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Celebrating World Mental Health Day

Despite all of the positive work which has been done over recent years, when it comes to discussions about mental health it is still all too easy for them to be to be clouded in misinformation or somehow seen as being something shameful. In many walks of life mental issues are simply not talked about or in some strange way are seen as being part of home life and therefore playing no part in the world of work.

It’s hardly surprising; after all it’s not so long ago that stress was seen as being a personal failure rather than a product of working conditions. But the fact that it’s not surprising doesn’t make it right. That’s why World Mental Health Day which is celebrated on 10 October each year is so important. It’s a chance to raise awareness of mental health issues across the globe as well as providing “an opportunity for all stakeholders working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people worldwide.”

Although World Mental Health Day is a global event, it also provides an opportunity for individuals and businesses and healthcare providers to speak up and share what they are doing in the field of mental health. For example, the Bank of England has released a video in which its staff speak out to help to end the stigma around mental health issues. Called ‘This is me’ the video highlights the personal stories of some of the people who work at the Bank of England. It is hoped that their testimony will help others to seek help if they need it. The bank’s actions also reinforce a pledge which they signed in 2013 as part of a time to change initiative.

World Mental Health Day is designed to raise general awareness and promote discussion but it also seeks to highlight one particular aspect of building help or awareness each year. In 2016 the overall theme is psychological first aid. Covering psychological and social support, psychological first aid aims to help those who may come across people who are distressed or in crisis, helping individuals to understand how to act and what to say as they essentially provide front-line support.

Those who may be called on to give psychological first aid could be in the emergency services or in the health sector, in education or business, or they may even be a passerby who has encountered a crisis situation. Whoever they are, by providing appropriate early intervention they could help to alleviate the immediate crisis; with advanced support then being provided by health and mental health and social service professionals.

The general information provided on the World Mental Health Day website is well worth a browse but the essential message which society needs to take on board is that mental health has to come out of the shadows and be accepted as a normal part of everyday life. Whatever the cause, whether it be stress or anxiety, addiction or any other sort of ongoing condition; being able to talk openly and with acceptance is an important step in ongoing management or recovery.

That’s why steps taken by organisations such as the Bank of England are so important; they help to open up debate and to remove stigma. But it’s up to all of us, whether we are in the health sector or not to play our part in reducing the stigma and discrimination which for too long has been faced by those with mental health challenges.

Post-Olympic preparedness

Let’s start with the uncomfortable truth; even for highly trained Olympic athletes sport can be dangerous. Anyone who doubts that only look at some of the horrific crashes in the cycling road races, or the broken leg suffered by the unfortunate gymnast in the opening days of the Rio Olympics.

But because sport can be dangerous, the better the preparation the more that injuries can be avoided or at least reduced. So whilst pictures of bored lifeguards sitting at the side of the Olympic pool may have given rise to some comment, competitors who inadvertently inhale water or suffer from a sudden cramp may be very glad that there is someone on hand to haul them out.

No matter what the sport; whilst talent plays its part, the secret to success is in the preparation. So those participating in sport have to ensure that their training is carefully balanced and this includes managing the pre-and post training warm up and warm down phases. Coaches too play their part in ensuring safety, as do those who manage sports venues. And this is before we bring in the ancillary support team which may include physiotherapists and chiropractors, sports nutritionists and psychologists.

However, whilst our Olympians may have a significant retinue to call upon, everyday athletes may find that the responsibility for safe training and performance falls very much more on their shoulders. This is not to say that support staff aren’t available if required; it is just that for the majority of athletes, health professionals such as physiotherapists are far more likely to become involved once an injury has occurred rather than at the preparation and training stage.

This of itself can cause something of a problem for health professionals. Following every Olympic Games there is a resurgence in interest in sports participation, and it is expected that the Rio Olympics will be no different. Whilst this is great news for sports clubs and for the overall level of fitness within the country, with a revival of interest in sport comes an inevitable increase in injuries. This can result in a significant increase in demand for health professionals to provide physiotherapy or other treatments.

Coping with this sudden increase in demand requires preparation. From a societal point of view, health professionals may feel that it is beneficial to work with local sports clubs, helping them to help their athletes to understand the importance of preparation in reducing the chances of injury.

But whilst this may play some part in helping sportspeople to look after their bodies, health professionals also need to work to streamline their practice in order to reduce strain on their time. Yet, as with fitness training, simple steps can make a measurable difference. For example, switching telephones to a virtual assistant service instantly frees up time which would otherwise be taken in simply talking to people and booking appointments. Similarly, offering an online booking service can help clients to book appointments at a time which is convenient to them without the need for a long discussion.

