The costs and benefits of active case management and rehabilitation for musculoskeletal disorders

The burden of musculoskeletal disorders (MSDs) to employers and workplaces is significant; and
the most important cost to employers and society is lost time from work.
‘Case management’ is a goal-oriented approach to keeping employees at work and facilitating an
early return to work. There is good scientific evidence that case management methods are costeffective
through reducing time off work and lost productivity, and reducing healthcare costs.
There is even stronger evidence that best-practice rehabilitation approaches have the very
important potential to significantly reduce the burden of long-term sickness absence due to
MSDs. The combination of case management with suitable rehabilitation principles is currently
being used effectively in multiple settings throughout the UK, and there is growth within the case
management sector. Current providers vary widely in quality and experience. There is limited
professional regulation, although localised standards of practice have recently become available.
Many of the factors influencing the adoption of cost-effective case management and rehabilitation
approaches rest with employers, and funders/commissioners of healthcare. It may be easier to
integrate these practices into large and medium-sized workplaces, but there is no reason why the
same principles cannot be applied to small businesses and the self-employed. It appears to be very
timely for the distribution of information to employers and other key players about how effective
case management and suitable rehabilitation approaches can be, and how applicable they are to
UK settings. To this end, an integrated model specific to the UK has been developed.
An evidence-based model for managing those with MSDs was developed that is widely
applicable to all types of industry and business in the UK. It describes the principles to apply in
order to integrate case management and rehabilitation with the workplace. It was derived from
high quality scientific studies, and research conducted into views on the applicability and
effectiveness within the UK.
It is recommended that HSE distribute guidance based on this model.