Health Benefits of Good Work eNewsletter February 2017

Welcome to the third edition of the Health Benefits of Good Work (HBGW) eNewsletter. A lot is happening in the HBGW space, if you have any initiatives, current or in the pipeline, please get in touch with us at afoem@racp.edu.au.

The Australian and New Zealand Signatory Steering Groups are now fully operational and we will keep you updated on their initiatives.

The Australian Signatory Steering Group held the second of its biannual Forums in Adelaide in November 2016. The Forum provided a platform for attendees to learn about the experiences of others. Speakers presented on the business benefits of providing employees with good work and industry practitioners shared their business challenges.

The Health Steering Group held its inaugural meeting in 2016. Health organisations present were encouraged to show leadership in HBGW through vision, influence and action. A number of issues were identified for further exploration including:

  • consumer engagement
  • training in medicine and allied health
  • the approach for older workers and people with disabilities
  • the role of the health industry in addressing health and good work. 

It was echoed that treatment providers have a common interest to find solutions to assist the patient or injured worker. A number of initiatives already underway in some sectors were identified and will be further explored including tools for early identification of at risk workers.

We will keep you updated on future activities of the Signatory and Health Steering Groups.

Union helps police officers achieve the health benefits of good work

A change in culture towards injured police officers returning to work has allowed the Police Association of New South Wales (PANSW) to work with the New South Wales (NSW) Police Force to find opportunities in the force for injured officers. 

Mr Ray Collins is a former police officer and has worked for PANSW for nearly 30 years. 

PANSW represents 16,500 police officers and is the only union that is a signatory to the Australian HBGW Consensus Statement. Mr Collins was Assistant Secretary at PANSW for 12 years before taking on the role of Death & Disability (D&D) Coordinator from 2006.

Mr Collins describes policing as a ‘contact sport’ and officers can incur both physical and psychological injuries as a result of their duties.

“Ironically, from 2006 to 2011 my role as D&D Coordinator was to advise and secure benefits for members who were medically discharging from the NSW Police Force,” he said.

In 2005, PANSW negotiated the Death & Disability Award which provided lump sum benefits to police officers who were medically discharged as a result of their injuries.

“In theory this was a well-intentioned financial security net and important benefit, however in retrospect it was fundamentally flawed,” said Mr Collins. 

The NSW Police Force environment wasn’t encouraging of return-to-work in suitable duties, injury management was adversarial and there was a lack of early intervention. Additionally lump sum benefits acted as a disincentive for the officer to return to work. 

By 2011, over 400 police officers were being medically discharged annually. 

The Death & Disability Award was becoming expensive and it was replaced by a new scheme that reduced overall benefits by 60 per cent. 

This outcome was a light bulb moment for PANSW.  

“We realised that previously we were part of the medical discharge culture that existed in policing, advising members on what they needed to do to exit and what benefits they would be entitled to.  

“But how was this really benefiting members? Sure, it was providing them with what they wanted but was it really in their best interest to leave employment? Were they getting better after leaving? Were they securing alternative employment? 

“With no genuine financial safety net available after exit, it was no longer viable to limit the conversation to benefits. It had to change to, how do you stay well, 'how can you get better, how do you stay/get back to work'. 

“This meant challenging the culture in the NSW Police Force,” said Mr Collins.

Mr Collins recalls veteran detectives who returned to work after injury and were consigned to photocopying, feeling like their skills were no longer valued because they couldn’t operate in the same way they used to.  

For PANSW ‘good work must be meaningful work’. 

Good work draws on the experience and expertise of the individual and provides them with secure, ongoing employment where they can continue to make a contribution to policing. 

Innovation is key to looking at how jobs can be modified to meet the capacity of injured officers, rather than simply looking at what positions are vacant.  

Some recent successes in the redeployment of injured members by the union include:

  • the job modification of a weapons training position for a Sergeant with a spinal injury
  • a permanent, part-time, position in an intelligence role for a Senior Constable with a hearing impairment (after two years of temporary placements)
  • placement of a Detective into the State Crime Command after four years of disputes around physical and psychological injuries
  • a return to pre-injury duties for a Supervising Sergeant at a regional police station after two years following an assault and bullying in the workplace resulting in chronic anxiety.  

All of these officers were destined to join the list of officers lost to the community through medical discharge. Looking at what tasks they could perform and what ‘good work’ meant for them meant they could continue in the force.

