Case Management as a tool to Improve the Health and Wellbeing of the Organisation

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Case Management as a tool to Improve the Health
and Wellbeing of the Organisation
Gerard MarsdenOccupational Health and Wellbeing
(OHW) Head of Service Jacquie ScottCase Manager
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Buckinghamshire Healthcare NHS Trust
Integrated (acute / community) Trustgt5,000
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
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Rationale for change
Persistently high levels of Sickness Absence
resistant to existing management practice
Lack of ownership and fragmented approach

Processes going round in circles
Detrimental effects on the health and wellbeing
of the individual
Increased pressure on the wider team, the domino
effect
QIPP agenda
Financial cost to the organisation
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The Financial Implications...
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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 Trusts 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

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Bradford score information shared monthly
Information/Data
Case Management action plans
Identify individuals score gt 300 gt 1000
Templates flowcharts distributed
Policy refresh
Project work streams
Health summit meetings monthly
Communication
Manage change effectively
Training sessions 11 group across Divisions
Training support
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Sickness Absence Activity
Quick response
Realistic and informed actions
Sickness absence tracker (OHW/HR)
Fast track to Counselling - 211 clients 2011/12
Specialist referral clinics
Fast track to Physiotherapy - 76 clients 2011/12
Stress Workshops 156 managers
Sickness Absence Workshops
One to one coaching
Health Summits (divisional)
Group seminars
Round table discussion
Home visits
Return to work interviews
HR / OHW liaison
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Case Management Activity2011/2012
Case Management Activity Total
Employee meeting 143
Sickness policy staff trained 455
Coaching 11 with manager 157
Case Conference meetings 36
Home visits 4
Health summit 51
Long term over 12 months returned 37
Panel pending 7
Panel dismissal 6
Ill Health Retirement 11
Redeployed 20
Resigned due to illness 18
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Activity in Occupational Health and Wellbeing
OHW Totals 2009 / 2010 2010 / 2011 2011 / 2012
Counselling Referrals 126 139 211
Counselling Appointments 470 434 845
Physio Referrals 142 52 76
Management Referrals 582 764 781
Phone Calls To Service (All Clients)     19819
Emails To Service Mailbox     2256
Needlestick Injuries   211 221
Musculoskeletal Audits     69
Reported Stress To OHW 90 86 134
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Progress by Case Manager
Division June 2009 May 2010 June 2009 May 2010 March 2011 Feb 2012 March 2011 Feb 2012
Top 20 individuals with highest Bradford score  No of Episodes Calendar Days lost No of Episodes Calendar Days lost
W C 136 2547 64 1210
Medicine 151 2199 50 1302
Surgery 193 2233 109 1091
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W C Division Bradford Factor
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Medicine Division Bradford Factor
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Surgery Division Bradford Factor
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Financial Savings to the Trust
Three Divisions having reduced lost days over the
specified period
1056
NSIC
1068
Medicine
1279
Surgery
3403
TOTAL
Days saved
TRUST SAVING 473,039.00 2011 - 2012

• Based on Mid point band 6
• 1.00wte
• 23 on-costs
• 5 day week

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Financial Savings to the Trust
Seven Divisions having reduced lost days over the
specified period
1741
Corporate
3496
897
Other Divisions (Est)
Medicine
1142
Surgery
1337
Days saved
WC
TRUST SAVING 950,353 2011 - 2012
9341
TOTAL

• Based on Mid point band 6
• 1.00wte
• 23 on-costs
• 5 day week

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Engaging staff
Making paperwork accessible
Changing habits
CHALLENGES
Showing the benefits
Gaining trust
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Sustainability
The Future

• Continue to engage
• Build resilience
• Share learning
• Refine processes
• Embed feedback and data collection

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Conclusions

• 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
• HPMA Winner 2012
• HSJ Efficiency Award Finalist 2012

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