Early intervention in work disability as part of the solution

Closer integration of health and social care has been proposed as a solution to simultaneously reduce expenditure, relieve pressure on key services and improve the outcomes and experience of system users1. To turn this theory into practice, AbbVie – together with the European Steering Group (ESG) on Sustainable Healthcare – launched over 30 pilot projects across Europe to gather evidence and scale-up new and effective sustainable healthcare practices.

The most pioneering programme to date is the pilot project, the ‘Early Intervention Clinic’ (EIC) at the Hospital Clinico San Carlos in Madrid2, which focuses on early intervention in MSK-related work disability with the aim of getting people back to work. Over 13,000 patients were randomized to early intervention or usual care. Temporary work disability (TWD) was 39% lower for early intervention patients and permanent work disability was 50% lower.

Also: patient satisfaction was high and analysis of cost-effectiveness showed that for every €1 of expenditure, €11 was saved in lost productivity and healthcare costs. If these results were applied across Spain, modelling suggests that the equivalent of over 81,000 additional Spanish workers would be available for work each day rather than taking sick leave.

Early intervention typically requires little in terms of additional resources (but they can be difficult to obtain) and facilities – rather, it enables more effective use of existing organisational and infrastructure resources in order to improve efficiency and value for money while establishing greater patient involvement in the development of care pathways and optimal health outcomes3. In practice, this means uniting Government ministries, either officially as one department or by promoting collaboration at the system level (i.e. cross-sectoral working), regional level and provider level.


Working days lost to MSK conditions each year in Spain


Reduction in temporary work disability


Reduction in permanent work absence in study


Additional Spanish workers would be available for work each day in Spain


Savings made in societal costs for every €1 of expenditure

1 Parliamentary Office of Science and Technology. (2016). Integrating Health and Social Care. Available at: http://researchbriefings.parliament.uk/ResearchBriefing/Summary/POST-PN-0532
2 Abasolo, L., Blanco, M., Bachiller, J., Candelas, G., Collado, P., Lajas, C. … Jover, J. (2005). A Health System Program to Reduce Work Disability Related to Musculoskeletal Disorders. Annals of Internal Medicine,143, 404–414.
3 British Association of Social Workers. (2016). BASW Position on Social Work and Integration Between Health and Social Care. London: BASW.

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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