Since 2012 PANSW has adopted a new program entitled CARE (Career and Resilience Education) in their interactions with members. Through the program, members are provided training to improve personal resilience including physical fitness and nutrition, career skills, financial planning and budgeting, conflict management and interpersonal communication, psychological fitness and suicide prevention.  

PANSW provides education on injury management and return-to-work and provides individual support and resources to assist injured officers and their families.

The NSW Police Force has also introduced the Workforce Improvement Program (at an initial cost of $15 million over three years) which includes a suite of programs including: 

  • leadership and injury management training for supervisors and management
  • resilience, stress management and self-harm mitigation training for all employees
  • establishment of three in-house physiotherapy and conditioning centres 
  • voluntary health checks at work by registered nurses (blood pressure, cholesterol, glucose levels)

PANSW has partnered with NSW Police to provide training content for in-service courses and curriculum, undertaking policy review and co-sponsoring the state wide delivery of resilience seminars by international experts.  

The overall approach has delivered a resounding return on investment and provided PANSW with the ability to advance benefits for members.  

Between 2012 and 2016:

  • total workers' compensation and death and disability costs have reduced by over $200 million
  • medical discharges have reduced from 30–40 per month to 6–7
  • police assessed as unfit for all work has reduced by over 50 per cent
  • workers compensation leave hours per month has decreased by 50 per cent.  

PANSW has subsequently been able to negotiate improvements to income protection by increasing the benefit period from five to seven years, and the government has agreed to extend funding for the Workforce Improvement Program with a further $17 million over four years.

PANSW and the NSW Police Force have had disputes, however they still work cooperatively and are currently discussing the expansion of partial operational roles as part of a new deployment policy for injured police.

As a member of the HBGW Signatory Steering Group (SSG), Mr Collins says his participation has influenced his work at PANSW.  

“I have learnt much from the group and I try to put this into practice in my own work. I hope to assist the SSG engage with other unions and highlight the difficulties faced by injured workers trying to return to the workforce across industries,” he said. 

Fire & Rescue NSW – helping firies continue to fight fires after injury

Mr Andrew Macgarity is Manager of Injury Management at Fire & Rescue NSW. He spoke to us about how becoming a signatory to the HBGW Consensus Statement has helped the organisation change their approach when working with injured staff. These changes have benefits for all staff, their families, management and the community the organisation assists in times of need. 

Tell us about yourself and Fire ​& Rescue NSW?

Fire & Rescue NSW (FRNSW) delivers essential emergency services for the community throughout NSW. The organisation comprises permanent firefighters, retained firefighters, administrative and trades personnel as well as volunteers in Community Fire Units. 

FRNSW is charged with protecting 90 per cent of the NSW population from fire, and 100 per cent of NSW from hazardous materials emergencies; while performing more than 75 per cent of all rescues in NSW. FRNSW also assists other agencies including the Rural Fire Service at bushfires outside FRNSW districts; the State Emergency Service with floods and storm damage and the Ambulance Service of NSW with emergency medical responses.

As an organisation that requires its staff to work in potentially hazardous environments, safety is always our highest priority. However, due to the work we do, injuries occur and given the important service FRNSW provides to the community, we need to ensure we do everything possible to ensure firefighters can return to the work they are trained to do. 

I manage the injury management team. My team works closely with the safety and health promotion teams to ensure injured firefighters receive the best possible care and support, using the research available into employer based interventions. 

Why did your organisation become a signatory to the HBGW Consensus Statement?
 
FRNSW has endeavoured to implement processes that are consistent with research regarding rehabilitation within the compensable environment, particularly the employer’s role in supporting recovery. 

The HBGW Consensus Statement and associated documents summarise the research demonstrating the importance of returning injured firefighters to meaningful work to facilitate their recovery and improve their overall wellbeing. 

Becoming a signatory was important to demonstrate our intent to provide the best possible assistance and support to our injured firefighters.  

What has been the biggest impact of HBGW for your organisation?
 
Firefighters value their role greatly, they are proud to provide service to the community and help people at their time of greatest need. As such, returning injured firefighters to this environment is important for their recovery. 

It allows their friends and colleagues to provide support and allows the injured firefighter to return to a role they value as soon as possible. 

By signing the HBGW statement, we have been required to re-think the reasonable accommodations available, particularly in relation to psychological injuries. We now have multiple avenues available to facilitate a return to work for injured retained and permanent firefighters, regardless of rank and geographical location. 

