Disgrifiad o'r contract
We are inviting tenders for a local evaluation of the Fit for Work North Wales (FFWNW), a project aimed at supporting employees with mild to moderate work limiting health conditions, who are off sick, to return to work and retaining employees with work limiting health problems in work. The project is funded by the European Social Fund through the Welsh Government.
Summary of the Fit for Work North Wales
Fit for Work North Wales is an early intervention service, working with employees who have been off work with work limiting health conditions, ideally captured at four to six weeks into their sickness absence and who are seeking to return to employment. The service also supports those at work struggling with a work limiting health condition and who work for an SME (small to medium sized enterprise). It employs a team of case managers who support their clients to access the support they need to return to work earlier than they otherwise would, or to keep them in work, when, without the support they may go on sick leave.
The case managers are able to refer clients, free at the point of entry, to physical therapies and/ or a range of psychological therapies which are commissioned locally and to mediate with employers where required, to support the transition back into work. Where more specialist support is required, the case managers are able to refer their clients to the appropriate organisations for advice and support with related issues such as debt or housing.
The service also provides information and advice for employers (principally by monthly workshops) who may have staff on sickness absence, or who are looking to develop their workplace health and wellbeing practices. The service supports employers to access information on a wide range of tools available to support health and wellbeing in the workplace, as well as help and guidance on the GP Fit note.
Background
RCS, formerly Rhyl City Strategy Community Interest Company, brings together a strong and active local partnership of key stakeholder organisations in order to develop solutions to local issues of unemployment and economic inactivity.
The strategy of RCS, is based on the idea that local partners can deliver more if they combine and align their efforts behind shared priorities, and are given more freedom to try out new ideas and to tailor services in response to local need. The programme encourages innovation and fresh new approaches as an appropriate response to entrenched problems.
In 2010, RCS led a bid with its partners Betsi Cadwaladr University Health Board and Public Health Wales to be included in a national programme of piloting; the ‘Fit for Work Service’. The programme was sponsored jointly by the Department of Health and the Department for Work and Pensions as part of the government’s health, work and wellbeing programme.
The Fit for Work Service (FFWS) was proposed following Dame Carol Black’s 2008 review of the health of Britain’s working age population. The service was to offer support for people in the early stages of sickness absence, particularly for employers working in small and medium-sized enterprises (SMEs). Dame Carol’s proposal was for a case-managed, multi-disciplinary and holistic early intervention service, providing tailored support for people in the early stages of sickness absence. This support might include advice about housing or debt management, or might address specific clinical needs through a range of therapies including physiotherapy and counselling. In 2010, eleven pilot sites in the UK were established to test whether the Fit for Work approach would help to facilitate an early return to work for employees in the early stages of sickness absence. In the second year, seven of the original eleven pilot sites were invited to participate in the continuation of the pilot until March 2013. Rhyl was included as one of these seven sites.
In 2013, RCS secured continuation funding for Fit for Work North Wales from the European Social Fund through the Welsh Government. The project is due to complete in December 2014.
FFWNW : Delivery Model
The FFWNW operates a psycho-social model, using an holistic approach to provide a support service to employed and self-employed people in the area. The service is primarily based at the West Rhyl Primary Care Centre; a large medical centre in the heart of Rhyl. It also has consulting rooms in Bethesda, Gwynedd and Colwyn Bay.
The service is aimed at employees in the early stages of sickness absence; eligibility criteria cover sickness absentees off work, ideally captured at four to six weeks; those with no or limited access to work- based OH; employees returning to sickness benefit having recently returned to work and longer term sickness absentees who have repeat/extended sick leave. Eligibility is conditional upon the indication being that the client is likely to return to work with support from the FFWNW.
The service is also able to accept referrals from self-employed and employed ‘presentees’ working for SME’s; that is those who are still in work but whose health condition is negatively impacting on their work.
Referrals into the service come from GPs, other health professionals, employers, or self-referrals. A large majority of referrals come either from General Practitioners or as self-referrals who have been told about the service by their GP; 120 GPs are currently referring in the geographical area. The service is targeted at small to medium sized enterprises, although is also able to accept referrals from larger employers whose employee is off sick and where there is no access to an in-house occupational health service; in the first year of operation, approximately half of all clients were employed by large organisations and half from SMEs.
The pilot area originally covered Rhyl in Denbighshire, Glyn and Abergele/Pensarn wards in Conwy, but was soon extended to cover Prestatyn, St. Asaph, Kinmel Bay and all of Colwyn Bay. The project now covers the counties of Denbighshire and Conwy and in early 2013 it expanded to include Bangor and the surrounding area. The area covered by FFWNW lacks services for employed people and seeks to enhance socio-economic regeneration and well-being. Almost half of the employed population work for large public sector organisations.
The FFWNW is a case-managed service and currently employs four case managers from employability/workforce development backgrounds. Following a referral into the service, case managers make contact with the client and arrange an initial meeting with them at one of the FFWNW consulting rooms.
Following an initial assessment, the case managers are able to refer clients to appropriate therapies, including physiotherapy or osteopathy and psychological services such as counselling, CBT, neuro-linguistic programming therapy, hypnotherapy and life coaching. The emphasis is very much on early and rapid intervention. Where relevant, the clients are also signposted to the expert patient programme, debt advice, benefits advice and career services. Additionally, the case managers are able to mediate with the client’s employer where required.
Discharge from the service is dictated by client need, and case managers make contact with clients at the six and twelve month period once they have left the service to monitor whether they are still in work.
At end June 2014, the FFWNW had seen a total of 1225 cases. 80% of those off work at entry to the service had returned to work at the end of their FFWNW intervention, while 85% of those who were in work and receiving support remained in work following their FFW intervention.
The Service is managed by RCS and supported by an Advisory Group comprising representatives from the RCS Executive Board, Betsi Cadwaladr University Health Board, Federation for Small Businesses, Welsh Government, and Public Health Wales.
Scope of specification
We realise the limitations and challenges of robustly evaluating a non- randomised intervention relying on before and after data. However, it is essential to generate a clear picture of the impact of the programme.
We require therefore:
1: An analysis of the potential impact of the Fit for Work North Wales on desired outcomes, including a number of identified ‘soft outcomes’
2: A health economics cost effectiveness analysis
3. A cost effectiveness analysis to assess impact on business - to include return on investment (ROI)
4: An analysis of the wider social and economic impact of FFWNW interventions for clients including the effects on family & community.
Point 4 should form a significant part of the work.
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