Dame Carol Black Review of health of the UK working population

A groundbreaking report on the health and wellbeing of the UK workforce has been unveiled by Dame Carol Black as she proposed radical changes to work-related health services to make them available to all.

The UK National Director for Health and Work published the first ever review into the health of the working age population – Working for a Healthier Tomorrow – calling for urgent and comprehensive reform and a new approach to health and work in Britain.

The review recognises that for most people work is good both for their long-term health and for their family’s well-being.  Its proposals focus on keeping people healthy at work, and also on helping them return to work if they get ill.

The review found that ill health was costing the country £100 billion a year – enough to run the entire UK National Health Service.

Dame Carol emphasised that although the economic cost was substantial, the human cost to families was immeasurable.

‘For most people their work is a key factor in their self-worth, family esteem and identity.

‘So if they become sick and are not helped quickly enough, they can all too easily find themselves on a downward spiral into long-term sickness and a life on benefits.

‘This is not only devastating for them, but also for their families. Their children suffer financially, emotionally and it can affect their long-term futures.

‘The aim of my review is not to offer a utopian solution for improved health in working life, but to identify factors that stand in the way and offer potential solutions.’

Dame Carol spells out the key challenges in the review, which include insufficient access to good work-related health support in the early stages of sickness, including mental health conditions. Provision is currently disproportionately concentrated among a few large employers, leaving the vast majority of small employers without support

Other issues include the current sick note process which concentrates on what people can’t do, instead of what they can.

Dame Carol makes key recommendations to overcome the challenges, including:

  • New ‘Fit for Work’ service to be piloted for patients in early stages of sickness – if rolled out the aim would be to make work-related health support available to all;
  • If successful Fit for Work should be extended to those on incapacity and other out of work benefits. Government should also expand provision of Pathways to Work to cover all on incapacity benefit;
  • Outdated paper-based sick note should be replaced with an electronic ‘fit note’, stating what people can do, not what they can’t;
  • Occupational health should be brought into the mainstream of healthcare provision;

The review is the result of wide-ranging research and consultation including a series of events held around the country and a Call for Evidence which produced more than 260 responses.

An important step was also the ground-breaking consensus statement signed by more than 30 health professional bodies, including the British medical Association and Royal College of General Practitioners

They pledged to help people enter, stay in or return to work, where appropriate, because it is often in the patients’ best interests.

‘Taken together, the evidence provides a clear and compelling case. In short, we cannot go on as we are.

‘I hope this review will lay the foundations for urgent and comprehensive reform. But there are difficult and challenging messages for everyone, whether they are politicians, healthcare professionals, employers, unions or individuals. All have a shared responsibility for the health of Britain’s working age population.

‘We must act now to build on the emerging consensus around a new approach to health and work in Britain, ‘ said Dame Carol.

Contact us today for further information on how we can support your workplace;

info@unitedhealthkent.com

 

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What injuries cost employers

What injuries cost employers

Musculoskeletal disorders (MSDs) such as back pain are one of the biggest causes of sickness absence on any given day and account for nearly a third of the total time taken off sick from work. Yet they are also easy to address with low cost and effective Physiotherapy interventions.

Each person with a MSD takes an estimated 17.2 days off work on average. Employers may also be subject to compensation claims from sick or injured staff. Managers and employers need to be aware what is happening in their organisation by encouraging staff to report problem in confidence and by monitoring and understanding sickness absence.

Business Examples

  •  Anglian Water reduced direct absence costs by £289,000 through the use of a Physiotherapy based programme with a return of on investment of £3 for every £1 spent. In addition claims for back pain reduced by 50% and ill-health retirement by 90%.
  • York Hospitals NHS Foundation Trust cut its long term sickness rates by more than 40 % through early intervention with physiotherapy. The number of staff off work for more than four weeks dropped from 99 to 57 and the number of staff off sick for more than three months dropped from 52 to 28. The project cost £100,000 but has saved the trust £200,000.
  • AstraZeneca -“Wellbeing in AstraZeneca” 2000. Through the provision of rehabilitation and treatment services such as physiotherapy, and health promotion such as sports facilities and health screening, the company has saved £200,000 a year in health insurance spend and absence levels are 31 % lower than average levels. 
  • The Royal Mail’s occupational support and therapy programme, including physiotherapy, has had substantial financial benefits, with the programme providing a return of approximately £5 for every £1 invested. Absence was cut by 25% between 2004 and 2007.

