Multi-Professional Team

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Multi-Professional Team

Workplace Health and wellbeing is managed by a multi-professional team.

FOHN

Faculty of Occupational Health Nursing provide access to principles of practice, framework documents and guidance to support occupational health practitioners, as well as high quality information and advice to decision-makers and the wider public. A not-for-profit organisation conducting activities to promote and strengthen the learning and practice of the art and science of occupational health (OH).

Resources: What is occupational health, Employing an OH Nurse, OH Nurse accreditation

FOM

The professional and educational body for occupational medicine in the UK and seeks to ensure the highest standards in the practice of occupational medicine.

Resources: Ethics Guide and SEQOHS

SOM

The Society of Occupational Medicine is the UK organisation for all healthcare professionals working in or with an interest in occupational health.

Resources: Find and OH Service, Value proposition

BOHS

The British Occupational Hygiene Society (BOHS) is a science-based, charitable body that provides information, expertise and guidance in the recognition, control and management of workplace health risks.

BOHS

HSE

The Health and Safety Executive (HSE) is Britain’s national regulator for workplace health and safety. We are dedicated to protecting people and places, and helping everyone lead safer and healthier lives.

HSE

IOSH

We help businesses to make the most of their investment in health and safety. Our expert team at IOSH for Business is here to help with all your occupational safety and health needs.

IOSH

VRA

The VRA is a multi-disciplinary UK-wide organisation supporting and promoting all those working in vocational rehabilitation and commissioning services whether in the public, private, voluntary or third sector.

Resources: VRA resource library, Find a practitioner

ACPOHE

The Association of Chartered Physiotherapists in Occupational Health and Ergonomics (ACPOHE) is a Professional Network of the Chartered Society of Physiotherapy.

Resources: Work & Health Hub and Find a Physiotherapist

RCOT

Helping people everywhere value the life-changing power of occupational therapy.

Resources: Specialist Section – Work and Find an Occupational Therapist

Occupational Therapy
Background | Specialist skillset | Occupational therapy services | Find out more

Background

The role of Occupational Therapy Within the Multidisciplinary Occupational Health Team

Where have Occupational Therapists come from, and why haven’t I seen them in my Occupational Health department?

Occupational therapists (OTs) have a long history of working in vocational settings and, in other countries, have for decades been a well-established part of the Occupational Health (OH) team. In the UK, however, whilst OTs have been working in OH since the 90s, this has been less mainstream. OTs are rehabilitation specialists and have always sat comfortably in vocational rehabilitation (VR) settings within NHS/social services/third sector, notably within income protection and personal injury settings. As the OH landscape is changing and moving towards a more biopsychosocial and rehabilitative approach, OT skills are becoming more sought after in OH settings.

Specialist Skillset

What does OT undergraduate cover?

OTs are “dual trained”. Their degree covers not only mental health and physical health but a vast breadth of conditions, including cognitive, neurodivergent, hearing and visual impairment. OTs are the only professionals that can undertake vocational assessments immediately post-qualifying. Although they can and do undertake a wide variety of post-graduate training and CPD, this isn’t a prerequisite to work in an OH setting. OT undergraduate training covers the assessment of the person, environment, and occupation (using the PEO model), which provides a useful framework in which to explain the OT approach to an OH assessment:

Person:

We are “Dual” or “wholistically” trained, meaning we can assess a very broad range of conditions. As a result, we focus on function over pathology. Whilst we take diagnoses and treatment into account, we are more interested in the functional impact upon occupational performance, or activities of daily living, including work.

Environment:

OTs are trained to assess the environment in which people carry out occupations: complex and simple DSE assessments, ergonomics both physical and cognitive, equipment recommendations, more subtle environmental aspects such as the cultural or organisational environment, sensory assessments for people with neurodivergent conditions and accessibility for visual impairment.

Occupation:

Throughout the OT degree, we learn about activity analysis. This involves breaking any task down into the minutiae of its components and demands. It can include cognitive, physical, cultural, and motivational components, to highlight a few. This places OTs particularly well to undertake vocational assessments as they will be able to understand the job thoroughly, or indeed, particular work task that any employee must do.

