Rehabilitation Services

Case Management

We work closely with insurers and claimant solicitors to facilitate early and appropriate access to medical and rehabilitation services for clients who have suffered mild to catastrophic personal injuries. Our aim is to reduce the impact of disability and restore function, with a focus on quality of life and return to work. Whilst working independently of litigation, we understand the personal injury claims process and deliver evidence-based, reasonable and proportionate rehabilitation services, professional reports and transparent communication with all stakeholders.

We accept single instructions as well as joint instructions under the Rehabilitation Code of Best Practice 2015.

Case Management Assessments & Services

Telephone Triage

Are you looking for early clinical access, decision support information and/or intervention for injured clients? A Telephone Triage is the perfect solution for these conditions.

RTW Plus’ trained triage professionals will make contact with an injured client within 1 working day of referral to discuss their current situation (including their injuries, treatment needs and functional status) and recommend a bespoke self-management programme, monitoring plan or further assessment.

A brief report providing a summary of findings along with the recommended pathway and expected outcomes is provided to the referring party(ies).

According to Government statistics, 30.7 million working days were lost in 2017/2018 due to work-related ill health and non-fatal workplace injuries. Stress, depression or anxiety and musculoskeletal disorders accounted for the majority of days lost due to work-related ill health (15.4 million and 6.6 million respectively). The cost of this lost time to the economy in 2016/2017 was estimated at £15 billion.

RTW Plus’ Telephone Triage service enables the early identification of, and provision of support for, clients who have sustained minor injuries and need support with remaining in, or returning to work. Our trained triage professionals are health and vocational specialists who are able to assess injured clients’ needs within 1 working day of referral and identify an appropriate rehabilitation pathway; expediting their return to full function and work productivity and significantly reducing the cost of absenteeism for employers.

Recommendations will vary depending on the nature of the client’s injuries and rehabilitation needs. Self-management or monitoring programmes may be appropriate for clients with minor injuries. For clients that require more support, we may recommend coordinated input from a case manager through our Minor Injury Management (MIM) service. Alternatively, if the client’s injuries are more complex, a more detailed Telephone Needs Assessment (TNA) or face-to-face Immediate Needs Assessment (INA) may be recommended.

Telephone Needs Assessment (TNA)

For cases where the client has suffered a moderate injury and has been off work for 3 months or more, a Telephone Needs Assessment (TNA) is utilised to explore their injuries, treatment received and ongoing issues, as well as identify the psycho-social factors which are impacting on their recovery and return to work.

A summary report provides insight into the client’s injuries (including relevant pre-existing conditions and treatment to date), the impact of these injuries on their daily activities and recommendations to help facilitate their recovery and return to work. The report includes estimated costs for the recommendations along with expected outcomes from each intervention.

Good work (The Good Work Commission) is known to have a positive impact on health and wellbeing and most common health problems can be accommodated at work with a flexible, collaborative approach and early intervention (Waddell & Burton, 2006).

A Telephone Needs Assessment (TNA) is conducted by a specialist case manager. The case manager will assess the client’s ongoing health concerns, identify the barriers preventing their return to work and recommend a rehabilitation programme to expedite their return to full function and work productivity, resulting in significant cost savings for employers. Client’s undergoing Telephone Needs Assessment are likely to require further input from the case manager – via our Minor Injury Management (MIM) or Complex Case Management services – to facilitate their recovery, as demonstrated in the below case study.

Immediate Needs Assessment (INA)

Our Immediate Needs Assessment (INA) is a holistic and comprehensive assessment designed to identify the immediate needs of clients who have suffered complex to catastrophic injuries. A suitably qualified RTW Plus case manager will undertake a face-to-face assessment with the client and prepare a fully costed report, outlining the recommended rehabilitation plan for the client.

As summarised by Dame Carol Black in the Working for a Healthier Tomorrow report (2008), early intervention “can result in good clinical outcomes, as well as a significant reduction in time spent off work”. The INA process enables early assessment and identification of the client’s needs and facilitates access to rehabilitation and support at the earliest opportunity, thus maximising their chances of regaining their independence and returning to employment.

According to Government statistics, 30.7 million working days were lost in 2017/2018 due to work-related ill health and

The INA forms the basis of a client’s rehabilitation programme. It enables the case manager to determine what support and rehabilitation measures the client requires in order for them to return as close as possible to the health status and lifestyle they enjoyed before the injury. We accept joint referrals under the Rehabilitation Code (2015) as well as single instructions from claimant solicitors.

Upon receipt of a referral, the case manager will conduct a face-to-face assessment with the client and provide a detailed Immediate Needs Report to the instructing party(ies) within 21 working days.

