1. Case Management as a tool to Improve the Health and Wellbeing of the Organisation Gerard Marsden Occupational Health and Wellbeing (OHW) Head of Service Jacquie Scott Case Manager

2. Buckinghamshire Healthcare NHS Trust Integrated (acute / community) Trust:>5,000 staff serving population of 550,000 Two acute hospitals: Wycombe and Stoke Mandeville includes National Spinal Injuries Centre Five community hospitals One Occupational Health & Wellbeing Department

3. Financial cost to the organisation Increased pressure on the wider team, the `domino effect` Detrimental effects on the health and wellbeing of the individual Detrimental effects on the health and wellbeing of the individual Processes going round in circles Lack of ownership and fragmented approach Persistently high levels of Sickness Absence resistant to existing management practice Rationale for change QIPP agenda

4. The Financial Implications... 2010/ 2011 in excess of 80,000 working days lost in year Equates to over 300 whole time equivalents lost for the year. Calculated at midpoint band 6 Costs in excess of £10 million in sick pay in year Plus the impact on Patient Care...

5. The Business Case & Role Bid submitted to Charitable Funds June 2010 Improvements in Health and Wellbeing of the staff. Benefits to patient care and recovery Potential for large financial savings Underpin the Trust’s Patient Promises Fundamental to success is the recognition that this is a Trust-wide role which requires significant skills Effective communicator Detailed understanding of how the organisation works Confidence in delivery Able to drive the agenda in a supportive way Competent – able to hit the ground running Commenced in role November 2010

6. Information/Data Case Management action plans Policy refresh Training sessions 1:1 & group across Divisions Project work streams Bradford score information shared monthly Identify individuals score > 300 > 1000 Templates & flowcharts distributed Health summit meetings monthly Manage change effectively Training & support Communication

7. Stress Workshops 156 managers Stress Workshops 156 managers Sickness Absence Workshops Sickness Absence Workshops One to one coaching Home visits Return to work interviews Group seminars Health Summits (divisional) Round table discussion HR / OHW liaison Sickness absence tracker (OHW/HR) Sickness Absence Activity Fast track to Physiotherapy - 76 clients 2011/12 Fast track to Counselling - 211 clients 2011/12 Specialist referral clinics Realistic and informed actions Quick response

8. Case Management Activity 2011/2012 Case Management ActivityTotal Employee meeting143 Sickness policy staff trained455 Coaching 1:1 with manager157 Case Conference meetings36 Home visits4 Health summit51 Long term over 12 months returned37 Panel pending7 Panel dismissal6 Ill Health Retirement11 Redeployed20 Resigned due to illness18

9. OHW Totals2009 / 20102010 / 20112011 / 2012 Counselling Referrals126139211 Counselling Appointments470434845 Physio Referrals1425276 Management Referrals582764781 Phone Calls To Service (All Clients) 19819 Emails To Service Mailbox 2256 Needlestick Injuries 211221 Musculoskeletal Audits 69 Reported Stress To OHW9086134 Activity in Occupational Health and Wellbeing

10. Progress by Case Manager Division June 2009 – May 2010 March 2011 – Feb 2012 Top 20 individuals with highest Bradford score No of Episodes Calendar Days lost No of Episodes Calendar Days lost Div one120168654630 Div two161170235634 Div three175220466925

11. Bradford Factor Bradford Factor

14. Based on:Mid point band 6 1.00wte 23% on-costs 5 day week Financial Savings to the Trust 1068 1056 1279 Div one Div two Div three Three Divisions having reduced lost days over the specified period 3403 TOTAL Days saved TRUST SAVING £473,039.00 2011 - 2012

15. CHALLENGES Engaging staff Making paperwork accessible Showing the benefits Gaining trust Changing habits

16. Continue to engage Build resilience Share learning Refine processes Embed feedback and data collection Sustainability The Future

17. Demonstrable benefits from investment in Case Manager Valued by Managers and Staff Endorsed by IIP Assessment for Health and Wellbeing Award: –“There is impressive and extensive support through good Health and Wellbeing practice, e.g. The Case Manager Absence/Sickness” Sharing Best Practices –NICE Conference, London, March 2012 –SE England Health & Wellbeing Conference, May 2012 Conclusions

18. Thank you Any Questions?