Clinical Governance for OTs

OTs are all registered with the HCPC and follow their standards of practice, including CPD, ethics and conduct. Our professional body is the Royal College of Occupational Therapists (RCOT), which provides guidance on our scope of practice and standards and ethics that guide the work of the occupational therapy workforce.

Occupational therapy services

As well as working as occupational health advisors, OTs work in a more specialist role and are often used to assess the more “complex” assessments. OTs gather objective and, if required, granular levels of clinical data on which physicians can make more informed decisions on ill health retirement or safety-critical work. As rehabilitation specialists, they are also well-placed to deliver vocational rehabilitation and case management interventions.

oh-therapists-map

Find out more

There have been many recent articles describing OT in OH settings. Examples can be accessed here, here and here. SOM hosted a webinar on this topic in 2022. RCOT has a specialist section, “Work”, which provides information and supports members working in this practice area. OTforOH is a recruitment agency which places OTs in OH settings and has information on its website about the value of OT.

royal-college-logo Helping people everywhere value the life-changing power of occupational therapy.

Occupational Health Physiotherapy
Background | Specialist skillset | Bio-Psycho-Social Model of Health | Find out more

Background

Fact 1:
PHYSIOTHERAPY ORIGINS ARE IN THE WORKPLACE

Physiotherapy was first defined as an occupation in 1894, with the founding of the Chartered Society of Physiotherapy (CSP). However, the origins of rehabilitation began around 1760, at the beginning of the Industrial Revolution. Here, the rise in factories and the use of machinery led to high numbers of occupational injuries, prompting the need for workplace health and safety. Further developments in physiotherapy rehabilitation occurred during World War 1 and World War 2 because of the large number of wounded soldiers with various physical injuries and disabilities.

Over the years, physiotherapy in the workplace continued to address major workplace health issues such as respiratory problems in coal miners, amputations from injuries operating heavy machinery and musculoskeletal injuries associated with manual labour. From the end of the 20th century to present day, physiotherapy in the workplace has developed to cater to the changing work demands we see today, such as sedentary occupations, psychosocial risks, and pandemic-related Occupational Health Challenges.

In 1947, the CSP established the Association of Chartered Physiotherapists in Occupational Health and Ergonomics (ACPOHE). ACPOHE continues today as a thriving Professional Network. More about ACPOHE below!

Specialist Skillset and Competencies of Occupational Health Physiotherapists

Fact 2:
PHYSIOTHERAPISTS IN THE WORKPLACE HAVE MANY SKILLS

Occupational Health (OH) Physiotherapists address the health and well-being of individuals in their work environment. Most OH Physiotherapists come from a rehabilitation or musculoskeletal background, although more recently, especially in the post covid years, physiotherapists with specialist respiratory, mental health or neurological skills are also entering the field of Occupational Health.

 

OH, Physiotherapy is multifaceted, addressing both physical and psychosocial aspects of health. The evidence supporting these benefits reinforces the integral role of physiotherapists in occupational health and their impact on creating healthier and more productive workplaces. Researchers continue to explore new avenues and interventions to enhance the effectiveness of OH Physiotherapy.

In addition to providing treatment services, such as musculoskeletal treatment, we also undertake many other roles and responsibilities within OH. These include:

  1. Injury Prevention:
    – Identification of potential workplace hazards can help prevent accidents and reduce the prevalence of musculoskeletal disorders.
    – OH, Physiotherapists can provide rehabilitation to increase the individual worker’s capacity through body conditioning.
    – Likewise, they advise on proper body mechanics and techniques to reduce the risk of injuries during work activities.
  2. Work Demands Evaluation:
    – Comprehensive analysis of demands of work tasks using a variety of techniques. This may be for an individual or group of workers.
  3.  Workplace Ergonomics:
    – Assessing and optimising workplace ergonomics of many work environments (not just offices) using a variety of ergonomic methods. OH, Physiotherapists undertake evaluations of warehouses, factories, refuse depots, construction sites and many other environments.
  4. Functional Measurement Tests and Assessment of Fitness for Work:
    – Assessment of individual’s physical abilities and limitations to determine their capacity to perform specific job tasks using clinical assessment skills and validated functional measurement tests.
  5. Occupational Rehabilitation, Recovery and Return-to-Work Plans:
    – Case Management of employees who are absent from work.
    – Rehabilitation programmes designed to facilitate the recovery of individuals who have suffered injuries or illnesses that affect their ability to remain in or return to work.
    – Implementation of exercise routines and therapeutic interventions to improve mobility, strength and functions.
    – Developing and implementing structured plans to facilitate an individual’s return to work after an injury or illness.
    – Collaborating with employers to create modified work duties that accommodate the employee’s capabilities during the recovery process.
    – Advising on ‘reasonable adjustments’ in the workplace.
  6. Pain Management:
    – Physiotherapists can help manage and ease pain associated with work activities.
    – Offering strategies for pain relief, such as exercises, stretches and manual therapies.
  7. Health Promotion:
    – Providing education and guidance on maintaining a healthy lifestyle, including exercises, nutrition and stress management.
    – Implementing wellness programs to enhance overall employee health and productivity.
    – Supporting behaviour change.
  8. Management and Leadership in OH:
    – Physiotherapists play an important role in management and leadership in OH.
  9.  Research:
    – Physiotherapists are increasingly engaging in research to highlight the benefits of OH Physiotherapy and to support growth and development of OH Physiotherapy.

OH, Physiotherapy offers many benefits such as:

  1. Productivity Enhancement:
    – Improving employee productivity by addressing musculoskeletal and other health issues and promoting overall employee well-being.
    – Enhancing return to work outcomes.
    – Prevention of musculoskeletal and other health issues.
    – Assisting in the development of strategies to enhance efficiency and reduce absenteeism because of health-related issues.
  2. Employee Satisfaction and Retention:
    – Demonstrating a commitment to employee health and well-being can contribute to higher job satisfaction.
    – Support improved employee retention.
    – Improved health and safety culture within an organisation.

Fact 3:
OCCUPATIONAL HEALTH PHYSIOTEHRAPY IS ALWAYS PERSON CENTRIC

OH, Physiotherapy always adopts the Bio-Psycho-Social Model of Health with the employee firmly at the centre of all assessments and interventions. The infographic below highlights how OH Physiotherapy adopts a person-centred approach.

fact-3

Fact 4:
WE ADDRESS PSYCHOSOCIAL OBSTACLES AND MENTAL HEALTH ISSUES

Most physiotherapists do not diagnose or treat mental ill-health unless they have dual qualifications. However, we do fully incorporate psychological and social obstacles in our assessment and management. We also understand the importance of physical activity and function in supporting individuals with mental health or psycho-social problems. It is common practice to use a variety of validated outcome measures and screening tools, such as the Orebro Musculoskeletal Pain Questionnaire, Keele Start Back Tool, Patient Health Questionnaire (PHQ) – 9, and the Pain Catastrophising Scale.

Fact 5:
OH, PHYSIOTHERAPISTS ADVOCATE FOR THE INDIVIDUAL AND THE EMPLOYER – JUST LIKE ALL OTHER OH PROFESSIONALS

There may be occasions where it is not appropriate for the OH Physiotherapist to be the treatment clinician and the decision maker on other OH management issues, such as the Assessment of Fitness for Work. However, OH Physiotherapists receive training to understand the dual role of Occupational Health in advocating for both the individual and the employer. There are many occasions where the OH Physiotherapist can provide treatment services alongside other OH services without compromising integrity for either party. If you have any concerns about this, please discuss it with the OH Physiotherapist involved. Also, please do not confuse occupational health specialist physiotherapists with physiotherapists who provide treatment services for employees but are not trained in occupational health. It is common, especially with private musculoskeletal physiotherapists, to offer treatment services for employees. Always check their qualifications if you are asking for occupational health opinions, as they may be more biased to support the ‘patient’ and fail to understand the broader implications for the organisation concerned.

Fact 6:
REGISTERED ACPOHE MEMBERS HAVE PROVEN COMPETENCE IN OH

We advise you to use ACPOHE as your ‘go to’ place to find OH Physiotherapists or to ask questions you may have about OH Physiotherapy. ACPOHE has various levels of membership and is open to qualified Health Professionals working in OH from all backgrounds. Registered Members are physiotherapists with demonstrable competence in OH. Click here, to find out more on ACPOHE Membership.