The Immediate Needs Report includes full details of the client’s injuries, symptoms and treatment to date as well as the impact of these on the client’s domestic and social circumstances, including employment. The report also includes a bespoke rehabilitation for the client, which includes:

Details of the interventions and supports that the client would benefit from in the short to medium term
The cost, timeframes and rationale for the recommended interventions and supports
The client’s goals and anticipated clinical and return-to-work outcomes from the programme

If the instructing party(ies) agree to the report recommendations, the client’s case manager will implement the proposed rehabilitation programme under our Case Management Services.

non-fatal workplace injuries. Stress, depression or anxiety and musculoskeletal disorders accounted for the majority of days lost due to work-related ill health (15.4 million and 6.6 million respectively). The cost of this lost time to the economy in 2016/2017 was estimated at £15 billion.

Minor Injury Management

Minor Injury Management (MIM) services are appropriate for clients who need diagnostic investigations or treatment for minor conditions, such as soft tissue injuries, simple fractures or mild-moderate stress or anxiety.

Clients are usually referred for MIM services following a Telephone Triage; however, it is also possible for clients to be referred directly to MIM services if they have been recommended a single course of treatment or specific investigation (e.g. MRI) by a suitably qualified healthcare professional or medico-legal expert.

RTW Plus operate an extensive network of private treatment and diagnostic providers who subscribe to our values and stringent quality assurance requirements. Trained triage professionals will contact each client to discuss their specific needs and preferences, refer the client to an appropriate provider, monitor their progress and report outcomes to the referring party(ies) once the intervention or investigation is complete.

Benefits to Clients

Access to high-quality private treatment and diagnostic services with our carefully vetted health professionals
Minimal waiting times (clients usually attend their first appointment within 10 days of referral)
Telephone support from a RTW Plus triage professional whilst treatment is ongoing

Benefits to referring parties

Provision of high-quality, cost-effective services with carefully vetted health professionals
Rapid access to treatment and diagnostic services to reduce work-related absence
Fully managed end-to-end treatment coordination service with service monitoring and outcome reporting

Complex Injury Case Management

Our experienced case managers work collaboratively with clients and their treating clinicians, employer and other stakeholders to coordinate evidence-based recovery services and facilitate their recovery and return to work.

RTW Plus adopts a biopsychosocial approach to case management, ensuring that the client’s needs are fully understood and accommodated at home, work and in their wider social context.

All our case managers are healthcare practitioners and/or vocational specialists with greater than 10 years’ experience of navigating, coordinating and influencing care pathways for clients with complex injuries and health conditions.

The aim of the case management process is to accelerate recovery and maximise the medical, psychological, social and vocational outcomes for clients who have sustained serious injuries. RTW Plus therefore operates a biopsychosocial model (Engel, 1977) of case management. This model ensures a whole-person approach to rehabilitation, leading to enhanced outcomes and cost reductions.

Once a client’s rehabilitation needs have been identified through a suitable assessment, their dedicated case manager will work with them to expedite their recovery and help them to return to full function and vocational activity in the most expedient and cost-effective way. This is likely to involve:

Agreeing rehabilitation goals and desired outcomes with the client and measuring progress against these
Collaborating with NHS practitioners and establishing a bespoke inter-disciplinary team
Coordinating evidence-based, private interventions, subject to need and funding availability
Liaising with employers and other stakeholders to facilitate the client’s return to work
Regular communication with the referring party(ies) to provide updates on the client’s progress
Preparing update reports which are compliant with the Rehabilitation Code 2015

Catastrophic Injury Case Management

At RTW Plus, we understand to achieve optimum recovery from catastrophic injuries, such as an amputation or brain injury, clients require coordinated input from an inter-disciplinary team of skilled professionals with specialist knowledge in that area of injury. Our catastrophic injury case managers are specialists in brain and neurological injury, complex orthopaedic injuries, amputations, spinal cord injury and poly-trauma and can work with clients across the age ranges. This specialist knowledge and extensive case management experience enables our case managers to coordinate effective and cost-efficient rehabilitation programmes for clients with catastrophic injuries, helping them to achieve the best possible outcomes.

At RTW Plus, we only work with the highest calibre case managers. Our catastrophic injury case managers are highly skilled professionals with greater than 10 years’ experience of navigating, coordinating and influencing care pathways for clients with complex injuries and health conditions.

Once a client’s rehabilitation needs have been identified through a suitable assessment, their catastrophic injury case manager will work with them to expedite their recovery, make accommodations for lost function and restore quality of life. This process is likely to involve:

Agreeing rehabilitation goals and desired outcomes with the client and measuring progress against these
Collaborating with NHS practitioners and establishing a bespoke inter-disciplinary team
Coordinating evidence-based, private interventions, subject to need and funding availability
Implementing care packages to ensure clients’ personal care requirements are met
Helping clients to source accommodation and adapt this to their specific needs
Facilitating clients’ return to work, voluntary activity and/or other meaningful activities
Regular communication with the referring party(ies) to provide updates on the client’s progress
Preparing update reports which are compliant with the Rehabilitation Code 2015

RTW Plus accept joint instructions under the Rehabilitation Code 2015 as well as single instruction referrals from claimant solicitors.

