Evaluation of a return-to-work intervention for hospital staff

Introduction:  To assess the impact of a rehabilitation programme targeted at hospital employees absent sick for > 4 weeks, we conducted a controlled before and after comparison in two hospital groups.  

Methods:  In January 2009, a new multidisciplinary rehabilitation programme was instituted at Southampton University Hospitals (SUH) for staff who had been absent sick for > 4 weeks. To evaluate its impact, sickness absence data were collected prospectively from management systems at SUH and at a nearby control group of hospitals (Salisbury) from January 2008 to March 2011. In addition, occupational health records at SUH were individually linked to sickness absence records to check the completeness with which the programme was taken up. Trends in absence rates were assessed by simple descriptive statistics. Comparisons focused on the years 2008 (before the programme was launched), 2009 (when it was just getting underway) and 2010 (after it had been firmly established).  

Results:  During 2009/2010, approximately 40% of employees at SUH who were absent for > 4 weeks, were referred to the rehabilitation programme within 6 weeks of going off sick. At SUH, the proportion of 4 week absences that continued beyond 8 weeks fell from 51.7% in 2008 to 49.1% in 2009 and 45.2% in 2010, while in Salisbury the corresponding proportions were 51.2%, 50.3% and 55.7%. This gave an improvement in the rate of return to work by 8 weeks at SUH between 2008 and 2010 of 6.5% (95% CI 1.2% to 11.8%), and a difference in improvement as compared with Salisbury of 11.0% (95%CI 1.7% to 20.3%).  

Conclusions:  Despite incomplete referral of eligible employees, these data suggest that the rehabilitation programme produced benefit. Further analysis will explore whether the programme is likely to be cost-effective.