Better access to vocational advice could improve absence from work due to pain

National Institue for Health Research (NIHR) funded research led by Keele University shows that providing better access to vocational advice for patients suffering with musculoskeletal pain will improve absence from work, and create huge societal cost savings.

Musculoskeletal pain (pain in the joints, bones, or muscles) is one of the most common causes of work absence. It is estimated that half of workers in Europe will experience pain at some point in their lives, costing approximately €12 million overall.

At present, ‘vocational advice’ or ‘occupational health’ services are scarcely available for employees within the UK. A patient’s GP is often the first port of call, where they are given a ‘Fit Note’ which sanctions absence from work for longer than seven days. Treatment to address the patient’s pain has previously only been given to those who already have notable long-term absence.

Recent evidence shows that early discussions about how to manage pain at work may prevent long-term absence from work. Researchers from Keele University’s Research Institute for Primary Care and Health Sciences worked with the University of Birmingham and the University of Huddersfield to assess this by working with GP Practices across the West Midlands.

GPs or Nurse Practitioners referred patients consulting with musculoskeletal pain to a vocational advice service within the GP Practice, where they received assistance and advice about how to manage their pain at work.

Lead author, Dr Gwenllian Wynne-Jones, a Clinical Trials Fellow at Keele University, commented:

“GPs often report they feel ill-equipped to manage occupational health issues. This research helps to demonstrate that by providing vocational advice within general practices, alongside best care for the pain condition from the onset of work absence, we are able to reduce that absence considerably.”

Over four months, patients who received the vocational advice reported five days less absence from work than those who did not, resulting in a significant cost saving to society compared to best care, and a return on investment of £49 for every £1 spent on the service. In addition, access to this advice improved work performance, presenteeism, and confidence to return to work.

Dr Wynne-Jones added:

“This NIHR funded study was only a small trial, but we predict that if vocational advice services were implemented across GP practices more widely, it could reduce absence over 12 months by approximately 16%, potentially saving society £500 million per year."