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The HealthWorks Team
2014
NHS GRAMPIAN
HEALTHWORKS
‘SCOTTISH OFFER’ FINAL
REPORT 2013-2014
Embedding routine enquiry about a person’s work
status into everyday clinical practice
Between 2013 and 2014 the HealthWorks team designed and
delivered training to hundreds of key healthcare staff on the
importance of routine enquiry about health and work. The training
increased staff awareness of health and work related inequalities.
Bespoke resources were produced and shared through a variety of
digital channels. Providing training and resources increased staff
confidence to signpost patients, and improved the quality of the
healthcare intervention being provided.
2014
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HEALTHWORKS REPORT 2013-2014
Embedding Health Works into everyday clinical practice across
NHS Grampian
o Executive Lead: Dr Annie Ingram, Director of Workforce.
o Health Works Strategic Lead: Dr Linda Leighton-Beck, Head of
Social Inclusion, Public Health Directorate.
o Health Works Team:
o Project Lead: Cecilia Thompson, Head Occupational Therapist Adult Mental
Health and Child & Adolescent Mental Health.
o Project Workers: Juliet McBean, Occupational Therapist,
o Rachel Little: Podiatry Educator and Society of Chiropodists and Podiatrists
Union Representative.
o Angie Duncan: Community Dietician.
o Shona Campbell: Occupational Therapist, Occupational Therapy Team
Coordinator (Marr Area).
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1. EXECUTIVE SUMMARY
The contribution of NHS Grampian to the ‘Scottish Offer’ Health and Work agenda
is to support our workforce at key points on particular clinical pathways, to be
confident and competent to ask people about their work status. To use this brief
meaningful intervention as part of routine clinical practice and to signpost people to
services which can further help.
A timely approach in the spirit of ‘making every opportunity count’ makes more
certain the likelihood that people of working age who use NHS Grampian services,
will come into contact with a workforce with a core competence about employability
matters in its broadest sense, and the confidence to respond when the need arises.
A concise training programme has been developed with local and other relevant
information resources, to support staff to have enhanced knowledge to call upon
when needed.
Combining the population approach of Public Health with the person centered
rehabilitative approach and clinical network of AHPs, maximised leverage for
change.
The dedicated HealthWorks Team identified a need to generate new system
approaches, processes and resources to support the delivery of the objectives.
Creating a variety of relevant training packages
Working closely with the Clinical Effectiveness to track progress from
baseline status.
Investing time in Health Intelligence to target the approach to be taken.
Setting up multiple platforms to share HealthWorks activities with a wider
audience:
This was underpinned by fostering collaboration within key arenas:
Learning and Development to influence staff induction and education.
Workforce Planning and Recruitment for dialogue on entry level jobs for
those returning to work after absence due to ill health.
Local Higher Education to affirm the importance for undergraduate medical,
nurse and AHPs in reducing health inequalities as a consequence of
worklessness.
General Practice as a key pathway for pilot activity for AHP Fitness
reporting and Vocational Rehabilitation (VR) delivery.
Other Health Board HealthWorks teams to share good practice.
2014
3
Clinical pathways, with a high volume of working age people using the service were
selected as the primary focus for the delivery of the training and distribution of
resources for greatest impact
Training was distilled to less than one hour, and feasible for busy staff. In addition
two media clips of an AHP delivering an intervention were developed. These
demonstrate the ease with which the work status enquiry can be woven in as part of
usual care.
230 professionals across pathways participated and included: pharmacists, nurses,
occupational therapists, psychologists, chaplains, podiatrists, healthPoint staff,
smoking cessations staff, physiotherapists, social workers, care managers, dieticians
and doctors.
Lack of familiarity with basic employment law is often cited as a deterrent to
addressing work matters with people who use the health service for fear of ‘saying
something wrong’ .The HealthWorks team cascaded learning from the NHS
Education for Scotland and Healthy Working Lives workshops on Understanding
the Workplace-Employment Law for VR professionals to key staff. 36 practitioners
participated and strengthened the available skill set for people who use our services
Whilst not exclusively used in mental health the Wellness Recovery Action Planning
(WRAP) for Work/Studying/Volunteering is a person centered approach used to
identify and address a range of issues which may assist a person with job retention
or remaining in a learner or volunteering role. The training was offered locally to
Occupational Therapists and was undertaken by 25 participants from differing
specialties
The HealthWorks team also designed a survey and scoped AHPs working with
adults of working age. The survey returns from the AHP Advisory Fitness for Work
Report Questionnaire illustrated a significant need for, and informed the training
currently being rolled out.
