1. SALUS RETURN TO WORK SERVICES Nancy Watson Senior Case Manager Salus – NHS Lanarkshire

2. Salus – Return to Work Model Population based approach aimed at supporting both Workless and those Absent from Work to return to the Workplace/Labour market. Three Tier Service Model Bio Psychosocial principles, De-medicalising conditions Promoting Education & Self Management Most of the Issues do not require Medical Solution Most of the solution is waiting to be accessed

3. Services Provided Voc Rehab to Workless populations Case Management (LA’s, Scot Gov, PCT, Private Sector..) Voc Rehab to populations at risk of Job Loss Fit for Work (SME based) Specific Population Work MCN Stroke Physiotherapy – Pain Management Keep Well – Screening Programme EASY – NHS Lanarkshire absence management All Externally funded (zero core funding) Approx 7,000 individuals per annum.

4. Case Management Content All programmes contain these elements: The Bio-Psychosocial Approach Telephone case management Initial holistic assessment including clinical risk assessment Pre & Post quantifiable measures Connection and supervision through multiple agencies where appropriate Cognitive/educational modules on understanding and managing conditions Co-ordinated Care Constant Communication throughout Outcome driven (Job, return to Work, Health Improvement goal)

5. Role of Case Manager

6. Core Elements Presenting Conditions Managing Depression Managing Anxiety Managing Aspiration Pain Management Managing Fatigue Managing Addiction Confidence Building Coping Strategies Health Promotion Managing social/family circumstances Linking to employability Services Mental Health 46% Musculoskeletal 28% Other 12% Alcohol/Drugs 11% Stroke 3%

7. Performance Mental Health (N=3,446) 7.24 11.5 9.0 4.9 0.0 2.0 4.0 6.0 8.0 10.0 12.0 PrePost Average Score Scale Point Anxiety Depression ANXIETY LEVELS FELL ON AVERAGE 37% DEPRESSION LEVELS FELL ON AVERAGE 46%

8. Performance - Function

9. Customer Satisfaction 92.3% of clients stated that case management had a positive impact on their current work situation 99.6% of clients would recommend the service to others 100% of clients rated their experience of case management as Excellent (78.3%) or good (21.7%) Delighted with the help I got. I wouldn’t be where I am today – back at work and feeling much better. Really excellent service that definitely helped me a great deal. Thanks for all your help. Case Manager was helpful in supporting me, made me realise I have a future. Happy with all the help I received. It has made a real difference to me. Thanks you so much. Really enjoyed the experience, you have given me information, and made me think about my future. Your service is very worthwhile.

10. Thank You Any Questions?

11. Reducing Sickness Absence Its EASY Moyra Anderson Absence Management Co-ordinator

12. Evidence Based Interventions that Reduce Sickness Absence Early Intervention Musculoskeletal Mental health OP/OHA/Other Case Managed approach Maintaining contact with employee / workplace Postal intervention- advice Health Promotion activities Phased return to work Work modification

15. Our Role Friendly Non judgemental People need support Continuous improvement Evidence based Proportionate

16. EASY Results For each SA event reported to EASY 1.Consent – a) participation b) data 2.Who – sex, age, job family 3.Where – Division, Clinical Division, Directorate, Ward 4.Cause of Absence – “Swiss” categories (http://www.iom-world.org/sicknessabsence/saclassn.htm)http://www.iom-world.org/sicknessabsence/saclassn.htm 5.When - First day of Absence, Date return to work

17. Mental Health 3056 SA reports in 2010 156 are due to Mental Health problems (5%) 103 of these stress related (66%) 11 work related (11%)

18. EASY Results

21. Secondary Compliance

22. Feedback Staff 89% satisfied with the help received from EASY 82% satisfied with waiting time for support services 84% rated NHSL as an employer positively 88% rated EASY Service positively Manager 87% felt EASY was helpful in returning their staff to work more quickly 94% felt involved during their staff members absence 89% rated the EASY Service positively

23. Conclusion Evidence based service model with support from Day 1 of absence Sickness absence reduced by over 30% Cost savings on bank staff £ 7 million directed towards productivity, rather than statutory sick pay Provides a snap shot of current health – related issues e.g. mental health Know why people are absent Led to strategic development of supportive services e.g. SPS, ECS