Enabling Life Potential through Vocational Rehabilitation

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Enabling Life Potential through Vocational
Rehabilitation

• a process that enables people with functional,
  psychological, developmental, cognitive and
  emotional impairments or health conditions to
  overcome barriers to accessing, maintaining or
  returning to employment or other useful
  occupation."

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Enabling Life Potential through Vocational
Rehabilitation

• Worklessness and not disease is the biggest
• cause of health inequality, social exclusion,
• deprivation , and mortality

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Enabling Life Potential through Vocational
Rehabilitation

• All services should be aimed at maximising
  functional capacity of the working age population
  physical, mental, social, spiritual
• It is not their diagnosis that is important its
  what they can do!
• AHPs crucial in delivering vocational
  rehabilitation services in Scotland

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Enabling Life Potential through Vocational
Rehabilitation - Healthy Working Lives Policy
Review

• promote the health, safety and well-being of
  employees in the workplace to help employees who
  become ill or injured to retain work to provide
  access to services to enable movement towards
  work for those out of work as a result of illness
  or injury to promote the benefits that work has
  for most people to encourage all stakeholders,
  including employers, employees, healthcare
  professionals, employability advisers and trades
  unions, to recognise the benefits of work for
  health and their role in maximising the ability
  of working age people to retain or gain paid or
  unpaid employment.
• AHPs critical to its success!

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Enabling Life Potential through Vocational
Rehabilitation - Healthy Working Lives Policy
Review

• Redesigning the Client Pathways.
• Mapping current services and client pathways
• to work
• Recommend improvements in provision of,
• and links between, services that move people
• towards work
• Identify gaps in provision of relevant services
• and recommend how these can be
• addressed.

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Enabling Life Potential through Vocational
Rehabilitation

• Dame Carol Black -
• prevention of illness and promotion of health and
  well-being
• early intervention for those who develop a health
  condition and
• an improvement in the health of those out of work
  so that everyone with the potential to work has
  the support they need to do so.

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Enabling Life Potential through Vocational
Rehabilitation

• Only 3-15 of companies in the UK have access to
  Occupational Health support services
  inequalities in access
• Access to general services which are too
  downstream from the workplace - delayed
  loosing valuable time
• SME Sector (where the majority of people work)
  few have access to any kind of Occupational
  Health Support
• Poor links between employers and primary care
• Sick-notes state what an employee cannot do work
  rather than indicating what work tasks they can
  do

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Enabling Life Potential through Vocational
Rehabilitation

• 48 of work related problems in Scotland of MSK
  origin
• UK 12.25 million work days lost due to MSK
  problems
• Costs 141 million just for GP consultations

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Enabling Life Potential through Vocational
Rehabilitation

• In Scotland there are over 275,000 Small Medium
  sized Enterprises (SMEs) providing approximately
  54 of all jobs. It is estimated that 10 billion
  is lost annually through working age ill health
  in terms of days lost and worklessness. It is
  known that 2.5-3.5 of workers leave the
  workplace each year through ill health.
  Approximately 60,000 people make a new Employment
  Support Allowance claim each year in Scotland.

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• Developing a
• Vocational Rehabilitation Service
• for Small and Medium Enterprises
• in a Health Board area
• - launched 12 February 2008
• Working Health Services Dundee
• Hotline
• 01382-825100

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Working Health Services Dundee - Referral process
Line Manager raise awareness
GPs
Individual
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Enabling Life Potential through Vocational
Rehabilitation

• Under the auspices of the NHS - free and
  confidential
• Case management model
• Multidisciplinary team
• Early intervention
• Easy to access service 01382-825100
• Aimed at Small and Medium Enterprises
• Occupational Health support, Health and Safety,
  Health Promotion, support through the HWL Award
  programme

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Enabling Life Potential through Vocational
Rehabilitation

• A proposed new Fit for Work service, based on a
  case-managed, multidisciplinary approach, would
  provide treatment, advice and guidance for people
  in the early stages of sickness absence.
• Proposal for a Scottish Fit for Work National
  Service

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Enabling Life Potential through Vocational
Rehabilitation

• The pilot seeks to build upon the national
  Condition Management Programme structure whilst
  complimenting the strategic approach undertaken
  by the Scottish Centre for Healthy Working Lives.
• enhance it by providing an additional service
  aimed exclusively at providing personalised
  return to work support for sickness absentees.
• Incorporate the work of the 3 pilots.

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Enabling Life Potential through Vocational
Rehabilitation

• Add Vocational Rehabilitative Fit for Work
  Services to existing CMP teams
• Existing Vocational Rehabilitation pilots in East
  of Scotland continue, joined by CMP led FFWS
  providing full Scottish national coverage.
• Case Management CBT approach encompassing full
  bio-psychosocial model
• Focus on return to work tailored programmes to
  return sickness absentees.

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Enabling Life Potential through Vocational
Rehabilitation

• Scottish Centre for Healthy Working Lives (SCHWL)
  acting as hub and referral gateway.
• SCHWL expand support role via info/advice
  provision for both health professionals and
  clients
• SCHWL use network to roll out attendance
  management module to SMEs
•  

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Enabling Life Potential through Vocational
Rehabilitation

• Pathway GP onto orthopaedic waiting list. Many
  centres in Scotland patients screened by ESPs
  within acute centres.
• National UK data identifies this pathway
  resulting in up to 70 not requiring surgical
  intervention.
• What does this mean for the patient? Sickness
  absence? Psychological problems? Reduction in
  functional capacity? No active management!

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Enabling Life Potential through Vocational
Rehabilitation

• A Community Based Multi-professional Triage Team
  / Orthopaedic Assessment Service (OAS) PTs
  and GPwsi
• A centralised referral management system NHS 24
  physiotherapy tele-health service?
• All AHP musculoskeletal services to be delivered
  within a single system
• All return clinic appointments following surgery
  seen by AHP MSK team

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NHS 24 Enhancing the MSK pathway
Community AHP MSK Services Integrated
MSK Team Physiotherapy Podiatry OT Dietician Pros
thetics Radiography Specialist nurse GPwsi
Self Referral via NHS 24
Electronic Referral
GP Referral
Electronic Referral
Walk in Self Referral
GP Referral
Electronic Referral
Orthopaedic waiting list
Vocational Rehabilitation Services Chronic Pain
Services
Rheumatology services
Other acute services
Self management and advice through NHS 24 web
base for rehabilitation
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Vocational Rehabilitation

• join a collaboration to develop education and
  training relevant to this vocational
  rehabilitation agenda
• Develop a vocational rehabilitation community of
  practice