The HealthWorks team has promoted the importance of engaging with new
employees in the organisation through a proposed insertion into the NHS Grampian
staff handbook. The overarching health message of ‘good work: good health’ is not
only important from the perspective of the patient pathway, but equally from the
viewpoint of the wellbeing of staff employed by NHS Grampian
Our most valuable resource, the Z Card supports the timely provision of relevant
information to help staff signpost to appropriate services, to support self-
management, rehabilitation and welfare mitigating options be it for themselves or
for the person using the health service.
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Across NHS Grampian sectors, AHP staff working with adults of working age were
scoped to inform the metrics required for the AHP Delivery Plan, and to
concurrently illustrate that ‘making every opportunity count’ is at the heart of the
person centered approach of AHPs.
211 responses were received of these:
99 % stated that they would ask a patient about their work status if it was
clinically appropriate at the time of intervention.
92% would consider changing the treatment intervention goals to
accommodate patient/ client identified work related goals.
90% would ask a person how they got on the next time they saw them if they
had signposted the person to other services for work and/or welfare issues.
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2. SETTING THE CONTEXT
The importance of finding, keeping and returning to work after illness and/ or
disability cannot be underestimated. Working and being involved in productive
activity is crucial for the health and socio-economic wellbeing of a person, their
family and community life, and is a key social determinant of good health (Black
2008, Marmot 2010, Waddell & Burton 2006).
The contribution of NHS Grampian to the ‘Scottish Offer’ Health and Work agenda
is to support our workforce at key points on particular clinical pathways, to be
confident and competent to ask people about their work status. To use this brief
meaningful intervention as part of routine clinical practice and to signpost people to
services which can further help.
A concise training programme has been developed containing local and other
relevant information resources, to support staff to have enhanced knowledge to call
upon when needed. A timely approach in the spirit of ‘making every opportunity
count’ makes more certain the likelihood that people of working age who use NHS
Grampian services, will come into contact with a workforce with a core competence
about employability matters in its broadest sense, and the confidence to respond
when the need arises.
NHS Grampian regards a strengthened alliance between many partners: carers,
employers and community services to be essential to support individuals to keep
connected with the world of work whilst overcoming a health barrier. By working
collaboratively it is possible to make a positive difference to people’s experience of
sickness absence, and to ameliorate for the consequences that could be associated
with an unnecessary and premature exposure to the world of worklessness.
Closer working links have been established during this project between the Public
Health Directorate, with its experience in health promotion and health behaviour
change, and Allied Health Professionals, (AHPs) with their expertise in
rehabilitation and enablement. Combining the population approach with the person
centered rehabilitative approach and clinical network of AHPs, maximised leverage
for change. This provided additional support for AHPs who had pledged (2012);
“to initiate support to individuals to remain at work or return to work… to improve
the physical health and well-being of people who use their services, focusing on
issues such as physical activity, nutrition and mental well-being”
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3. THE BID (‘SCOTTISH OFFER’)
A bid by NHS Grampian for Health Works extension funding in 2013/2014 from
Scottish Government was successful, enabling the AHPs HealthWorks team to
capitalise on progress to date. The intent was to further extend the scope and range
of activities being undertaken, and to underpin the infrastructure, and readiness of
the organisation and workforce to make a sustained contribution to this area.
For this to be possible, the HealthWorks Team identified a need to generate new
system approaches, processes and resources to support the delivery of the objectives.
Creating a variety of relevant training packages and undertaking a major
revision of supporting information, so that staff could easily provide up to
date, relevant, and locally accessible services related to employability matters
as required.
Working closely with the Clinical Effectiveness team to design pre and post
training questionnaires, service and training evaluation forms to track
progress from baseline status.
Investing time in Health Intelligence to target the approach to be taken.
Setting up multiple platforms to share HealthWorks activities with a wider
audience: NHS Grampian intra/internet webpages, nationally at conferences
and locally in the form of research based presentations and in-house press
articles.
Underpinning this systems approach was the need to create and foster collaborative
relationships within key arena:
Learning and Development to influence staff induction and ongoing
education.
NHS Grampian Workforce Planning and Recruitment for dialogue on entry
level jobs for those returning to work after absence due to ill health.
