Developing a more effective approach to vocational rehabilitation
Written by Mark Baylis, UK Rehabilitation Council
Vocational and clinical rehabilitation – especially getting injured and sick people back to work – is an area in which the UK lags behind most other economically advanced countries. Although there are many other reasons for this, key factors include rehabilitation being a lower priority within the UK’s National Health Service (NHS), and a disjointed approach to the different services that help people on the journey back to independence.
The private sector is increasingly moving into the vacuum created by the low level of state provision, in terms of both funding and care provision. The insurance industry led the way with the publication in 1999 of the Rehabilitation Code, which provides a legal framework for care to begin even while the two sides are still negotiating the size of any personal injury damages. The claimant lawyer community, initially unsure of the insurers’ motives, has given the initiative its wholehearted support.
Employers, meanwhile, are steadily increasing their use of rehabilitation, again using private sector providers. Many can see the advantages in terms of productivity, staff continuity and morale. Again, the insurance industry is playing an important role. Nearly all the big players in the market have embedded an element of rehabilitation into their Employers’ Liability and Income Protection policies and many go so far as to offer financial incentives, in terms of lower premiums, to employers who use rehabilitation.
Despite these advances it has to be acknowledged that the uptake of rehabilitation has risen at a painfully slow rate – and this is where there is a continuing opportunity for the healthcare sector. Sickness absence costs the UK economy an estimated £16.8 billion annually, which represents direct costs of £595 per employee per day plus indirect costs of £465.
Employers, including the public sector, remain reluctant to become engaged with rehabilitation. This is partly because of regulatory and taxation obstacles, but mostly it reflects deep-seated inertia and a feeling that it is too much trouble.
Yet there are some glittering success stories. Last year, for example, Rentokil announced it had saved 30 years of absence as a result of its rehabilitation programme with the enthusiastic backing of the workforce and unions.
The UK Rehabilitation Council, an umbrella charity for organisations that support rehabilitation, has a shared interest with the private healthcare sector in seeing more employers embrace the concept. To assist the process it has produced its own standards, which are designed to help people who purchase and commission rehabilitation.
Mark Baylis is deputy chair of the UK Rehabilitation Council, www.rehabcouncil.org.uk
Dexcom: changing the lives of people with type 1 diabetes
It is estimated that 9.3% of adults around the world are living with type 1 diabetes, which amounts to a total of 463 million people. A further 1.1 million children and adolescents under the age of 20 are living with the condition.
Unlike the more prevalent type 2 diabetes, where the body still produces insulin and symptoms develop slowly, people with type 1 diabetes need regular insulin injections or pumps, and must monitor their sugar levels frequently.
In recent years a number of remote glucose monitoring systems have become available that patients can use at home. These work with a sensor, usually placed under the skin, that measures glucose levels every few minutes. This information is then transmitted wirelessly to a device like a smartphone or tablet, which can then be shared with their clinician.
British actress Nina Wadia's son Aidan, 14, has type 1 diabetes, and has been managing his condition using Dexcom, a glucose monitoring system used by patients all over the world. Here Wadia explains how Dexcom has improved their lives.
As a parent of someone with type 1 diabetes, what is your day-to-day life like?
Being able to take a breath, think and pivot constantly without getting frustrated becomes an essential mindset because sometimes it feels like each day is determined to be different from the day before. Whatever worked yesterday is going to misfire today.
Which areas of yours and Aidan’s life are most impacted by diabetes?
The one thing that you have to fight hard to reclaim is spontaneity, especially when it comes to food and exercise. It’s only when this is taken do you realise how essential each one is. You can be flexible and there are no real limits, but only in the sense that a great athlete can be flexible without limits because they’ve trained super hard to be that way. So we’ve all had to become athletes when it comes to being spontaneous.
How has Dexcom helped you and Aidan?
Dexcom has brought future science fiction to real life today. The continuous glucose monitoring system is tiny, sits discreetly on his body and gives him a ten-day breather between sensor changes, so it's goodbye finger-pricking seven times daily.
Dexcom is totally active at a grass roots level and for Diabetes Awareness has pledged to donate £2,000 if #DexcomDiabetesStories and/or #DexcomWarriorStories is shared 200 times! I’ll be sharing more on social media and would love to hear how other families are winning their fights.
Maybe most importantly Dexcom is trying to introduce a reimbursement programme for type 1 diabetes patients which will give greater access to modern, life changing hi-tech. I want to spread the word on the importance of accessing it through this campaign.
If you compared your life today with how it was before Aidan was using Dexcom, what has changed?
It's always working, which lets him take his mind off diabetes for longer stretches. It also lets me get off his back. We both receive alerts so I no longer have to pester him by asking him what his number is, and especially importantly, I don’t have to wake him at night to prick his finger if I’m worried. Dexcom gave us back our sleep!