If your company has five or more employees then The Health and Safety at Work Act 1974 places a duty on you to have a written statement on Health and Safety. At United Health we can help you fulfill these obligations and maintain a healthy workforce. For more information on our services please contact us at;

info@unitedhealthkent.com

 

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Running tips

Running tips

Are you a seasoned runner training for a marathon or a novice who has decided to increase their activity and fitness levels? Whatever your running ability it is important to ensure that your training is designed in a way to allow your body to adapt to the intensity of the activity and that you recognise the early signs of common problems experienced by runners so you can take prompt action.

If you are starting out:

  1. Get an appropriate pair of trainers.
  2. Start training slowly. If you do not walk far or often then try a walking programme first, then build up to a walk and light jog interval session i.e. 2 minutes walk and 2 minutes light jog.
  3. A warm up for running can be as simple as a walk – gradually increasing the pace over 3-5 minutes. You can introduce dynamic stretches – this is when you stretch the muscle but do not hold the stretch.
  4. At the end of the walk or run then you need to stretch. This can help prevent muscles getting sore and tight post exercise. You should stretch all the muscles that you have used so really focus on the legs, although you can do some back and arm stretches as well.

Other common issues for runners can be hip, knee and foot pain. If you experience pain in these areas ensure you are warming up and cooling down when training. If you feel that you are doing this then try reducing your training intensity until symptoms improve. If symptoms persist then seek advice from your Doctor or a Physiotherapist – early intervention usual means less treatment and less time rehabilitating.

Remember this is general advice. Before embarking on an exercise programme consult your doctor. If you experience shortness of breath or pain you should cease exercise and seek medical advice.

 

 

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Golfing injuries

Common injuries
The most common injuries in golf are back injuries. Most of these injuries are simply muscle or ligament strains that usually get better in a few weeks. Changing technique and equipment can help golfers with chronic (long-term) back pain play around the injury.

Constant bending over causes extreme stress on the muscles and joints of the lower back. The use of newer and longer golf clubs can allow your body to remain closer to an upright position and help relieve stress on your back.

The elbow is the next most commonly injured area. Most elbow pain results from tennis elbow or golfer’s elbow. Tennis elbow is an inflammation of the tendons that connects the forearm to the elbow. The lateral tendons allow the elbow to extend (straighten). Golfer’s elbow is an inflammation of the tendons that allow the elbow to flex (bend). Treatment consists of rest, ice and NSAIDS. For chronic cases cortisone injections may be used. The Physiotherapist may also suggest that you take stress off your forearm and elbow while playing.

Prevention
To avoid injuring yourself while playing golf, there are several things you can do. First, always warm up carefully before playing.

Several studies have shown that most golf injuries are a result of poor techniques. A few lessons from your local golf instructor may help you tune up your swing to avoid an injury.

If you are struggling with a golfing injury then contact us to see how we can help you.

 

 

 

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United Health – Supporting local business

Supporting local businesses

Sarah Verrion of United Health has set up United a small business networking group in Deal, Kent. This is an informal group which invites small business owners to share ideas and experiences and support one another in building their businesses. The core group of attendees are below – just click on the hyperlinks to see the Webpages:

Gavin Photography – Creative and Wedding Photography

Tasha’s Tasty Treats Ltd – Wedding, Celebration, Novelty, Cakes Cookies & Sweets

Juicy Media

 

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Local running club – Sandwich

Do you want to get fit? Do you want to find like minded people to train with? Then Fleet Feet running club may be the place for you. If you are over 18 years old and wish to train Fleet Feet offer trainer led running sessions through the week for different levels of runners from beginners to those who have been running for years. To find out more visit their google site below;

https://sites.google.com/site/pfleetfeet/home

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Helping employees stay and return to work after injury

The Assessment of Fitness for Work

With evidence that long periods away from work can be detrimental to an individual’s health, the CSP has lobbied for more employers to recognise the importance of supporting employees to remain in work, even when they are unable to conduct their normal duties.

How can Chartered physiotherapists help change this situation?

Why is it important? Physiotherapists should be at the forefront of sick absence management. The Assessment of Fitness to Work tool offers the profession the way to prove our worth. Using the tool should offer practical help to patients and employers in keeping them working effectively through recovery.

The Assessment of Fitness for Work is an A4 document providing a tick-box for ‘can work with adaptations’/’can’t work’ and a space for advice on how to retain an employee in work whilst recovering from illness or injury.

If the employer cannot implement the recommendations, the employee can then give the form to their GP for use in completion of the Fit Note.

