Transcript Anna Tebay

Working with Health Professionals
to Reshape Health Services
Anna Tebay
Work for Health Programme Lead - GMPHN
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GMPHN – Who We Are
GMPHN is a collaborative organisation that works
on behalf of the 10 Greater Manchester Directors
of Public Health to ensure that public health has a
strong and credible voice with national, local and
regional partners
We work with local partners to help reduce the
impact of ill health on individuals and to support the
Greater Manchester economy
http://www.gmphnetwork.org.uk/
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Work for Health Programme
Aim
• To reshape Health Services to integrate work as
part of a patients treatment plan
Outcomes
• Focus on speeding up recovery time and helping
patients better manage their health conditions
(mental and physical)
• Helping people stay in work
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Definitions
• ‘Work’ is paid or unpaid activity undertaken in a
meaningful and structured way to deliver benefits to
others
• The definition includes caring, volunteering, self
employment, fostering, mentoring and wider civic
engagement
• Long term health conditions that this project has
focused on include: MSK conditions such as back &
neck pain, mild strokes, asthma, COPD, diabetes,
heart disease, depression, bipolar and anxiety
What We Know
• Good work is good for health and wellbeing
• Being unemployed for more than 12 months
significantly reduces life expectancy equivalent to
smoking two packets of cigarettes a day (Francis 2010)
• Individuals will often have a combination of physical
and mental health conditions – and the reasons for
being out of work will change (Black and Frost 2011)
• When an individual is unwell they make an early
judgement on whether they will be returning to work,
influenced by family, friends and health professionals
3 Pathfinder Sites
Bolton (Farnworth), Oldham (Stanley Road), Wigan (Worsley Mesnes)
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Insight Interviews
• To find out why work was not routinely
included as part of a treatment plan
• Participants recruited from local healthcare
and community settings
• Group and individual interviews
• 12 focus groups; 7 individuals
• Interviews transcribed
• Thematic analysis conducted
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Why isn’t Work routinely included as
part of a patient’s Treatment Plan?
• Health professionals have mixed views as to whether
patients should be 100% fit before returning to work
• Inconsistent practice across Greater Manchester
• Perception that patients with the mildest health
conditions are the most likely to want to work
• Attitudes and perceptions present the greatest barrier
Key Finding: Health professionals are nervous
about having the conversation of work and
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health
Perceived Barriers: Talking Work & Health
Health Professionals:
• Assumption that the conversation was taking place with
other health professionals
• Perception that people would rather be on benefits than
work and therefore don’t want to discuss work and health
• Perception that patients don’t want to return to work until
100% fit
• Perception that work discussions will be viewed as
‘pushing’ people back to work before they are ready
• Nervous about how this could damage relationships
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Health Professionals:
• Health professionals are uneasy about how patients
will receive non medical treatment and advice about
work
• Unsure of how to start the conversation about work
and health
• Uncertain of what to discuss
• Discussions of work and health usually take place
with those perceived as the most motivated to work
rather than those that would benefit the most
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Perceived Barriers: Talking Work & Health
Individuals:
• Individuals perceive health professionals as not
having the time or desire to discuss anything non
medical
• Work not seen as something that health
professionals would provide advice on
• Thought that health professionals would be more
likely to discuss work and work adaptations for
physical health conditions than they would for mental
health
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Testing Perceptions
• No examples of negative experiences as a result of
raising the conversation of work and health
• When individuals brought up the conversation, health
professionals were receptive and engaging
• Individuals were ill prepared for the conversation and
left having wished they had asked more questions
• In the main, health professionals didn’t feel that work
and health conversations would impact on
appointment times
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• The patient was ill prepared for the conversation
• Conversations were not maximised to full
advantage
• Allied health professionals were under utilised
in supporting people to stay in or return to
work
Key Finding: Both the individual and the health
professional wait for a cue from the other before
raising the conversation of work and health
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Cultural Attitudes
• Cultural shift is needed to normalise working with
health conditions
• Treatment needs to consider the whole person, this
includes work
Key Finding: Society focuses on what an illness may
prevent people from doing, rather than crediting what
we can do
• Most of the barriers that we identified are around
having the conversation of work and health
• The second phase of the work for health programme
focuses on mechanisms to alleviate these barriers
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A Suite of Evidence Based Tools
• Developed with and for health professionals
• Roll out across Greater Manchester
Work for Health Training
• Conference events to obtain ‘buy-in’
• GP peer led discussions
• Allied Health Professionals (AHP)
• Psychological Practitioners
• Core training programmes
• Joining up practice GP’s and AHP’s
• Public Health colleagues
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Work for Health
Conversation Guide
• Developed by Salford University
• Assess values and beliefs the patient holds
about work
• Gears the conversation as a solution focused
approach after identifying concerns
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More than a quarter of the 28 million
workers in this country are managing a
long term health condition or
impairment
For too long we have assumed that people
with health conditions should be
protected from work. The reality is that
work can be good for health, aid
recovery and support people to
manage their conditions better
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Commissioning Framework
• A health systems approach that focuses on promoting
and integrating good clinical practices which will help
individuals remain in or return to employment during
periods of physical or mental ill health
• This framework seeks to address the identified gap
between evidence, guidelines and health care
practice
• Aims to create dialogue between commissioners to
reinforce that mental and physical health often can
not be disaggregated
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Summary
• Work for Health principles will be embedded
within practice as a sustained approach
• All aspects of roll out will be monitored and
evaluated
• Learning will be shared with other regions for
best practice and utilisation
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Questions?
Anna Tebay – Work for Health Programme Lead, GMPHN
[email protected]
01942 48 3079
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