BJD Work package

Main project / Train the Manager Musculoskeletal Health in the Workplace Project
Sub project
Project leader / Anthony Woolf
Project group / Bone and Joint Research Group, Treliske
Project type / iProject – internal / aProject – associated / cProject – collaborative
Collaborating partners / RCHT Treliske, Cornwall Council, Plymouth Derriford
Timeline / Expected start (2014-01) / Estimated completion (2014-12)

PROJECT DESCRIPTION (Max 1 page, full details in project plan)

Project – Aim (150 words)
Aims
1. To encourage Organisations to incorporate musculoskeletal health into their strategic aims and to promote good musculoskeletal health throughout their workforce.
2. To train line managers to promote musculoskeletal health and manage musculoskeletal problems in the workplace
Objectives
a.  To develop a model Musculoskeletal Health Management Policy that can be adapted by organisations in order to provide a formal structure for the prevention and management of musculoskeletal problems.
b.  To develop a presentation that can be delivered to organisation Executive Boards proposing training for line managers in the promotion of musculoskeletal health and management of musculoskeletal problems in the workplace.
c.  To identify the training needs of managers in relation to the promotion and management of musculoskeletal health
d.  To develop a musculoskeletal health training programme for line mangers
e.  To design an assessment tool to enable the training programme to be delivered to meet the needs of individual organisations
f.  To pilot the manager training programme in large and medium sized organisations.
g.  To evaluate the pilot to establish the acceptability and effectiveness of the training course and related materials.
Project - Background (300 words)
Background
Musculoskeletal health problems are one of the leading causes of absenteeism and presenteeism in the workplace in the UK and in Cornwall. Musculoskeletal problems are common and are caused by injury, illness and ageing. Many workers have musculoskeletal health problems some of which are causally related to their work. The latest estimates from the Labour Force Survey show that in Great Britain
the total number of work related musculoskeletal disorder cases in 2011/12 was 439,000, 41% of all work-related illnesses.1 An estimated 7.5 million working days were lost through musculoskeletal disorders (MSDs) cause by or made worse by work during the same period.1 The economic impact of work loss and absenteeism arising from musculoskeletal conditions is striking. In the UK, lost working time attributable to MSDs cost the economy £7 billion in 2007. 2 For the EU the cost is estimated at between 0.5-2% of GDP annually. 2
In Cornwall data from 2 of the largest employers (data is not in the public domain) indicates that 18-20% of all sickness absences are due to musculoskeletal conditions. In 2011/12 Cornwall and Isles of Scilly PCT spent over £57.6 million on problems of the musculoskeletal system. This equates to £104 per head of the population which compares to a national average of £98. Musculoskeletal spend ranks fourth after mental health (£212) circulation (£148) and cancer (£116).3 Cornwall’s population has a higher proportion of older people than the national average with 19% being in the 65-84 year age group compared to a national average of 14%.
Challenges of work and musculoskeletal conditions have been highlighted in Fit for Work reports2 and were an issue raised as important in consultations with people with arthritis in Cornwall.
With an ageing population, retirement age increases and societal lifestyle changes leading to increased obesity and physical inactivity the issue of musculoskeletal health in the workplace is set to grow. Physical disability due to musculoskeletal problems will be a major barrier to the extension of working lives. Therefore health interventions in the workplace will become increasingly important for productivity and public health.
Project – Plan (400 words (target audience, population, methods , feasibility etc)
Interventions
1. Establishment of an Expert Advisory Group
Experts in musculoskeletal health, education, health promotion and occupational health with an interest and expertise in work place health will be invited to sit on an Expert Advisory Group. This group will advise on various aspects of the development and delivery of the work place training programme as explained below. The members of the panel will be identified from previous educational consensus work and through professional networks and relevant professional organisations.
2. Development of a model Musculoskeletal Health Management Policy
This will:
·  Identify individual responsibilities of personnel for musculoskeletal health
·  Describe a work based musculoskeletal health promotion plan
·  Describe a musculoskeletal disorders prevention plan (MSD Prevention Guidelines – OHSC Ontario)
·  Describe how MSDs can be managed within the workplace
·  Present guidelines for rehabilitation and re-entry into the workforce
3. Development of Musculoskeletal Health presentation for organisation Executive Boards.
This will include:
·  An overview of musculoskeletal health including personal cost to workers, financial cost to employers, what the future looks like, empowering individuals to make informed choices about their own health.
·  Importance of incorporating musculoskeletal health into the strategic aims of the organisation
·  Presentation of a model Musculoskeletal Health Management Policy.
·  Benefits of training line managers in the management of musculoskeletal health within their work team
4. Identification of the training needs of managers to promote and manage musculoskeletal health
·  Carry out literature search to identify existing evidence on the role of managers in maintaining musculoskeletal health in the workplace and what training they need to carry out this role. The literature will be identified using an electronic database. Other sources will be identified through communication with experts in this field. Because much relevant work is not published in peer reviewed journals all efforts will be made to identify “grey literature” and existing examples of best practice in the work place.
·  In order to identify the training needs of managers, focus group discussions will be held with employees and managers from different industries. Four focus groups will be held: one with employers, one with employees, one with employers and employees and one with experts in occupational health with experience in a variety of industries and organisations. These groups will discuss the barriers and facilitators to maintaining musculoskeletal health in the workplace, what role managers can play and what training they need to help improve musculoskeletal health in the workplace. The focus group discussions will, with the participant’s permission, be recorded and transcribed. The transcripts will be analysed using Thematic Analysis.
