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September 24, 2015

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Case study: how physiotherapy saved John Lewis 41,000 working days

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By Phil Clayton, MD of Physio Med

Medical evidence shows that early physiotherapy intervention on musculoskeletal injuries can prevent acute conditions becoming chronic and promote swifter recovery, return to the workplace and improved productivity levels.

In an industry that employs people across a wide spectrum of both physical and office-based jobs, the John Lewis Partnership was keen to establish a solution to help its employees recover more quickly and safely from injuries and conditions that required treatment, as well as putting in place wider occupational health and preventative measures to safeguard the wellbeing of its Partners (staff)and so turned to Physio Med to provide a robust, blended physiotherapy intervention and OH service.

Brief

John Lewis Partnership (JLP) employs circa 94,000 Partners across 414 UK sites, including John Lewis and Waitrose stores, distribution centres and Group sites. The range of job roles is vast – from retail sales to warehouse operatives, office workers to security workers – and many can be physically demanding.

With access to NHS physiotherapy via GP referral taking up to 14 weeks, Partners suffering from musculoskeletal disorders (MSDs) were often absent from work for extended periods or less productive at work while waiting to access treatment.

JLP wanted to offer all Partners consistent and timely access to physiotherapy services, to help reduce the incidence, duration and recurrence of musculoskeletal injuries and associated sickness absence.

JLP’s objectives included:

  • To reduce employee discomfort and pain levels, due to MSD
  • To minimise associated absence and facilitate an early return to work
  • To improve productivity
  • To reduce the incidence, duration and recurrence of absence due to MSDs
  • To provide the above with an evidence base demonstrating value for money

Solution

Physio Med had worked with Waitrose since 2006, providing physiotherapy services.

In August 2013 Physio Med began working with the JLP Partnership Health Services across the entire group, to implement its innovative, and award winning, PAL (Physiotherapy Advice Line) service, which provides fast access to a blended approach of fast-track telephone triage, remote multimedia self-management and on-site face-to-face treatment and advice. Physio Med also put an enhanced occupational health physiotherapy service into operation, which included Display Screen Equipment (DSE) / Ergonomic Assessments and Functional Capacity Assessments, for all Partners.

Partners reporting an injury via the JLP Health Hub receive a triage call from Physio Med within four hours, followed by an initial assessment from a Senior Chartered Physiotherapist within a maximum of three days, incorporating a series of evidence-based clinical questions and movements and tasks to facilitate diagnosis to decide if they require face-to-face treatment or can self-manage their condition via PAL.

Those deemed suitable to self-manage are then given personalised treatment plans, exercises and advice on the best ways to assist the healing process. This included:

  • Appropriate advice regarding their work station, lifestyle, medication, posture and methods of symptomatic relief
  • Realistic advice on modifying the working day to accommodate the injury
  • An individually tailored progressive exercise programme created by the physiotherapist to speed up healing, communicated via comprehensive videoexercise files, and accessed via a computer, smartphone or tablet.

Partners who require face-to-face treatment are treated a JLP on-site facility or referred to one of 780 hand-picked practices across the Physio Med UK network

Outcome

With average access time for NHS physiotherapy standing at more than 14 weeks one of the key drivers for JLP was reducing the time employees were absent from work and improving the productivity of those at work but suffering pain.

Between February 2014 to January 2015, 2,324 appropriate referrals were made to Physio Med, with initial assessment appointments taking place within an average of just 1.9 working days of the triage call. 67% of all referrals were managed remotely, with 18% being referred for face-to-face intervention after initial assessment and 15% being referred for face-to-face after the full ten day remote intervention.

58% of Partners were discharged after ten days, as their condition was either resolved or they were able to effectively self-manage their condition.

At the point of referral 20% of employees were absent from work, with 25% at work on modified duties and 55% at work but suffering pain and therefore operating at reduced productivity levels, highlighting the hidden cost of presenteeism.

Of those employees off sick at the point of referral, 89% returned to work following treatment and overall 96% of all who used the service were safely maintained at or returned to work.