The Assessment of Fitness to Work form can therefore help GPs, employees and employers to focus on what a person can do whilst using work as part of their rehabilitation rather than sign a person off to recover at home.

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Acute Injury Management

Acute (New) Injury Management

The guidelines for the treatment of injuries to the body’s soft tissue, known as the P.R.I.C.Eguidelines. Injury to the soft tissue of the body is a major cause of pain and disability and this clinical guideline sets out recommendations for treatment during the first 72 hours after an incident takes place.

P.R.I.C.E. is an acronym which stands for:

PROTECTION 
Protect from further injury (e.g. by using a support, or high-top lace-up shoes).

REST
Avoid activity for the first 48–72 hours following injury and consider the use of crutches.

ICE
Apply ice wrapped in a damp towel for 15–20 minutes every 2–3 hours during the day for the first 48–72 hours following the injury. Do not leave ice on while asleep. Do not use heat.

COMPRESSION
Compress the injury with a simple elastic bandage or elasticated tubular bandage, which should be snug, but not tight. Remove before going to sleep.

ELEVATION
Rest with the leg elevated and supported on a pillow until the swelling is controlled. Avoid prolonged periods without the leg elevated.

For most soft tissue injuries pain relief such as Paracetamol rather than an anti-inflammatory is best – for the first week let your body’s natural healing process work. If at 8-10 days there is still significant pain and swelling then try some NSAIDs (non steroidal anti-inflammatory drugs) e.g. Ibuprofen for 8-10 days (N.B. always read the label and take any medication as the manufacturers instructs. If you are unsure see your GP).

Any injury should be assessed immediately to ascertain its severity and provide the appropriate management to ensure a more complete recovery of function.

 

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Osteoarthritis

What is osteoarthritis?

Osteoarthritis is a common condition that may cause joint stiffness, swelling and pain – usually in the knees, hips, feet, hands and spine. Some people’s arthritis can be so severe that joint replacements are the best solution, while others experience few symptoms even though x-rays show that they have quite advanced osteoarthritis.

What causes osteoarthritis?

It is not known exactly what causes osteoarthritis, although it can be triggered by injury or repeated stress on a joint many years earlier. For example, carpet layers often develop osteoarthritis in their knees due to years of wear and tear. It is usually affects people aged 50 and over, and is more common in women. Genetic factors play a role in some forms of osteoarthritis.

How can physiotherapy help?

Physiotherapists are highly skilled at helping those with osteoarthritis, as they can help improve movement, strengthen muscles, and increase or restore mobility.

 

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Manual Handling Training Kent

Manual handling training –  Back care

Postural balance
Maintaining the natural curves of your spine:
• Is the key to a healthy back;
• Allows for best shock absorption and stability; and
• Allows for optimal functioning and weight transfer by the ligaments, muscles and joints when lifting, pushing, pulling and holding.

Manual handling (MH) is lifting, pushing, pulling or holding something.

Before lifting
Before MH you should ask yourself if it is necessary or is there is another way i.e. a lifting or moving aid. If not then:

• Assess the load to prepare yourself i.e. what does it weigh? Is it stable? Are their good hand holds? Is it hazardous?
• Plan the lift i.e. where are you going to take it? Do you need another person to help? Are there stairs on the way?

When you are ready to lift
• Now get as near to the object as you can get.
• Make sure your feet offer a wide and stable base of support i.e. ‘staggered stance’.
• Bend your knees and keep your back straight (do NOT twist your back) as you go to move.
• Make sure you have a stable grip/hand hold.
• Move slowly and keep the load close to your body.

Carrying the load
Move in a controlled way. Remember that the environment (light, noise, thermal affects, slip and trip hazards) can make a difference to the risk when lifting.

At work and at home
Think about your foot position i.e. ‘staggered stance’. Get as near to the object or task as you can safety so you limit the amount that you have to reach. Keep your back straight and do NOT twist your back. Always ask yourself can this be made easier by changing the position of what you do?

Remember to keep the load close…….

AND

Remember to face the object or task and use your hips and knees to bend down…..

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We have joined Physiotherapists Locally

We service the South East Kent region, including Deal and Canterbury and consult for businesses in South East London.

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Low back pain

Evidence based treatment for low back pain

The information detailed in this article refers to acute non specific low back pain. Acute low back pain describes symptoms lasting 6 weeks or less.

About 80% of us will experience back pain in our lifetime and most of us may experience this more than once and nearly all of us will go on to make a good recovery.

