April 2007
Welcome to the Rehab Direct monthly rehabilitation news bulletin for April 2007.
Our aim in this bulletin is to give you an overview of what is happening in rehabilitation, and what is contributing either to early returns to work after injury, or causing injuries and other conditions to last longer than they need to.
We welcome users’ comment or suggestions for new subject areas we might monitor. If you would like to know more about Rehab Direct please visit our site
Emphasis is on workplace stress
Who gives a thought to mental health in the workplace? It can take the personal crisis of a celebrity such as Stephen Fry, or the cricketer Marcus Trescothick to bring the matter to light: and even then, not for long. Yet, according to the Department of Health, one in six of us suffers mental health problems.
The workplace is used to dealing with obvious cases of disability such as the wheelchair-bound employee. The challenges are visible and understandable: easier access and an adapted workstation can solve things. But mental illness, where there's no outward sign of incapacity, throws up complex problems.
The FSB's Health Matters report, designed to feed into government thinking, is the first survey of members specifically on sickness absence and workplace health.
It says more can be done to build relationships and understanding between employers and GPs, and to identify incentives for businesses to guard the health and welfare of employees. In a survey of almost 4,000 FSB members, 75% of which had 0-9 employees, 43% reported no impact on their business from sickness absence. That's the good news.
The bad news was that for 11.2% - 289 responses - poor mental health was the third most common cause of people taking time off. Stress, depression or mental health is at a significant level, not surprising when 22% of us work more than 60 hours a week.
Anxiety and stress can result from returning too soon after a physical illness so a cycle of sickness builds up. But inevitably many bosses and sole traders say if they go sick, things don't run well. They can't afford time off.
The FSB found a general low awareness of the support available from government and health providers for managing absence. But bosses themselves can do things to help. The feel-good factor is essential - if people are happy at work, then time off due to sickness falls away dramatically. The report advises bosses to let staff know how important they are.
This is echoed by the Department of Health, which claims that 80 million working days are lost annually to stress. In a perfect world every employer would be understanding; every employee with a problem accommodated.
But it doesn't work out that way. Take the woman who applied for a cleaning job at a care home and admitted having schizophrenia. She experienced 'complete silence' on the end of the phone. A few days later came the rejection letter - hardly surprising when fewer than 40% of employers would entertain hiring someone with a mental health problem.
BT strives to be 'psychologically sound, socially responsive', identifying vulnerable and 'hotspots of distress.' They haven't rejected any job application on grounds of mental illness since their strategy has been in place. BT claims mental health sickness absences are down 30% and that stress claims have reduced dramatically.
Compare this with the lot of the hapless council manager who moved to what he imagined would be a quiet local authority. He ended up working 80 hours a week. 'After seven months I had a breakdown and was signed off sick,' he said. 'They came back and said, 'If you're not back at work within a week, you're sacked.' It was horrendous. A week later I was sacked.'
Employers have a duty to ensure staff are not made ill by their work. Moreover it makes sense that those taking part in projects to increase mental health awareness report improved retention and reduced sickness levels.
From last December, public organisations were required to publish a disability equality scheme. About time too, many will feel - although, for some individuals, it has already come too late.
Companies warned of dangers of stress
The Chartered Institute of Personnel and Development (CIPD) is urging companies to train line managers in identifying the symptoms of excessive stress or face potentially high compensation claims. The organisation has published three guides to help employers tackle the problem, which it claims costs British business of £9.6 billion each year in compensation and sick days.
Ben Willmott, employee relations advisor at the CIPD, said: "Employers who fail to manage stress are vulnerable to litigation and potentially high compensation payouts. Good people management can help to prevent most of the problems causing stress at work, such as lack of control over workload."
European whiplash model could save the UK £150m
The UK is out of step with Europe in the amount of whiplash claims insurers have to pay, with potential savings of £150m easily within the industry's grasp.
Allianz Cornhill head of claims Jon Dye said that in the UK 17% of motor liability claims involved whiplash, which is significantly higher than countries such as France (9%) and Holland (8%). As a percentage of bodily injury claims, whiplash made up 76% of that total, while in France the figure was only a fraction of that at 3%.
"Do we have more vulnerable necks in the UK?" questioned Mr Dye.
He estimated that the UK insurance industry currently pays out £1.25bn in whiplash claims a year, but that this could be cut significantly by following his parent company's lead and developing causation analysis techniques to look at things like the likelihood of injury related to speed of impact.
In 2003, as a result of this, Mr Dye said Allianz in Germany rejected 6000 out of 33,000 whiplash claims at first notification, of which 4000 disappeared straight away without query. After further investigation 1600 were settled with compromise, while 400 were litigated, of which the insurer only lost 60 cases.
Early adoption of these techniques in the UK has resulted in 7% of Allianz Cornhill cases being put under further investigation. Mr Dye added that, if the German example was mirrored in the UK, and 12% were defeated, this would represent 30,000 claims, a saving of £150m.
Rising claims cost solution
The use of non-OE parts and recycled parts was highlighted as something insurers could more widely promote to curb claims costs.
Mr Dye described the use of non OE parts as a "real opportunity", highlighting that last year Allianz Cornhill saved £1m by using them, and in January 2007 alone it saved £100,000 using non OE parts. "This is serious money," he added.
Allianz rehab pledge
Allianz Cornhill is planning to employ more specialist staff to help co-ordinate rehabilitation services for claimants who have suffered severe injuries. For the past 12 months two rehabilitation co-ordinators have been working alongside severe-bodily-injury claims handlers. However, the firm's motor casualty claims manager, Martin Saunders, said three more are being sought by the end of the year.