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

Buckinghamshire Healthcare NHS TrustIntegrated (acute / community) Trust:>5,000

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

Financial cost to the organisationFinancial cost to the organisation

Increased pressure on the wider team, the `domino effect`Increased pressure on the wider team, the `domino effect`

Detrimental effects on the health and wellbeing of the individual

Detrimental effects on the health and wellbeing of the individual

Processes going round in circlesProcesses going round in circles

Lack of ownership and fragmented approachLack of ownership and fragmented approach

Persistently high levels of Sickness Absence resistant to existing management practice

Persistently high levels of Sickness Absence resistant to existing management practice

Rationale for change

QIPP agendaQIPP agenda

The Financial Implications...

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 Trust’s Patient Promises

Fundamental to success is the recognition that this is a Trust-wide role which requires significant skills

Effective communicatorDetailed understanding of how the organisation works Confidence in deliveryAble to drive the agenda in a supportive wayCompetent – able to hit the ground running

Commenced in role November 2010

Information/Data

Case Managementaction plans

Policy refresh

Training sessions 1:1 & group across Divisions

Pro

ject

wo

rk s

trea

ms

Bradford score information shared monthly

Identify individuals score > 300 > 1000

Templates & flowcharts distributed

Health summit meetings monthly

Manage change effectively

Training & support

Communication

Stress Workshops156 managers Sickness Absence

WorkshopsOne to one coaching

Home visits Return to work interviews

Group seminarsHealth Summits

(divisional)Health Summits

(divisional)Round table discussionRound table discussion

HR / OHW liaison

Sickness absence tracker (OHW/HR)

Sickness Absence Activity

Fast track to Physiotherapy -

76 clients 2011/12

Fast track to Counselling - 211 clients

2011/12

Specialist referral clinics

Realistic and informed actions

Quick response

Case Management ActivityCase Management Activity2011/20122011/2012

Case Management Activity TotalEmployee meeting 143Sickness policy staff trained 455Coaching 1:1 with manager 157Case Conference meetings 36Home visits 4Health summit 51Long term over 12 months returned 37Panel pending 7Panel dismissal 6Ill Health Retirement 11Redeployed 20Resigned due to illness 18

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

Activity in Occupational Health and Wellbeing

Progress by Case Manager

DivisionJune 2009 –May 2010

March 2011 – Feb 2012

Top 20 individuals with highest Bradford score

No of Episodes

Calendar Days lost

No of Episodes

Calendar Days lost

Div one 120 1686 54 630Div two 161 1702 35 634Div three 175 2204 66 925

Bradford FactorBradford Factor

Bradford FactorBradford Factor

Bradford FactorBradford Factor

Based on: Mid point band 6 1.00wte23% on-costs5 day week

Financial Savings to the TrustFinancial Savings to the Trust

1068

1056

1279

Div one

Div two

Div three

Three Divisions having reduced lost days over the specified period

3403TOTAL Days saved

TRUST SAVING£473,039.00 2011 - 2012

CHALLENGESCHALLENGES

Engaging staffEngaging staff

Making paperwork Making paperwork accessibleaccessible

Showing the Showing the benefitsbenefits

Gaining trustGaining trust

Changing Changing habitshabits

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

data collection

SustainabilitySustainability

The Future

• 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

ConclusionsConclusions