Vocational Consultancy

There is strong evidence that good work (The Good Work Commission) has a positive impact on health and wellbeing, reduces recovery times, improves long-term health and happiness and increases life expectancy (Waddell & Burton, 2006). RTW Plus offers Vocational Consultancy services to individuals and employers to facilitate job retention or career redirection and optimise employee engagement and productivity.

Vocational Consultancy Services

Vocational Assessment

Vocational Assessments are in-depth interviews conducted by one of our experienced vocational consultants. The aim of a Vocational Assessment (VA) is to understand an individual’s current vocational situation in order to enable them to remain in, or return to, work after injury or illness.

Each assessment is tailored to the individual’s unique circumstances, but is likely to include an evaluation of their qualifications, previous work history, transferable skills and a review of the local labour market. The referrer is provided with a detailed report outlining the assessment findings and fully costed recommendations.

Research shows that the longer someone is not working, the less likely they are to return to work (Ministerial Task Force for Health, Safety and Productivity, 2004). Furthermore, people who have been off sick for 6 months or longer have an 80% chance of being off work for 5 years (Waddell and Burton 2006).

According to Fit for Work Scotland (2016), “there is an increasing awareness that a swift and well-supported return to the workplace (and back to a normal routine) can aid a person’s full recovery and ensure their mental wellbeing”. Early intervention is therefore key.

Vocational Assessments (VA) are interview-style assessments conducted by one of our skilled vocational consultants. The nature of the interview will depend on the needs and goals of the client, but assessments will usually cover the client’s interests, abilities, aptitudes and skills for work with the aim of facilitating an early return to work with an existing or new employer.

Vocational Assessments are most useful for clients who:

Have been off work for an extended period with limited or no contact with their employer
Have been made redundant on the grounds of incapacity
Need help identifying what type of work or training they could pursue

A comprehensive report containing the assessment findings and recommendations is shared with the referring party(ies) after the assessment. For clients that require ongoing support, we may recommend coordinated case management or vocational consultancy services. For complex cases, additional assessments may be required to determine the client’s functional status, job demands or optimise their work environment.

Job Demands Analysis (JDA)

A Job Demands Analysis (JDA) is a systematic assessment occurring at the workplace used to quantify and evaluate the physical, psychosocial and environmental components of a job, including both the essential and non-essential tasks.

The detailed report outlines the demands of the specific job role, which can then be matched to a worker’s individual capabilities to determine their fitness for work, identify reasonable adjustments and facilitate the development of graded return to work plans.

A Job Demands Analysis (JDA) is a tool that is used to quantify the physical and psychological demands of a specific work role.

Conducted at the workplace by one of our experienced case managers or vocational consultants, a Job Demands Analysis involves a thorough assessment of the identified work role. This may involve the assessor conducting interviews with workers, reviewing job descriptions and other relevant paperwork as well as observing and (where possible) measuring specific job tasks.

Job Demands Analyses are commonly used to inform return to work planning for employees who have been off work with illness or injury. The objective information contained in the Job Demands Analysis Report can be used to compare an individual’s known functional capacity against the demands of the job to determine the suitability of the role and inform any reasonable adjustments required. A Job Demands Analysis can be completed for previous roles the individual is looking to return to after injury or illness, or a new role they are considering as part of a career re-direction process.

In addition to helping individuals to return to work safely, a Job Demands Analysis is also a useful tool for employers who wish to quantify the demands of specific roles so they can implement measures to maximise the health and safety of their workforce.

Functional Capacity Evaluation

A Functional Capacity Evaluation (FCE) is an objective assessment which uses a set of standardised tests in combination with observation and clinical reasoning to determine an individual’s physical capability and ability to perform specific tasks.

The comprehensive report clearly defines the functional capabilities of the worker. This information is often used in conjunction with a Job Demands Analysis (JDA) to determine an individual’s fitness for work, identify strategies to enable them to remain in work or plan for a successful return to work.

A Functional Capacity Evaluation (FCE) is a “systematic method of measuring an individual’s ability to perform meaningful tasks on a safe and dependable basis” (Matheson, 1996). It is most often used as an objective measure of an individual’s physical capacity to perform work tasks and to establish which tasks they can perform safely, assist with return to work planning and providing objective information to inform career redirection decision-making.