Local Higher Institute of Education undergraduate medical, nurse and AHP
training to affirm the importance of health inequality as a consequence of
worklessness being sufficiently prominent in the curriculum.
General Practice key pathways for pilot activity for AHP Fitness reporting
and Vocational Rehabilitation (VR) delivery.
Sharing resources with other Health Board HealthWorks teams.
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4. IDENTIFYING KEY PATHWAYS
Clinical pathways, with a high volume of working age people using the service were
selected as the primary focus for the delivery of the training and distribution of
resources for greatest impact.
These pathways were pan Grampian and were constituted by multi-professional and
on occasion cross agency personnel.
This intent was deemed pertinent and important, based on the clinical experience of
the HealthWorks Team. Appropriate targeting would create sufficient momentum to
overcome ‘initiative fatigue’ an ever present barrier to embedding ‘real’ practice
change. It would also overcome objections which often arise about the relevance of
particular objectives to daily clinical work.
Subsequent experience reinforced this concern that ‘buy in’ could not be presumed
and confirmed the need to maintain overall trajectory on key pathways and not to be
swayed by opportunistic training.
As the training programme rolled out requests to deliver to particular pathways
arose and this was undertaken on a responsive basis. In total, 31 areas were trained
and given resources, or supported to continue and enhance the type of work related
to employability already being undertaken by supporting skills and knowledge.
The following table demonstrates an example of the clinical pathways covered:
Pulmonary
Rehab
City/Shire/Moray
Community
Dietetics:
Health Helpings
Community
Pharmacists
Keep Well Community
Dieticians
City/Shire/Moray
Out Patients
Peter Brunt Unit
Out Patients
Elective Ortho
Podiatry
City/Shire/
Moray
Diabetic
integrated
screening
Chest Heart
Stroke Nurses
Community OT
City/Shire/Moray
Neurological
Rehab Specialist
Nurses/OTs
(including
Stroke)
Community
Psychiatric
Nurses
Psychology
services
RCH
Chaplaincy
Physiotherapy
Mental Health
Out Patient
Physiotherapy
Mental Health
City/Shire/Moray
healthPoints Smoking
cessation
Visual &
Hearing
Pathway
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5. TRAINING
The training (see appendix 1) was re-designed from the original Scottish
Government’s Employability Training for Healthcare Professionals Programme. It
was distilled to less than one hour, as being a feasible time delivery for busy staff. It
was presented face-to-face and was intended to be adaptable; depending upon the
audience, and delivered by trainers with extensive clinical knowledge. That way
flexibility to respond to pertinent clinical issues, or suggest solutions to any barriers
to implementation that staff may have anticipated was feasible. This responsiveness
was enhanced and made possible by the completion of the pre-training questionnaire
(see appendix 2) which allowed the trainer to briefly analyse the results before
training commenced. The benefits of this approach meant a bespoke and highly
relevant quality training session was given each time and this was borne out by the
training evaluation process.
During the training staff audiences were introduced to
The locally made Z Card (see appendix 3); for giving to people whose health
conditions affected their ability to work,
A staff prompt sheet (see Appendix 4) (a quick resources and aide memoire
for the busy clinician)
Relevant government produced leaflets supporting the importance of asking
about work as part of routine clinical practice and challenging some popular
myths around health and work.
To allow for equal and fair access to the (cost free) resource materials the audience
was also directed to online resources available to support their learning within the
NHS Grampian Hi Net and the Public Health Information Resource Centre which
had been stocked with supplies of the z card. These resources are available at
http://www.nhsghpcat.org/
In addition to this, two media clips of an AHP delivering an intervention but
omitting to provide helpful information to support the clinical intervention, and the
other, demonstrating the ease with which the work status enquiry can be woven in
as part of usual care, were designed, scripted and filmed by the HealthWorks Team
in conjunction with the University of Aberdeen. These clips were then made
available on-line to illustrate, at a basic level, how simple an intervention it is to ask
about a person’s work status and signpost onwards using the z card.
Using the post training questionnaires (appendix 5), the HealthWorks team could
evidence that a range of 230 professionals across pathways participated and
included: pharmacists, nurses, occupational therapists, psychologists, chaplains,
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podiatrists, healthPoint staff, smoking cessations staff, physiotherapists, social
workers, care managers, dieticians and doctors.
