Staying Fit for Work

Lord Darzi’s long-awaited review, “High Quality Care for All”, has continued the concentration on helping people stay at work (through speedy access to physiotherapy). This theme entered the public realm with Dame Carol Black’s recent report which proposed faster access to physiotherapy.

Her review of the health of the working population, “Working for a Healthier Tomorrow”, was published in March 2008 and sets out a proposal for “Fit for Work” services which would avoid the delays in accessing appropriate treatment for employees, such as physiotherapy.

Work and employment have proven benefits for health and well-being. Employers will be encouraged to invest in workplace initiatives to promote fitness and there is good evidence that this kind of scheme is financially worthwhile for employers.

Failure to support people early on when they are off work can have severe consequences, with the risks of long-term ill-health which prevent the ability to work rising rapidly with time. Disability from low back pain and mental illness are the most important and physiotherapists and psychologists address these issues in back to work programmes and pain management.

From next year pilot studies will be introduced which will bring together musculoskeletal services (such as physiotherapy), psychological therapy and other supporting approaches to help people stay at, or return to work.

Self referral to physiotherapy, where the patient can direct themselves where they think they can get help best, has been very successful. This has shown high levels of patient, physiotherapist and GP satisfaction and people who self refer to physiotherapy take fewer days off work and are half as likely to be off work for a month compared with people referred by the normal GP route.

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