·  Using the findings of the literature, the review of best practice and the focus group findings the project team will develop a list of the knowledge, skills and attitudes needed by managers to promote and manage musculoskeletal health in the work place. This will be presented to the expert panel for comment and revision using a modified Delphi technique.
·  The Delphi technique is an established method for generating ideas and facilitating consensus among individuals who have special knowledge to share. In this project there will be 2 Delphi survey rounds each lasting 2 weeks. In the 1st round the experts will be asked to review the list of knowledge, skills and attitudes. They will be asked to rate these as essential, preferable, optional or not required. They will then be asked to generate a list of teaching objectives with specific education topics to be covered under each objective. They will also be asked to indicate whether these topics are “core” or “specific”. Core topics are those that all managers should have training in, specific topics are those that are essential for specific work forces profiles. Only those topics that reach a consensus of essential or preferable will be taken forward to round 2. In Round 2 the panel will be asked to agree on a set of learning objectives. The Expert Advisory Group will work with the project team to develop operational definitions and to develop the curriculum.
5. Development of a musculoskeletal health training programme for line mangers
The development of the training programme will draw on the experience of the project team in developing and delivering musculoskeletal health training programmes for a range of professional and lay audiences nationally and internationally. It will use the successful model in which training is delivered by a professional together with a lay person who is affected by musculoskeletal health problems. Using a person affected by a musculoskeletal problem as a trainer adds a valuable dimension because it enables the trainees to hear about peoples first hand experience of living with musculoskeletal health problems, the difficulties they encounter, how it affects their lives and how they have dealt with these difficulties. In this programme the training for line managers will be delivered by an occupational health professional together with a person with experience of working with a musculoskeletal health problem.
The content of the training programme will be guided by the needs assessment. The training will have core elements that will be delivered in all organisations. In addition there will be a range of optional modules which will be offered to particular organisations. For example a module for those organisations with an office based workforce and a module with a workforce made up predominantly of manual workers.
The core programme may include:
·  Overview of musculoskeletal health and well being, individual responsibility for own health
·  How to identify jobs and work practices that can put musculoskeletal health at risk, conducting a musculoskeletal health assessment
·  Pre-placement considerations and monitoring musculoskeletal health in your work team
·  Importance of early problem recognition and actions to be taken including referral pathways, occupational health, primary care
·  Workplace adjustments and rehabilitation
Training materials may include slides, handouts, DVDs and on-line materials.
6. Design of an assessment tool to enable the training programme to be delivered that meets the needs of individual organisations
An assessment tool will be developed to enable the training needs of individual organisations to be assessed and to identify which of the training modules to be included in the training package.
7. Pilot the manager training programme.
The manager training programme will be piloted in 4 different organisations in the UK of varying size and workforce profile. The pilot will include:
Presentation to organisation Executive Boards
Use of assessment tool
Delivery of training programme to line managers
8. Evaluation of the pilot.
The pilot will be evaluated to assess the acceptability and effectiveness of the training course and related materials. The acceptability and effectiveness of the training will be investigated using pre and post training interviews and questionnaires administered to trainers, trainees and members of the work force. These will be administered a week before the training takes place, immediately after the training and 3 months after the training. Participants will be asked for their views on how the training could be improved and how the training affected their working practices.
9. Revision of training package
In response to the evaluation findings the training package and materials will be revised to ensure that the training is both acceptable and effective.
Project – Expected outcome (300 words)
10. Future developments
1. The next phase of the project will be to develop a Train the Trainer package which will give instruction on how to effectively deliver the training to managers. This will enable the project to develop a cohort of trainers (occupational health professionals and employees with experience of musculoskeletal health problems) who can deliver the training across a range of organisations nationally.
2. This project can be used as the basis for developing a Musculoskeletal Health Standard or Award which can be awarded to Organisations meeting a standard set of measures demonstrating good musculoskeletal health in the workplace. This will allow organisations to show their positive contribute to their corporate social responsibility and will further increase awareness of musculoskeletal health in the workplace.
Project – Resources needed (100 word (estimate of costs –details in budget sheet))
Costs
COSTS / £
Research Associate 208 days / 26,802
Project Manager 104 days / 15,646
Occupational Health Nurse 70 days / 11,246
Room hire / 400
Refreshments / 200
Travel to meetings / 350
Transcription / 600
Stationary / 500
Printing / 800
TOTAL / 56,544
Potential funding sources (100 words)
Request to Cornwall Arthritis Trust
The first phase of the project is to develop the training programme and the second phase is the piloting of the programme, evaluation and revision. Support for phase 1 is requested at a cost of £30,000. The intention is to seek further funding for phase 2 from other sources.
Appendix 1) Project plan (4 pages), 2) Budget (1 page), 3) Business plan
Work package submitted by:
Anthony Woolf / Date

