Telephonic support to facilitate return to work: what works, how, and when? (Research report No 853)

Summary
There is wide acceptance that a timely return to work for people with health problems is a desirable goal. Telephonic approaches have much to offer in supporting work participation for people with common musculoskeletal and mental health problems. When well designed and implemented, and with suitable governance, they compare favourably with face-to-face approaches.
Telephonic approaches are not a replacement for standard clinical healthcare: they are a complement. Telephonic contact has a dual role: to identify peoples’ needs, and then signpost them to the right intervention at the right time.
The evidence supporting telephonic approaches is generally robust, being based on a synthesis of academic, institutional, and best practice sources.
There are several key aspects of telephonic approaches that facilitate early return to work outcomes. They have optimal effect when used in combination:
• Assessment: identifies the client’s needs and their obstacles to return to work, which guide the return to work plan.
• Triage: allocates cases to the most appropriate rehabilitation pathway using a stepped-care model.
• Advice and information: fostering positive beliefs, setting expectations, and giving self-management advice.
• Case management: managing the client’s journey has cost benefits: telephonic approaches provide clear advantages through speed and ease of access, shorter waiting times, optimised referrals to face-to-face interventions, efficient use of resources.
A well-designed and delivered telephonic service can enable a substantial proportion of cases to entirely self-manage their health problem and work participation.
Provision should be made for a tiered component of the service that combines telephone and face-to-face contact in order to accommodate cases with more complex health problems or difficult obstacles to work participation.
The effectiveness of telephonic services in achieving positive work outcomes relies heavily on the training and skills of staff, and on the adoption of a strong work focus by all the key players, including support at the workplace.
There is robust evidence that, when properly implemented, telephonic case management approaches can speed return to work and reduce overall case costs. Telephonic intervention by appropriately trained professionals has been shown to be safe and acceptable to users.