Fact 7:
OH, PHYSIOTHERAPISTS ENJOY BEING PART OF THE MULTIDISCIPLINARY TEAM

We love working as part of a multidisciplinary team and undertaking inter disciplinary education with other OH professionals. Ask us questions, tell us about what you are doing, debate difficult questions with us.  We always welcome the interaction.  Click here to access ACPOHE’s Free Work and Health Hub (click on – FREE GUEST ACCESS).

Hear from the specialists

Vocation Rehabilitation
Background | Specialist skillset | VR in OH | Find out more

Background

If you’ve not heard about VR before, it is:

‘Any process that enables people with functional, physical, psychological, developmental, cognitive or emotional impairments to overcome obstacles to accessing, maintaining or returning to employment or other occupation​’.

A simple way of understanding the breadth and depth of VR is to know that if you are supporting someone to remain in work or helping them to find work and return to the workplace then you are considered a VR practitioner, which comes as a surprise to many who don’t identify with this title.

To explain this further, a VR practitioner can be both clinical and non-clinical and there’s a huge variety of job roles they perform, including VR practitioners​, case managers​, OT, physiotherapist, psychologist, counsellors, rehabilitation counsellors, employment support specialists​, disability employment advisors​, occupational health practitioners​, HR advisors​, line managers​, social workers​, union representatives​, GPs, consultants and nurses.

Practitioners also work in a range of different settings including occupational health, the insurance sector​, the NHS​, Job CentrePlus​, charities​, prisons​, homelessness services​, social care​, refugee services​​ and social enterprises​.

VR practitioners are supported by their own membership organisation: The Vocational Rehabilitation Association which was set up in 1994 and is now the go-to organisation for vocational rehabilitation practitioners and those interested in the field. Its aims are to:

  • promote the professional knowledge, attitudes and skills of vocational rehabilitation practitioners
  • provide a vehicle for the exchange of ideas and experience across the UK
  • contribute towards the development of quality standards and training
  • promote equal opportunities within our field of practice
  • increase awareness and recognition of vocational rehabilitation throughout the world of work.

The VRA has a vibrant events schedule including monthly webinars and networking events, two conferences a year and an Awards programme celebrating vocational rehabilitation projects.  As an organisation we are regularly asked to be part of steering groups supporting the area of work and health, including those at government level.

Specialist Skillset

Given the breadth of roles within VR, there are no training courses that lead to a specific qualification. Rather there is a set of standards produced by the VRA to support practitioners to develop their skill set in VR. These are found on the VRA website, here.   Often employers of VR practitioners will provide in-house support to develop and hone their skill set ‘on the job’.   Some professional organisations such as RCOT provide VR education as part of their subsections.  Independent organisations also provide training opportunities, examples of which are here: https://www.e-lfh.org.uk/programmes/strokevrtoolkit/, https://www.physiquipe.com/events/vocational-rehabilitation-course/, https://ergocom.co.uk/courses , https://acpohe.csp.org.uk/content/acpohe-courses,  https://www.otforoh.com/are-you-an-ot, and https://www.uclhcharitycourses.com.

VR in OH

As a profession, we work closely with other practitioners as part of a case management approach.  We are used to working as part of a multidisciplinary team and include all stakeholders in the work that we do.  We make for a strong member of the OH MDT as we can carry out assessments as well as design and deliver interventions to support the return to work of absent employees.  A core part of VR is return to work planning and implementation as well as advising and training employers in reasonable adjustments and the equality act as well as how to support their colleague.  VR practitioners also support in the delivery of wellbeing activities as part of the focus on enabling people to remain in their work role and not falling out of work.

Often practitioners are also skilled clinicians so can bring a wealth of clinical knowledge as well as a different perspective on health and work issues. This skills mix can be invaluable to both in-house and external occupational health providers.

Find out more

Please drop us a line at enquiries@vrassociation.org.uk or visit our website: https://vrassociationuk.com/  to find out more. We’re always happy to help!