FCE’s can offer objective answers to questions such as:

Is this individual fit to return to work?
What duties can the individual perform safely at work?
What alternative roles is the individual able to perform?
Is the individual ever likely to return to work?

RTW Plus utilises the Matheson FCE System, which is the only FCE system based on an evaluation philosophy. Rather than apply a rigid set of tests to all clients, the Matheson approach enables skilled assessors to identify which questions and standardised tests and tools to apply for each assessment, enabling specific questions to be answered and simulation of real-world task performance. Tests and tools applied as part of the FCE have a high degree of validity and reliability.

The FCE assessment usually takes place over the course of a day and involves the client undertaking a clinical interview and being asked to perform various physical tasks, such as lifting, bending and hand dexterity tasks which are observed and measured. After the assessment, the assessor will prepare an extensive report outlining the findings, answers to any specific referral questions and their future recommendations.

Ergonomic Assessment

The Ergonomic Assessment (EA) is designed to help optimise working environments by maximising the comfort and productivity of workers and helping to prevent and/or manage illness or injury.

The assessment consists of an objective evaluation of an individual’s job, their work environment and how they perform the role. The assessment report includes any areas of concern and makes recommendations to minimise risk and facilitate optimal performance in the workplace.

Ergonomics is the scientific discipline which aims to maximise the ‘fit’ between people and their work. It is a powerful tool which, if implemented correctly, can reduce the potential for accidents, injury and ill health and maximise performance, comfort and productivity (HSE Guide, 2013).

An Ergonomic Assessment (EA) is an evaluation of an individual’s workstation conducted by a qualified ergonomist and involves discussion and observation about how job tasks are performed. During the assessment, the ergonomist may suggest simple solutions which can be implemented immediately, whilst more complex recommendations will be included in the subsequent Ergonomic Assessment Report.

Ergonomic Assessments can be completed on an individual level to ensure a good fit between a worker’s capabilities and limitations and their work tasks, equipment and environment. Individual Ergonomic Assessments are often completed for workers who have been injured or diagnosed with a specific health condition and require specialist advice to optimise their work environment and prevent further injury or exacerbation of their condition.

It is also possible to conduct Ergonomic Assessments for shared workstations designed for multiple users, for example hot desks, checkout counters and office spaces. Whilst it is not always possible for employers to optimise workstations for individual workers, applying good ergonomic principles to shared workspaces, such as good lighting, furniture placement and the provision of flexible equipment can make a significant difference to worker health and productivity.

Vocational Consultancy Services

Vocational Rehabilitation

All our vocational consultants have greater than 10 years’ experience of helping individuals to remain in, or return to work or productive activity after illness or injury.

They work collaboratively with the individual, their employer and other stakeholders and support them to achieve their vocational goals. The support required will vary from person-to-person and may range from the development and implementation of graded return to work plans and/or reasonable adjustments to career redirection including job searching, CV design and interview support.

Sickness absence is costly.

The estimated cost of sickness absence to the UK economy is estimated at £15 billion per year (government figures)
Employers are estimated to spend £9 billion per year in sick pay and associated costs (Black & Frost, 2011)
People who have to stop working often face negative health, economic and social consequences from being unemployed (Black & Frost, 2011)
Day-to-day living costs are 25% higher for people with a disability than for non-disabled people (Papworth Trust, 2012).

Conversely, there is strong evidence that ‘good work’ (The Good Work Commission) impacts positively on physical and mental health and wellbeing (Black, 2012) and being in employment has financial and psychosocial benefits for people with mental health conditions (Sainsbury et al. 2008).

Vocational rehabilitation is “whatever helps someone with a health problem to stay at, return to and remain in work”; it is an idea and an approach as much as an intervention or a service (Waddell, Burton & Kendal, 2008).

At RTW Plus, our skilled vocational consultants provide injured clients with vocational rehabilitation services that are tailored to their individual needs.

This may involve:

Working with an employer to design and implement a graded return to work plan or negotiate reasonable adjustments
Assessing an individual’s aptitude for a certain role, including their physical and cognitive skills, personality, interests and other transferable skills
Helping individuals to find work, which may include helping them with job seeking, CV development and/or interview skills
Working with an individual to identify a new vocational pathway, which may include retraining

Vocational consultancy can be provided on its own or in conjunction with our case management services.

Case Management

Case Management Assessments & Services

Telephone Triage

Telephone Needs Assessment (TNA)

Immediate Needs Assessment (INA)

Minor Injury Management

Complex Injury Case Management

Catastrophic Injury Case Management

Vocational Consultancy

Vocational Consultancy Services

Vocational Assessment

Job Demands Analysis (JDA)

Functional Capacity Evaluation

Ergonomic Assessment

Vocational Consultancy Services

Vocational Rehabilitation

Pain Management

RTW Plus Connexions

Rehabilitation Services

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