Optimising implementation

In addition to enabling cross-ministry working, identifying and engaging ‘clinical champions’, developing ‘models of care’ and overcoming barriers, further steps, which are outlined below, should be taken to optimise the implementation of an early intervention service.

Develop an implementation plan

An implementation plan comprises:

  • The establishment of a cross-sectorial platform and robust policy leadership underpinned by a clear and effective value proposition
  • The identification of a clear common goal among cross-sectorial stakeholders
  • The presence of a clear and feasible implementation strategy with a realistic timeframe
  • Application of appropriate incentives within the system
  • Communications (providing information regarding the implementation plan and its progress)
  • Monitoring progress
  • Evaluating results

An audit tool for best practice

To capture and share best practice, the following metrics should be used:

  • A ‘process measure’ based on how quickly the patient was seen
  • A ‘work measure’ based on how quickly the patient was able to return to work
  • A ‘journey measure’ based on patient reported outcome measures (PROMs)
  • A patient satisfaction/experience measure
  • An ‘efficiency measure’ based on healthcare and sick leave savings

System indicators

It is vital that the effectiveness of an early intervention service is properly assessed. The following represent measurable targets that demonstrate, objectively, the value of early intervention:

Reduction in temporary work disability (TWD), i.e. number of work days lost to an MSK condition

Reduction in permanent work disability

Percentage of patients that have successfully returned to work and the time taken to do so

Reduction in direct healthcare costs

Reduction in long-term disability compensation

Reduction in out of work costs

1 Direct costs could include: costs of specialized care; emergency department, medical, and surgical admissions; diagnostic tests; physiotherapy; and rehabilitation.

Fit for Work Global Alliance is led by The Work Foundation and supported by AbbVie.

Toolkit partners:

Toolkit sponsor:

Fit for Work Global Alliance is a multi-stakeholder initiative, driving policy and practice change across the work and health agendas in Europe and worldwide (over 35 countries). The vision is to raise awareness of the facts of MSKs and make the case for more investment in sustainable healthcare by promoting and supporting the implementation of early intervention practices. Fit for Work is led by The Work Foundation – Lancaster University, which is also providing the Secretariat. AbbVie is founding sponsor since 2008. All the research is produced independently by The Work Foundation, with full editorial control resting with the think-thank alone.

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