A REPORT from University of Huddersfield experts has ensured that an ambitious Government scheme to help more people return to work from sick leave will include telephone support as a key component. Although some complex cases will require face-to-face sessions, it is argued that if trained advisers contact clients by phone, the result will be a faster, more cost-effective service with shorter waiting times.
Later this year, the Department for Work and Pensions (DWP) launches its new Health and Work Service (HWS). It is a bid to reduce levels of sickness absence by offering specialist advice to people who have been off work through illness for more than four weeks.
Companies and consortia are currently bidding for the £200 million, five-year contract to run the new HWS and their tenders must include proposals to provide telephone support.
This is in the wake of research carried out by Professor Kim Burton OBE and Dr Serena McCluskey, of the Institute for Research in Citizenship and Applied Human Sciences at the University of Huddersfield.
They were asked by the DWP to investigate the issue and in tandem with their colleagues Nicholas Kendall, of the University of Otago, and Pauline Dibben, of Sheffield University, they produced a report entitled Telephonic support to facilitate return to work: what works, how, and when?.
"The Health and Work Service is a hugely ambitious project. It has not been tried on this scale so it has generated considerable international interest," says Professor Burton. He and his team, after examining a wide range of evidence, concluded that phone support could offer advantages for an occupational health support service. The report states that:
"There is robust evidence that telephonic approaches can be suitable for assessing clients' needs and can compare favourably to face-to-face methods. The assessment can be used to make decisions about allocation to appropriate care through a triage process. This means that telephonic methods can be used effectively to assess the clinical, work and participation needs of people with common health problems, and they can be as effective as face-to-face approaches in doing so. In addition, telephonic methods can be used to allocate people with common health problems to occupational and clinical management pathways through a triage process that is both effective and efficient."
Case management via phone offers advantages
It is acknowledged that there are cases where telephone contact would be inappropriate, especially when clients had communication problems or complex medical issues. But the report argues that case management via phone offers advantages that include "reducing delays, integrating intervention components, optimising referrals, co-ordinating stepped care and communicating between the key players." Therefore telephone support will be embedded in the new HWS, which will be phased in from October and fully rolled out by April 2015.
Professor Burton and Dr McCluskey stress that rigorous training will be vital for phone advisers, who will be offering the triage and stepped-care support when they guide people back to work.
New approach to sickness absence
The roots of the new approach to sickness absence can be traced to 2006, when Professor Burton – an occupational health expert with a speciality in back pain issues – was the co-author of a Government-backed report entitled Is work good for your health and well-being?. It concluded that employment was vital for people's psychosocial needs as well as their economic well-being.
This report had an influence on Health at work – an independent review of sickness absence conducted for the Government by Dame Carol Black and David Frost CBE, published in 2011. Their review proposed the new Health and Work Service, and Professor Burton and his team were then asked to appraise the contribution that could be made by telephone support.
There was large body of data to be analysed, said Dr McCluskey, who has been invited to present the findings at the annual conference of the Vocational Rehabilitation Association, on 15 May in London.
"There wasn't a lot of material specifically dealing with how effective telephonic support is at facilitating return to work," she added, "but it is used in a variety of different health conditions as a way of managing symptoms and helping to provide easier access to larger numbers of people."
Professor Burton said that much of the research surrounding telephone support was based on the "biopsychosocial model", which helps understand how to identify and overcome obstacles to return to work.
"It is to do with a case manager talking to that individual, asking them about their own thoughts and beliefs about their health and work, asking them about the workplace, to see if there are any obstacles preventing them from returning – whether the work is too heavy for them, the line manager too tough on them or whatever might be making it more difficult for them to return to work, then working out ways to deal with the obstacles2.
University's repository research paper: http://eprints.hud.ac.uk/19300/1/Burton_et_al_2013-telephonic_review.pdf