5.1 GENERAL PRACTICE
The central role of General Practice staff to the support of patients with health
barriers to work is vital. To this end much infrastructure, dialogue and preparation
has occurred with primary care colleagues in mind to pave the way for the next
stage of implementation. It was erroneously anticipated that the rollout of existing
resources could be embedded within the new patient health screening pathway. This
however could not be eventuated because of the multiplicity of practice and differing
emphasis in screening that is the norm. This due in part to the General Practice
Quality Outcomes Framework (QOF) guidance and the prioritising of specific
strands of the GP workstream by the GMS contract such as additional Vaccination
and Immunisation; Health and Social care integration; Unscheduled care;
Dispensing arrangements and GP Recruitment and Retention.
Thus a change of tack was required. The NHSG GP subcommittee has considered a
briefing from the HealthWorks team as to whether a pilot proposal within two GP
practices could have the potential. This is to support persons experiencing health
barriers to work to have access to timely Vocational Rehabilitation (VR) through a
designated portal, to include the implementation of the AHP Advisory Fitness to
Work Report and to spread access to the signposting materials and resources within
the practice context by a shared practice model.
The aforementioned has led to the current development of a proposal with the
Aberdeen City GP cluster lead. A robust evaluation of impact on early access to VR
for those experiencing mild to moderate mental ill health as barriers to work is
currently under consideration. In addition the skillset and support to the potential
operational staff involved has been provided in preparation to ensure good clinical
governance.
A further development as a result of the undergraduate healthcare students work
stream opened a productive dialogue on the HealthWorks agenda with the Medical
Student’s GP Undergraduate Training staff at the University of Aberdeen. This has
led to a sharing of resources and cross-fertilisation of ideals with a Consultant
Occupational Health Physician in NHS Grampian with an opportunity to embed the
HealthWorks training with the Occupational Health staff subsequently arising.
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5.2 STAFF INDUCTION HANDBOOK
The HealthWorks team has promoted the importance of engaging with new
employees in the organisation through a proposed insertion into the NHS Grampian
staff handbook which is currently under review. The overarching health message of
‘good work: good health’ is not only important from the perspective of the patient
pathway, but equally from the viewpoint of the wellbeing of staff employed by NHS
Grampian.
NHS employees are as likely as anyone to be in a household that has an unemployed
family member, to be in low paid, or part time work, and to be in receipt of welfare
benefits and negatively experience welfare reform changes.
Our most valuable resource, the Z Card supports the timely provision of relevant
information to help staff signpost to appropriate services, to support self-
management, rehabilitation and welfare mitigating options be it for them or for the
person using the health service.
5.3 CHANGE PROCESS All of the work of the AHP HealthWorks team has been overseen by the AHP and
Public Health Project Board which met quarterly and reviewed progress against
objectives to date, reflected on barriers to implementation and agreed next steps.
5.3.1 STAFF TRAINING AND SCOPING To consider change within the health care context it is essential to know the current
state, to decide on the plan, to evaluate the implementation process and
concurrently support staff knowledge and skills acquisition, since change is complex,
and not without challenge. Clinicians essentially want to know if proposed changes
will improve outcomes for the patient. They need to understand why change is
happening, what the clinical evidence is to support this, and to have time to reflect
upon their professional contribution and its impact upon practice.
At the heart of the project was the need to scope current state and this was
undertaken on a number of occasions, namely by means of the pre-training
questionnaires and the scope of AHPs working with adults of working age for the
AHP Delivery Plan 3.3 Metrics scope. This information was used to shape the
delivery of training deemed as essential to support staff and is hereby reported.
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5.3.2 EMPLOYMENT LAW AWARENESS TRAINING
Lack of familiarity with basic employment law is often cited as a deterrent to
addressing work matters with people who use the health service for fear of ‘saying
something wrong’ .This was borne out by the results of the HealthWorks training
questionnaires. As a consequence the HealthWorks team decided to further cascade
learning from the NHS Education for Scotland and Healthy Working Lives
workshops on Understanding the Workplace-Employment Law for VR professionals
to key staff.
36 practitioners participated and strengthened the available skill set for people who
use our services and session evaluation confirmed that by matching content to
identified needs a high degree of overall usefulness and satisfaction from
participants was achieved
The two aims of the course were:
To increase awareness and information on employment and disability
legislation
To explore the application of new knowledge to clinical practice
Session evaluations indicate a high correlation between course aims and meeting
participant expectations and needs.