What has been the biggest learning curve for your organisation since embarking on the HBGW journey?
 
One issue that has arisen from some parties is the questioning of the motivation for this process. This is driven by a perception that returning to work is more about financial outcomes and ‘ticking a box’. 

My experience is employers who seek financial reward in this way do have slightly improved short-term outcomes, but as the return to work process is not well considered, the injured worker becomes disengaged and demotivated, which inevitably impacts their recovery. 

As such, it has been important that the act of signing the HBGW Consensus Statement is not the end of the process. It needs to be part of an overall systematic approach of providing best practice rehabilitation and return to work programs. 

The other important learning is the need to consult people who have been through the process as well as health professionals who specialise in occupational rehabilitation. This ensures the assistance provided is based on the most recent medical research, while also being practicable for the workplace and individual. While the consultation can be quite confronting initially, it is a vital step to ensure the processes are providing injured workers the assistance and support they require, which can lead to significant improvements.

Have you found any champions for HBGW within your organisation or stakeholders?

The Executive and Commands of FRNSW have been very supportive of this process since it was first proposed. 

Initially, there was some feedback from some involved in the return to work process regarding the productivity and meaningfulness of ‘lighter duties’. As noted above, we attempted to overcome this through prolonged consultation and feedback from Commands and injured firefighters. 

While we still have work to do, it has meant some of the firefighters who have been injured have become champions for the goals that we have.  

Do you have any advice for organisations thinking about implementing HBGW principles in their workplace?
 
Becoming a signatory to the HBGW Consensus Statement provides an important reference document for all employees and also provides employers all of the support and assistance available from the RACP and HBGW steering groups. 

Implementing HBGW principles also ensures rehabilitation goals match with human resource needs, which also helps financially. 

I would encourage any organisation that is interested in the health and wellbeing of their staff to become a signatory.   

Worklessness: can physiotherapists do more?

Physiotherapist Dr Anne Daly spoke to us about the importance of the health benefits of good work to physiotherapy, a topic she explored in a recent editorial – Worklessness: can physiotherapists do more? 

The physiotherapy profession is a well trained, well regulated, reasonably priced healthcare resource that extends throughout all tiers of the community, the health care system and the country. 

Physiotherapists’ expertise in musculoskeletal health and the exposure they have to a patient's functional abilities provides excellent insights into a person’s capacity for work.

However, conversations between a physiotherapist and a patient regarding the patient’s employment are not always standard practice. For some, these conversations are considered out of scope for the physiotherapist – ‘not my job’, ‘too hard’, 'not what I was trained to do’. It is also important to acknowledge that physiotherapists in primary care are currently not paid to address a patient’s work capacity.

The Australian Physiotherapy Association is a signatory to the Realising the Health Benefits of Work Australian Consensus Statement, but many members would be unaware of its existence, or its importance. 

Dr Daly said her editorial seeks to lift the awareness of all physiotherapists about the sustained impacts of worklessness on patients and their families, our communities, the healthcare system and society.  

“I am hopeful that physiotherapists will start a conversation about what we could do as individuals, and as a profession, to address worklessness and advocate for the health benefits of good work.

“Primary care physiotherapists see injured Australians early, often regularly and for longer consultations than their General Practitioners are able to. There is therefore great potential for physiotherapists to influence the outcome when it comes to getting back to work,” she said. 

The editorial is beneficial reading for all doctors and allied health professionals looking to change the conversations around work and health. Worksafe Victoria has developed a number of resources that encourage physiotherapists and healthcare professionals to consider a return to safe and good work as part of patient rehabilitation. 

The Australian Physiotherapy Association is a member of the Health Steering Group (HSG), an initiative of the Australasian Faculty of Occupational and Environmental Medicine (AFOEM). The vision of the HSG is that all healthcare professionals will implement the principles of the health benefits of good work into their practice. 

Get involved and spread the word

If you would like to share your organisation’s experience with the HBGW initiative in future editions of this eNewsletter, contact AFOEM at AFOEM@racp.edu.au

We are committed to spreading the word on HBGW and growing the Consensus Statement signatory base so please forward this newsletter to any organisations who may be interested. 

Organisations can find more information and become a signatory to the HBGW Consensus ​Statement on the How to become a signatory page.

We look forward to hearing from you. 

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