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Stakeholder Objectives Before Rehabilitation

• Claimant

• Wants to return to pre-accident/trauma situation

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Stakeholder Objectives Before Rehabilitation

• Claimant
• Solicitor

• Wants to return to pre-accident/trauma situation
• Wants the best deal for their client

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Stakeholder Objectives Before Rehabilitation

• Claimant
• Solicitor
• Insurer

• Wants to return to pre-accident/trauma situation
• Wants the best deal for their client
• Wants to reduce overall costs and deal with claim
  quickly

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Stakeholder Objectives Before Rehabilitation

• Claimant
• Solicitor
• Insurer
• Employer

• Wants to return to pre-accident/trauma situation
  Holy Grail
• Wants the best deal for their client
• Wants to reduce overall costs and deal with claim
  quickly
• Wants claimant back to work and so reduce long
  term sickness costs

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Achieving the Objective

• Choosing a Provider

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Achieving the Objective

• Choosing a Provider
• Recognised by the governing body

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Achieving the Objective

• Choosing a Provider
• Recognised by the governing body
• Clear pricing policy

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Achieving the Objective

• Choosing a Provider
• Recognised by the governing body
• Clear pricing policy
• Effective communication

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Achieving the Objective

• Choosing a Provider
• Recognised by the governing body
• Clear pricing policy
• Effective communication
• Adhere to Service Level Agreement

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Achieving the Objective

• Choosing a Provider
• Recognised by the governing body
• Clear pricing policy
• Effective communication
• Adhere to Service Level Agreement
• Convenient location

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Achieving the Objective

• Choosing a Provider
• Recognised by the governing body
• Clear pricing policy
• Effective communication
• Adhere to Service Level Agreement
• Convenient location
• Has relevant expertise

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Main Treatment Types

• Physiotherapy
• Psychology (CBT)
• Other

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Physiotherapy
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Physiotherapy

• Of all claimants referred for initial
  physiotherapy assessment

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Physiotherapy

• Of all claimants referred for initial
  physiotherapy assessment
• 5 will actually require no additional treatment

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Physiotherapy

• Of all claimants referred for initial
  physiotherapy assessment
• 5 will actually require no additional treatment
• 5 will require a surgical procedure

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Physiotherapy

• Of all claimants referred for initial
  physiotherapy assessment
• 5 will actually require no additional treatment
• 5 will require a surgical procedure
• 90 can successfully be treated through
  physiotherapy

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Physiotherapy

• Of all claimants referred for physiotherapy 90
  will need no more than six treatments

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Physiotherapy

• Of all claimants referred for physiotherapy 90
  will need no more than six treatments

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Psychology (CBT)
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Psychology (CBT)

• In 10 of assessments no further treatment is
  indicated

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Psychology (CBT)

• In 10 of assessments no further treatment is
  indicated
• 10 of all claimants referred for psychological
  assessment will not engage with the process

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Psychology (CBT)

• In 10 of assessments no further treatment is
  indicated
• 10 of all claimants referred for psychological
  assessment will not engage with the process
• Typically only 80 of those assessed will accept
  the need for treatment

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Psychology (CBT)

• In 10 of assessments no further treatment is
  indicated
• 10 of all claimants referred for psychological
  assessment will not engage with the process
• Typically only 80 of those assessed will accept
  the need for treatment
• 95 of those treated are successfully meet the
  rehabilitation goals set.

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Psychology (CBT)

• Critical Factors

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Psychology (CBT)

• Critical Factors
• Early intervention is required to minimise the
  time available for negative thought processes to
  be reinforced

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Psychology (CBT)

• Critical Factors
• Early intervention is required to minimise the
  time available for negative thought processes to
  be reinforced
• Claimant engagement in the process is critical

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Psychology (CBT)

• Critical Factors
• Early intervention is required to minimise the
  time available for negative thought processes to
  be reinforced
• Claimant engagement in the process is critical
• Choice of appropriate therapist is essential

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Psychology (CBT)

• Critical Factors
• Early intervention is required to minimise the
  time available for negative thought processes to
  be reinforced
• Claimant engagement in the process is critical
• Choice of appropriate therapist is essential
• CBT has to be measured and outcome orientated

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Stakeholder Benefits
Claimant Best Possible Treatment
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Stakeholder Benefits
Claimant Best Possible Treatment
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Stakeholder Benefits
Claimant Best Possible Treatment
Employer Best Possible Treatment Resulting in
RTW
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Stakeholder Benefits
Claimant Best Possible Treatment
Employer Best Possible Treatment Resulting in
RTW
Solicitor All the above plus efficient
administration and communication
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Stakeholder Benefits
Claimant Best Possible Treatment
Employer Best Possible Treatment Resulting in
RTW
Solicitor All the above plus efficient
administration and communication
Insurer All the above plus reduced overall costs
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