And when appointments have been made, SMS text reminders help to ensure that people turn up on time today treatments, helping the day to run smoothly and reducing the incidence of missed appointments. Similarly, online filing patient notes means that patient details are available at the click of a button rather than following a lengthy search through filing cabinets.

With a little preparation comes the chance for success. The majority of sportspeople will never experience the Olympic Games as a competitor; but they still can push their own boundaries, challenging themselves to be the best that they can be. With health professionals on side, helping to keep people fit and to manage injuries, we all have chance to benefit from the Olympic legacy.

Occupational Health – Planning The Future

“Good work is good for health, good for business and good for national prosperity.”

This by-line from a report by the Council for Work and Health perfectly sums up why occupational health needs to become an integrated part of health provision in the UK. The report was drawn up in response to demographic changes allied with the need for employers to improve productivity and efficiency levels. With that in mind, the report’s authors aimed not only to create a vision for occupational health practice but also to identify the level of healthcare training required to deliver the vision into practice.

The Council for Work and Health aims to provide a coordinated voice for all of the professionals who work in the occupational health field. Formed in 2008 its projects include the provision of advice and guidance for employers as well as training for occupational health practitioners and allied health professionals.

This latest report entitled ‘Planning the future: Implications for occupational health; delivery and training’ came up with six key recommendations which were aimed at ensuring that occupational health not only meets the needs of the working population but also provides an early intervention mechanism. These recommendations are:

to integrate occupational health into mainstream healthcare provision in order to provide a greater level of holistic patient care
the creation of government incentives to encourage investment in healthy workplaces, perhaps by removing the tax liability for occupational health and well-being interventions
to boost the visibility of occupational health within the workplace by providing employers with access to relevant professional help and by promoting the return on investment in occupational health
to develop competency frameworks within a multiagency approach in order to boost the skill levels of those working within the operational health field
to develop models both to facilitate workplace health planning and to predict the match between requirement and supply
to attract and train professionals to meet expected needs

In recent years businesses have moved away from seeing their employees as necessary costs, nowadays recognising their people as the most valuable asset which a business can have. In tandem with this, occupational health is increasingly being seen as a valuable aid to employee well-being.

Whilst some businesses may employ dedicated occupational health teams, the opportunity exists for health practitioners such as physiotherapists and osteopaths to have more flexible arrangements with business. This may include the provision of general advice, being called in on an as needed basis or providing ongoing support to members of the team who have particular health needs.

Other health professionals such as counsellors may also be called on an as required basis. For example, those drawing up business continuity, or risk management, plans are increasingly taking account of the effects of disasters on their employees’ mental well-being. Providing access to counselling can make a measurable difference in helping employees to return to ‘work as usual’ following an event.

We live in a time in which NHS resources are stretched. In business too, low productivity levels are causing concern leading to a constant demand to do more with the resources which we have. In addition, the rise in retirement age is increasingly going to require businesses to work with their employees in order to help people to continue to carry out their duties as they move towards later retirement. All these factors and more place an increasing focus on the role of occupational health professionals. As Professor John Harrison said “It could be argued that there has never been a more important time for occupational health as a key contributor to the health and wellbeing of working age people.”

Avoiding Après Ski Physiotherapy

Christmas is well and truly over; but with summer still a far away promise it could be time to pack the bags and swap the damp coldness of the UK for the crisp clear coldness of a ski resort. We are now well and truly into the ski season with plenty of snow around to delight the skiing senses.

However, whilst most will return unscathed from their assaults on the mountain trails sadly some will return rather more bandaged up than when they left. There have been reports that overenthusiastic indulgence in après ski is partly to blame but French ski resort physiotherapists are pointing the finger in an entirely different direction.

According to a report on the Chartered Society of Physiotherapy website, skiers just aren’t getting fit enough before they hit the slopes. The report quotes Val D’Isere physiotherapist Louise Allison who highlighted the way in which differing ski conditions can cause a range of injuries. So, for example, hard-packed icy snow can lead to back injuries whilst deep snow is more likely to lead to knee ligament problems.

The essential message from the report though is that if people take the time before they go on holiday to really get themselves fit then their chances of injury are lessened. And we’re not talking here about the odd hour in the gym; people should be looking to carry out a combination of strength, endurance and overall fitness training in order to prepare themselves for the intense level of exercise at altitude which skiing requires.