The advice……Stay active…… research indicates that one of the most important treatments for low back pain is movement. People who stay active at home and at work despite the pain get better more quickly. Simple pain relief with painkillers can be useful if required. If you need them, try to take them through the day as indicted rather than waiting until the pain is really bad to ‘get ahead’ of the muscle spasm and symptoms. It is also important to remember that maintaining the neutral ‘S’ shaped posture (as opposed to C shaped) of your back reduces the stress through the discs, joints, ligaments and muscles.

If your symptoms don’t resole quickly with the above advice, seek advice from a Physiotherapist. Physiotherapy can assist with a wide variety of musculoskeletal problems. Physiotherapy involves assessment of the injury/symptoms, treatment through exercise prescription and other modalities together with advice and education. How can physiotherapy help low back pain?

• Advice and early return to graded activity.

• Mobilisations.

• McKenzie therapy.

• Specific stabilisation exercises.

• General exercises and stretches.

• Ergonomic advice.

• Postural advice.

For further information please contact the United Health physiotherapy team.

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Vehicle Ergonomics

Choosing a car – what to look for

Remember, the more adjustable features within your car, the greater likelihood of you achieving good and comfortable posture that suits you.

Seating

• Choose a comfortable and supportive seat which allows you to adjust the height and tilt independently of each other.

• The base of the seat should neither be too long nor too short – it should support your thighs and should be positioned to ensure adequate space between the edge of the seat and your knee, i.e. you need to avoid pressure behind your knee.

• The seat should be wider than your hips and thighs.

• Adjusting the height of the seat should allow your feet to reach the pedals without stretching. You should also be able to reach all hand controls easily and have a good view of all the display instruments, as well as good all round vision.

Back rest

• The back rest should come to shoulder height and should not obstruct your rear vision. It should be wide enough to support your shoulders.

Lumbar support

• The back rest should provide continuous support along the whole length of your back. An adjustable lumbar support may help to achieve this, but be careful – if it does not offer full adjustment this could result in pressure points of gaps.

• An adjustable lumbar support should offer up/down and in/out adjustment.

• Always ensure the lumbar support fits your shape and is comfortable.

Steering wheel

• Choose and adjustable steering wheel – one that can move in and out, up and down and can tilt.

• Power steering will take the strain off your back.

• Make sure the steering wheel is positioned centrally – if it is off-set it could put an extra strain on your spine.

• The steering wheel should not obstruct the display panel.

Pedals and gearbox

• An automatic gearbox can sometimes be helpful.

• Pedals should be centrally positioned with adequate space in between. Off-set pedals can put extra pressure on the spine.

Boot

• Choose car with appropriate sill height, easy access and enough space for your needs. The sill height should, for example not be too low, so that when manually handling loads in/out of the boot, you can do so with good, comfortable postures and therefore minimise the risk of injury.

Car environment

• Ensure you have comfortable leg and head room.

• Air conditioning will help to keep you comfortable

Good posture and regular exercise can play a key role in

preventing back pain.

Posture

Any posture, no matter how good it is, can lead to discomfort if it is held for too long. Therefore it is important to adopt a range of comfortable driving positions and to make frequent changes to avoid, or help delay, the onset of discomfort.

You should also take regular breaks and avoid driving for more than four hours a day.

The Highway Code recommends taking a break of at least 15 minutes every two hours. This should be the maximum length of time you drive without a break, and on each break, you should change your position, i.e. get out of your car and walk around.

Where possible try to avoid using your car as an office. Many of the tasks, such as using a laptop and sorting out paperwork in a car, cause you to bend forwards, resulting in increased stress on your back. Find an alternative working environment which allows you to achieve good posture.

If you experience discomfort when driving, listen to your body. Report the discomfort to your physiotherapist or ergonomist.

 

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Neck pain

Neck pain is very common and up to two thirds of the population can experience an episode of neck pain at some point. Full recovery occurs in most cases and the usually advice includes keeping the neck mobile and return to a normal, active lifestyle. You can help prevent and treat neck pain by following this advice.

Lying postures

If you wake up with a stiff and painful neck, it could be as a result of a poor sleeping position. To help prevent neck pain, sleep with your neck in a position so that your head is in a straight line with your body.

  • Use a pillow that supports your neck.
  • A firm supporting pillow may be used when lying on your back; a second may be required when lying on your side. Do not sleep with more pillows than necessary.
  • You may find it better to use a feather or polyester / hollow-fibre pillow.
  • A towel rolled to three inches in diameter can be placed in the pillow cover and used to support the hollow of the neck.
  • Do not sleep on your stomach as this places strain on the neck.