By ensuring Partners were referred and treated quickly, those that used the service reported an average reduction in pain of 55% and improved productivity and function in real terms by 24% (59% to 83%) equating to 1.2 days pp/pw working a five day week.

Those referred for Face-to-Face treatment received an average of just over four physiotherapy sessions.

As part of the complete occupational health physiotherapy service offered by Physio Med a further 934 referrals were made for DSE, Work Station and Functional Capacity Assessments.

In financial terms the blended service model and fast access to treatment has bridged the gap in the NHS physiotherapy waiting list, helping JLP to reduce sickness absence and improve productivity – saving thousands of working days.

Based on the 2,324 Partners who engaged with PAL over the 12 months, JLP estimates it saved 41,010 working days, delivering an estimated saving of more than £2,676,000 – which equates to an ROI figure of 5:1

Physio Med reports back to JLP on a host of criteria – including anatomical injury site, referring locations, job roles and further breakdown of the service impact on pain levels and productivity – identifying trends to help JLP put practices and measures in place to reduce future injuries and issues.

Nick Davison, Head of Partnership Health Services at JLP, said: “The range of operational roles throughout John Lewis Partnership is extremely varied, with many being quite physically demanding. As a business which invests significantly in the health of our Partners we have developed our own unique internal health services structure. Physio Med recognised the importance of working with and complementing our own internal OH resources and adapted their ways of working to fit within our own operations.

“Physio Med was able to highlight that half of our Partners were receiving treatment whilst still working but at a significantly lower level of productivity. By introducing PAL and routing appropriate conditions that respond well to guided exercise through remote management, like lower back injuries, we have been able to help those Partners get better over a much shorter time period, reducing their pain faster, increasing their mobility and increasing their productivity by over 20%. A great result for the individuals affected and the business as a whole.”

Phil Clayton is Managing Director of Physio Med

Sleep and Fatigue: Director’s Briefing

Fatigue is common amongst the population, but particularly among those working abnormal hours, and can arise from excessive working time or poorly designed shift patterns. It is also related to workload, in that workers are more easily fatigued if their work is machine-paced, complex or monotonous.

This free director’s briefing contains:

  • Key points;
  • Recommendations for employers;
  • Case law;
  • Legal duties.
Barbour EHS

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Nigel Dupree
Nigel Dupree
4 years ago

Brilliant news and “proof of concept” underpinning Grannies adage about “a stitch in time saves nine” or pretty close with a 5 to 1 ROI or a five fold cost/benefit by simply putting the horse back in front of the cart. Perhaps, this might encourage a little mindfullness surrounding other issues that too many insist on denial, like, you know, “I see no ships” and consequential omission to do something, in fact, anything to pro-actively to prevent, reduce or even mitigate the near critical mass of 60% + of DSE user operators reporting the debilitating symptoms of Computer Vision Syndrome… Read more »

Brian Oldham
Brian Oldham
4 years ago

I have two inputs to make – one is a comment and one is a question. 1. It is sad that stories like this still have to be rolled out to inform/convince the world of work that these interventions are cost effective. Well done JLP. 2. We in Somerset CC have been running a similar programme since January 2015. I am interested in others’ experience of HMRC rules which can regard treatment taxable benefit. They have not make it easy for us to provide this opportunity without having a process for capturing those who do not qualify for the exemption… Read more »

Peter T
Peter T
4 years ago
Reply to  Brian Oldham

In addition to the government disincentives (via taxation adjustmets) to consider, it is also a crying shame that the adversarial nature of our court system, particualarly as it applies to torts/damages claims means that legal advisors tend to discourage company sponsored early intervention on the presumption it is admitting liability. Obviously, a direct result of this “act or omission” is to increase the longer term costs of the subsequent claims. It is a great shame that the Employers Liability Compulsory Insurance scheme does not put aside/invest a sum of money from this revenue scheme into medical insurance to provide early… Read more »

 

 

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