It’s a lesson which doesn’t just apply to ski fitness. The more we look forward and plan to avoid problems, the fitter we can be in the long run. This applies in business as much as it does in our private lives. As we’ve been quoting from a physiotherapy website, let’s take a physiotherapy practice as an example.

In common with other types of health practice, there is a constant demand for physiotherapy time. However, there are certain times of year, such as in the winter when demand increases further. It’s not just the snow; slippery pavements and poor driving conditions can also lead to a whole variety of calls for physiotherapy help. But by planning and preparing, in effect increasing the fitness of the practice, it is possible to ensure that patient treatment times are maximised whilst admin is kept to a manageable minimum.

That doesn’t mean that procedures are skimped, rather the practice has become more efficient. Take the maintenance of patient records for example. Having large filing cabinets stuffed with patient notes may look impressive but it is hardly conducive to efficient working. It’s all too easy to miss file records, not to mention the fact that when a patient moves between treatment centres there is a delay while records are also transferred. Electronically filing patient records means that not only are they instantly accessible from any designated point (subject to secure access), the chances of misfiling are lessened.

Or how about payment management? When patients pay for their treatment it is all too easy to become bogged down in the appointment, issue invoice, chase invoice, receive check, pay into bank rigmarole. All this takes time, something which health practices rarely have in abundance. The solution is to take card payment details at the time of the booking and then confirm the payment as soon as the appointment has taken place. This is quick, simple and saves considerable administration time.

In a 24/7 always on world it is too tempting to simply react to the moment, to take each challenge as it arrives. Planning and preparation can make a measurable difference to the outcome whether we are off skiing or faced with treating the injuries of those who have been out on the slopes.

Reducing Missed Appointments

The recent junior doctors’ strike has highlighted the cost of cancelling or delaying treatment both to the NHS and to patients. Whilst emergency cover continued to be provided, the inevitable cancellation of some operations has added to waiting lists and left patients having to manage their conditions for an extended period of time.

Whilst these delays have been occasioned by strike action, on a day-to-day basis the NHS and other health providers are forced to delay or reschedule treatments simply because patients fail to turn up for booked appointments. These ‘space blockers’ not only cost health services in terms of wasted appointment times, they also prevent other patients being treated in their place.

The problem is so acute that many health providers have resorted to adopting systems such as SMS text reminders or telephone reminders in a bid to cut down on missed appointments. Even with these measures in place a department of health report published at the beginning of this year estimates that one in 10 hospital appointments (5.6million) are missed. At an average cost of £160 per missed appointment this equates to a significant amount of wastage, something the NHS can little afford.

In an effort to reduce missed appointments still further, the Department of Health has carried out a research trial looking at the wording used when reminders are sent out. The trial, which was conducted in conjunction with Barts NHS Trust, compared various forms of text message. All started with a reminder of the appointment time and date with subsequent variations including:

To cancel or rearrange call xxx.
9 out of 10 people attend. Call xxx if you need to cancel or rearrange.
Not attending costs NHS £160 approx. Call xxx if you need to cancel or rearrange.
Not attending wastes money. Call xxx if you need to cancel or rearrange.
Please be fair to others and call xxx if you need to cancel or rearrange.
Please attend or call xxx cancel/rearrange or we will record as a missed apt.

Whilst all of the variations produced a slight reduction on the original SMS which merely asked people to call the number on their appointment letter to cancel or rearrange; the message which specified the cost of not attending was shown to reduce missed appointments to 8.2%, equivalent to a 23% reduction in no-shows. Whilst an 8.2% no-show rate is still not ideal, the reduction in missed appointments still represents a considerable saving to the NHS.

Although this experiment purely related to hospital appointments, it does demonstrate the way in which a careful choice of words can make a difference to the way in which SMS text messages are perceived and actioned. Health professionals may therefore wish to choose a form of wording which best suits their client base, perhaps by undertaking their own trial with a variety of phrases which they feel may resonate with their clients.

Of course, those health professionals who charge for appointments have another option which they can use to encourage clients to attend. Taking credit card details at the point of booking enables health professionals to charge a no-show fee in the event that the appointment is missed. Adding a comment about this no-show fee to an SMS appointment reminder may well encourage patients to either attend the appointment or telephone to rebook.

At the end of the day reducing missed appointments benefits everyone from patients to health professionals as well as the country as a whole. The more timely the treatment, the better the outcome; so it therefore pays for patients to be treated at the earliest opportunity to reduce the chance of the condition escalating thereby requiring additional treatments. If a simple change of words on the SMS text reminder can reduce no-shows by 23% then it is something which all health professionals would do well to consider.