5.3.3 WELLNESS RECOVERY ACTION PLANNING
(WRAP) TRAINING
Whilst not exclusively used in mental health the Wellness Recovery Action Planning
(WRAP) for Work/Studying/Volunteering is a person centered approach used to
identify and address a range of issues which may assist a person with job retention
or remaining in a learner or volunteering role. The training was offered locally to
Occupational Therapists and was undertaken by 25 participants from differing
specialties. Participants identified a number of pre training aims for the course
which were predominantly themed as follows:
To learn about WRAP
Read, reflect and apply to practice
With all aims achieved by participants and a high overall usefulness score being
achieved, the content was well matched to need. The facilitator’s case studies were
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identified by 16 people as the most useful aspect of the training. 22 participants’
plan to take forward the learning by using the WRAP in clinical practice with
immediate effect whilst the remaining identified peer support from colleagues who
attended WRAP training as the kind of support needed to facilitate this embedding.
5.3.4 AHP ADVISORY FITNESS FOR WORK TRAINING
To support routine enquiry and document the interventions of AHPs around health
and work matters, the Allied Health Professions Federation developed a template
called the AHP Advisory Fitness for Work Report (Appendix 7), and anticipated that
this would be introduced into clinical practice across the UK. However NHS
Grampian did not have a baseline awareness of the infrastructure and needed to
support its workforce to implement and embed this. So the HealthWorks team
designed a survey (appendix 7) and scoped AHPs working with adults of working
age.
211 responses were received, representing 5 professions, from across the in-patient,
out-patient and community service areas. Of all respondents 43% had no
knowledge of the AHP Fitness for Work Report, 55% did not know where or how to
access it, 93% would not feel confident to use it and 82% were not aware of what
actions were needed to ensure compliance with policy on the safe storage of it as a
potential electronic record.
The preferred clinical educational supports identified by participants were as
follows:
66% wanted a profession specific workshop on how and when to use it.
60% wanted clear guidance from line management.
53% wanted dedicated time to access a learning module
45% wanted buddying with an AHP colleague to feel more confident in its
use.
NHS Grampian AHP HealthWorks team developed specific training to support its
staff, with the use of some materials from NHS Fife, and the first cohort of
professionals to undertake this training has occurred with further sessions planned.
Training evaluation to date indicate that 100% of participants considered the
training relevant, with 90% stating that knowledge and understanding of the
‘Report’ had improved, with 50% reporting readiness to implement it into practice
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post training, and 71% identifying the importance of peer support to the embedding
in practice and from whence that would be received.
5.3.5 AHP WORKFORCE SCOPE
Across NHS Grampian sectors AHP staff working with adults of working age were
scoped to inform the metrics required for the AHP Delivery Plan, and to
concurrently illustrate that ‘making every opportunity count’ is at the heart of the
person centered approach of AHPs.
211 responses were received of these:
99 % stated that they would ask a patient about their work status if it was
clinically appropriate at the time of intervention.
92% would consider changing the treatment intervention goals to
accommodate patient/ client identified work related goals.
90% would ask a person how they got on the next time they saw them if they
had signposted the person to other services for work and/or welfare issues.
5.3.6 Additional Activities
A member of the HealthWorks team has presented and run workshops with
Aberdeenshire Employability partners and Health staff, to share the best evidence
for improving the prospects of those individuals experiencing severe and enduring
mental ill health retain or find employment or meaningful activity. To present facts
on the % of those wishing to work versus those who are actively engaged in this
activity and the subsequent health inequalities that arise. To take the opportunity
to emphasise the reduction in hospital length of stay and outpatient crisis use for
people who are in competitive employment with open ended support as opposed to
those who are not.
A member of the HealthWorks team has supported the infrastructure change for
staff on an emerging VR pathway who may be required to provide low intensity
psychological interventions (a holism approach) to be supported in practice by a
psychological modality accredited trained clinician.