Sitting postures

  • Sit upright and avoid working with your head bent or turned for long periods of time.
  • It is important to maintain the gentle curve of the back of the neck. Avoid letting your head sit forwards long periods when reading and performing tasks at work and at home.
  • If you use a computer check that your desk height and computer screen are set up appropriately.
  • Try to move your neck little and often.

Other advice

  • It is better to keep your neck active.
  • Move slowly through stretches. Avoid rolling your head round in a circular motion.
  • To drive safely you must be able to turn your head quickly. It is best not to drive until any bad pain or stiffness has settled.

Achieving the correct posture

Pull your chin in as far as possible and then releasing the last 10% of this movement. Try at all times to maintain this correct posture and alignment.

Exercises

Aim to keep your neck moving as normally as possible. You should not let it stiffen up. Simple exercises can help to restore your range of movement, promote strength, ease stiffness and help get your neck back to normal. As far as possible continue with your normal activities.

Basic neck exercises

Head retraction

Pull your chin in keeping your neck and back in a straight position. Remain looking straight ahead throughout the exercise and do not tip your head backwards or forwards. Hold this position for a few seconds – then relax. Repeat 5 times.

Extension

Pull your chin in (as in the first exercise) then tilt your head backwards looking towards the ceiling – maintain this position for a few seconds – then relax. Repeat 5 times.

Rotations

Pull your chin in (as in previous exercises) and turn your head as far to the right as possible until you feel a gentle stretch. Maintain this position for a few seconds – then relax. Repeat to the left. Repeat 5 times.

Stop these exercises if they make the pain worse and seek advice from a medical professional (i.e. your GP or physiotherapist).

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Skiing and snow boarding injury prevention

Skiing and Snow Boarding

The ski and boarding season is here and over the coming months many of you will venture out to the slopes. Without training joints and muscles are easily injured (particularly the lower limb) which can be very frustrating and disappointing when you want to enjoy your holiday. Below are a few suggestions for exercises that can be completed in preparation for a ski or snow boarding holiday.

Please note:

If you have any a pre-existing injury it is advisable to discuss these exercises with a physiotherapist before starting. You should not experience any pain with these exercises, if you do please stop doing them immediately.

  1. Static Wall Squat: This exercise strengthens the quadriceps and hamstrings using your own body weight (as in skiing and boarding) to help support the knee.

With your back against the wall, lower yourself down until your legs form a 90° angle. Repeat until moderate fatigue. If this is too difficult start by squatting to a 110° angle and progress to 90°.

N.B. Ensure that your knees stay behind you toes and do not let your bottom go lower than your knees.

2. Stability squats with an exercise ball: This exercise is similar to the wall squat but is more dynamic.

Place the ball between the wall and your mid back, then lower yourself down until your legs form a 90° angle, then return to upright.

Repeat until moderate fatigue.

N.B. Ensure that your knees stay behind you toes and do not let your bottom go lower than your knees.

  1. Lower limb trunk curls: This exercise uses the legs and truck to support through the hips and back.

Assume a push-up position on the ball (image on the left). Keep the wrists directly below the shoulders. In one slow and fluid movement roll the ball underneath you as shown (in the image on the right). Keep core muscles strong and back as straight as possible. Repeat until moderate fatigue.

4. Gluteal/hamstring lift: This focuses on the backs of the legs, these muscles work with the quadriceps and hip muscles supporting the knees and hips.

Lie with your lower legs on the exercise ball, raise torso so that knees, hips and shoulders are all off the ground and in-line. Once you have lifted your buttocks, bend your knees to 90°, repeat until moderate fatigue. Be sure to maintain correct alignment of your joints.

N.B. Do not let your lower over arch. Keep spine ‘long’.

Are the above exercises easy? Then try these more difficult single leg exercises.

6. Single leg Stability squats with an exercise ball.

See Exercise 2 for more details.

Repeat until moderate fatigue.

5. Single leg Static Wall Squat

See Exercise 1 for more details.

Repeat until moderate fatigue.

7. Lower limb trunk curl with single leg.

See Exercise 3 for more details.

Repeat until moderate fatigue.

8. Gluteal/hamstring lift single leg.

See Exercise 4 for more details. This time DO NOT BEND KNEE, just lift hips off the floor.

Repeat until moderate fatigue.

For further information please contact the United Health physiotherapy team.

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