Table 8 Project History

How the Project was Acquired
In June 2012 AW had an exchange of ideas with Wolfhart Puhl and others about the problem of musculoskeletal conditions and disorders in the workplace being the leading cause of workloss, and a growing challenge to prolongation of working lives. It was suggested that The Bone and Joint Decade recognises this is an important area and that a programme of activities with employers should be developed. This would help broaden the BJD from just being about illness to more about health and would potentially broaden the BJD partnerships with nonmedical companies. In December 2012 a programme outline was developed. Jack Skrolsvik agreed to approach Statoil in Norway in January 2013 with a view to funding the project.
The ideas were discussed at the World Network Conference in Rio in July 2013 and in August 2013, a funding proposal was prepared and subsequently presented to Cornwall Arthritis Trust.
In December 2013, Cornwall Arthritis Trust agreed £30k of seed funding to initiate the project.
.
How the Project is Progressing
A literature review was completed and then Focus Groups held at the following pilot sites:
Cornwall Council
Plymouth Derriford Hospital
GE Home Lending Call Centre
Tulip Food Processing
Next step is to carry out the Delphi exercise.
(Updated 10th November 2014.)
Which resources will be involved
Work is being carried out by Jim Howarth and Josephine Erwin at RCHT Bone and Joint Research Group, Treliske.


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