The HealthWorks team members ran a workshop session for AHPs on the health
consequences of specific working conditions such as increased diabetes, adverse
coronary events, carcinogenic mutation, decreased mental well-being, increased
substance misuse that can arise from zero hour contracts, 12 hour contracts,
consistent night shift working, delayed transfer from offshore facilities to illustrate
that the right work can be good for you and can address CEL01 health ambitions
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Presenting to the AHP Professional Advisory Committee to define the need to
capture the data of staff activity in the health promotion/ work intervention
/signposting domains to support evidence for the contribution of the workforce to
CEL 01 and Welfare Mitigation Outcomes Planning
The HealthWorks team is in dialogue with Health Working Lives senior advisor to
consider how the Board may evidence real time competitive work opportunities for
returners to work, through the Healthy Working Lives award scheme.
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6. DISSEMINATION OF FINDINGS
An important part of sharing the activities and results of the NHS Grampian
HealthWorks team with a wider audience was achieved through regular submission
of posters or oral presentations to relevant conferences. Attendance at large
stakeholder events and regular updating on websites and media platforms was
undertaken. The following list demonstrates the varied platforms and national
stakeholder events NHS Grampian’s HealthWorks Team presented at or contributed
to:
1. Public Health Conference (Scotland) 2012. Juliet McBean
2. NHS Grampian Public Health Annual Report Article. 2012-2013. Cecilia
Thompson.
3. The Allied Health Professions (Scotland) Conference
Delivering Solutions and Demonstrating Impact: AHPs as Agents of Change.
October, 2013. Shona Campbell.
4. UpFront, the NHS Grampian Newsletter. 2013.HealthWorks Team.
5. Public Health Conference (Scotland) September 2013. Cecilia Thompson.
6. GP Cluster newsletter10th Jan 2013. Shona Campbell.
7. HEDG presentation.2013. Cecilia Thompson.
8. Employability fora. 2014. Cecilia Thompson.
9. AHP Research Network Symposium. Are We Ready to Write Fitness To Work
Reports? 2014. Juliet McBean.
10. AHP Blog: HealthWorks in NHS Grampian. 2014. Cecilia Thompson and
Juliet McBean .
11. Global Email Communication. Juliet McBean and Cecilia Thompson.2014.
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7. DELIVERING AGAINST NATIONAL
OBJECTIVES
7.1 CEL 01 HEALTH PROMOTING
HEALTH SERVICE
On the 16th January 2012, the Scottish Government produced CEL 01 for action in
hospital settings. The concept “that every contact is a health improvement
opportunity” is central to the Quality Ambitions for both Person-Centered Care and
Effective. The CEL was brought about by the Improving Population Health Action
Group which supports the Effective Ambition and the Efficiency and Productivity-
Prevention and Early Intervention work stream. The Health Works agenda and
activities being addressed by the team are under pinned by CEL 01.
7.2 THE AHP DELIVERY PLAN
The AHP national delivery plan for the allied health professions 2012-2015 clearly
set out in section 3.3 the following Action to be achieved by 2013:
“AHPs from health and social care will ask people who use their service about their
work status as an essential component of their consultation and will initiate support
to individuals to enable them to remain in or return to work”.
The aforementioned information in 5.3.5 gives evidence to support the progress of
health AHPs in NHS Grampian. Progress with the Health and Social Care
Integration agenda will provide opportunity going forward to scope and support
AHPs in Social Care to demonstrate similar practice change.
7.3 THE OUTCOMES FRAMEWORK FOR
HEALTH IMPROVEMENT
The evidence of activity to date sits well within the Outcomes triangle for Health at
Work
Intermediate Behavioral Outcomes: with individuals being signposted to
access services , and supported to return to or remain in work
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Environmental Intermediate Outcomes : with services changing towards
meeting the needs of people at an early stage in the care pathway with
improved knowledge of and attitude towards the importance of work and
being in good health
High Level Outcome: of improved health and wellbeing of working age
population as key pathway staff turn attention towards health promotion and
active rehabilitative interventions
7.4 MITIGATING THE IMPACT OF WELFARE
REFORM
Whilst much remains to be achieved to mitigate for welfare reform overall within
the NHS Board the actions of the HealthWorks team have made a significant
contribution , creating a solid foundation of knowledge, skills and signposting
support of the following dimensions of the Outcomes Focused Plan :
Short Term Outcome Activities
Identify staff at risk of poverty and provide appropriate services and support
Training front line staff to respond to social and economic circumstances
which are affecting health and wellbeing by actual intervention or
signposting onwards
Ensuring staff are aware of agencies they can refer patients to for welfare
benefits advice and support within and out with the NHS
Ensure that staff have confidence and skills to raise issues of financial
security
Provide specialist(VR) support for staff providing frontline Services
Influence a more accurate assessment of ability to work
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Implement evidence based Vocational Rehabilitation pathways to support
those with health conditions to retain or return to employment
Medium Term Outcome:
More People with health conditions return to work or retain employment or
meaningful activity as per changes in statistical returns.
Long Term Outcome:
The HealthWorks team is driving its activity towards evidencing that NHS
Grampian is mitigating against an increase in health inequalities as a
consequence of Welfare reform by supporting its staff to intervene early,
supporting the organisation to consider entry level jobs for those returning to
work after illness or disability, and increasing its volunteering opportunities.
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8. MOVING FORWARD
The creation of the z card and prompt sheet are the two most widely used resources,
both of which are regularly updated and hosted centrally and on-line. The strategy
for updating in future years is in hand.
The training courses which have been created will need ongoing content review, to
retain relevancy and currency of information. In principle this is agreed as a task
that identified cross sector AHPs who have the specialist expertise, will address
going forward.
In addition a trainer for trainers model within the AHP workforce which can locally
support ongoing training to include the AHP Fitness for Work Report training will
be realised.
In recognition of the integration agenda NHS Grampian AHP leadership would wish
to support the needs of other AHPs working with adults of working age in both Local
Authority and partner agencies. Due consideration of the sharing of developed
training and expertise going forward is anticipated and will be guided by operational
management teams.
The online websites (intranet/internet) are currently up to date and our proposals to
address these in the coming months are in hand and at the time of writing we have
agreement, in principle, for funding to support this work.
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APPENDIX 1
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APPENDIX 2
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APPENDIX 3
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APPENDIX 4
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APPENDIX 5
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7 AHP SURVEY
AHP Advisory Fitness for Work Report Questionnaire
1. Do you work with adults between the ages of 18-65? YES / NO
2. Have you heard about the AHP Advisory Fitness for Work Report?
YES / NO
3. Would you know how to access it? YES / NO
4. Would you feel confident in explaining the purpose of the AHP Fitness for Work Report
to patients?
If YES go to 5
If NO go to 6 YES / NO
5. To whom might you send the AHP Advisory Fitness for Work Report?
Employer
Patient
GP
Employer’s Occupational Health Service
6.1
6.2
Would you feel confident enough to use the AHP Advisory
Fitness For Work Report in practice tomorrow? YES / NO
If YES how confident on a scale of 1-10? ________
Then go to Q8.
If NO go to Q7.
7. What would help you put the AHP Advisory Fitness for Work Report into Practice?
Clear guidance and protocol from NHS Grampian AHP
management team.
A profession specific workshop on how and when to use it.
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Dedicated time to access a learning module.
Buddying with an AHP colleague who is more confident in its use
8. Can the AHP Advisory Fitness for Work Report be used to:
Sign people off sick YES / NO/ Don’t know
To claim sick pay from employers YES/ NO / Don’t know
Offer practical advice to employer/employee to retain an YES / NO / Don’t know
individual in work.
Make comment on work duties that are not in the person’s job YES / NO /Don’t know
description.
9.
Can a practitioner do a workplace assessment to inform the
AHP Advisory Fitness for Work Report? YES / NO / Don’t Know
10. Should the patient’s diagnosis be included on the report form? YES / NO / Don’t Know
11. Are you aware of what you must do to comply with NHSG policy on the safe storage of
the AHP Fitness Report as an electronic record? YES / NO
12. Please Tick
Are you an: (please tick one)
Occupational Therapist
Physiotherapist
Podiatrist
Dietician
SALT
Other (Please state)
2014
30
13. Is your post: (please tick one)
Permanent
Rotational
Temporary
14. Do you work PRIMARILY in: (tick all that apply)
An in-patient setting
An out-patient
The community
A split hospital/community post
None of the above
15. Which Sector do you work in? (please tick one)
Mental Health and Learning Disability
Aberdeenshire CHP
Aberdeen CHP
Moray
Acute Services
Child and Family Services
2014
31
GLOSSARY OF TERMS
AHP Fitness to Work Report
OH occupational health
RCH royal cornhill hospital
AHP allied health professionals
WRAP Wellness Recovery Action Planning
OT occupational therapist
PT physiotherapy
SLT speech and language therapists
HI-Net Health Information Network
CGI clinical guidance intranet