Smarter Payments

Its end has been long predicted but we may now be seeing the final death throes for the cheque as a means of payment. It’s not going to go quietly, after all the first cheque was recorded in 1659 and by 1717 the Bank of England pioneered pre-printed check forms, but it seems as though the inevitable is happening and the cheque is giving way to the march of technology.

In fact, it may not just be the cheque which is on its way out. Cash too is under threat as contactless and card payments rise in popularity. So much so, that a report from UK cards Association comments that ‘consumer spending has undergone a revolution in the past decade.’

Highlights of the report include the fact that in the ten years to 2014 card spending has risen from £270 billion to £566 billion with supermarkets, pubs and restaurants being among the key gainers. Interestingly, 71% of card transactions are now made using debit cards, a rise on the 58% seen in 2004 and an indication of the way in which we are increasingly looking to contactless payments as an alternative to cash. Speaking about the results Richard Koch, Head of Policy at The UK Cards Association, said “Cards are accepted in more places than ever before and with innovations such as contactless cards and digital wallets, this trend is sure to continue.”

Whilst high-street stores may be leading the way, the increased acceptance of cards as a means of payment benefits businesses across the board. For example, health professionals are increasingly looking to card payments as a means of settling treatment charges. Thanks to initiatives such as digital wallets and mobile payments which are supported by the card system, even sole practitioners can collect payments from their customers by card. And by using other initiatives such as the Clinic Appointments secure card payment processing system, health professionals and their customers can take advantage of a secure payment system linked to an online booking service.

Moving to a direct card payment system brings multiple benefits for patients and healthcare professionals alike. For a start, paying by card is quick and simple for patients; moving them away from the treatment/invoice/payment cycle which can be time-consuming and lead to confusion over payments due.

For the health practice, not only are card payments quicker, they can also lead to a smoothing out cash flow. But the ability to take payments by card can also help to ensure that clients who book treatments actually turn up for them. Taking card details at the point of booking enables health practices to charge a ‘no-show’ fee in accordance with their advertised procedures. And if clients know they will be charged even if they don’t turn up, they are more likely to ensure that their appointment is kept.

In fact, card payments are such a win-win scenario that the only real surprise is that they have as yet to be universally adopted by those health professionals such as physiotherapists and chiropractors who charge directly for their services.

One Step Too Far

In our last article we commented on the way in which exercise regimes have moved on; with the emphasis now being on providing exercise and mobility training which not only suits individual pursuits but also the individual athlete. With the Rugby World Cup being very much in evidence at the moment, it’s a theme which we thought we would return to.

Aside from the numerous injuries which seem to have befallen the Welsh team, opening skirmishes have led to injury worries for numerous players. Some will be rested before being brought back into the fray later on in the campaign whilst for others their World Cup dream is already at an end.

The neutral observer may question why there are so many injuries when it comes to the big tournaments. Admittedly rugby is a game which begets injuries but it has to be asked whether there is an underlying reason for so many key players to become injured at the same time. Again the neutral observer may wonder whether it is simply that in rugby injuries are rife, but we only hear about them thanks to the increased publicity which world cups bring.

But there has to be more to it than that and whilst some injuries are simply down to the run of the game or bad luck, it has to be wondered whether others may be as a result of a desire to field the best team possible. This can lead to circumstances such as players who are carrying a minor injury being selected in the hope that they will be fit in time for the tournament, players ignoring slight niggles as they don’t want to miss out on the tournament, or even a bit of overtraining in a bid to be as ready as possible for a key match.

Whatever the reason, players who entered the tournament in hope are leaving it in pain; being forced to swap the field of glory for the physiotherapy table. As they depart they bring a lesson for all of us. It’s one thing to push yourself to the limits of your ability but take one step too far, be unrealistic in your expectations, and you will run the risk of harm. We all like to think we can cope under pressure, we all like to think that we can just do one bit more and one bit more again but even those at the top of their game have their limitations.

In other words, sooner or later we will reach the limits of our abilities and when that happens we have to call on others for help. And that is not an admission of failure; it is simply an acknowledgement that when we are open to calling others on to our team, we can stretch just that bit further and do just that bit more.

For injured players, it will be the help of physiotherapists and other health and fitness professionals. For those same health professionals, it may be the help of administrators or assistants in areas such as booking and keeping track of appointments, maintaining virtual client records or simply in answering the telephone to avoid interruptions to client treatments.

Sportsperson or not, sooner or later we all come up against our limits. Getting the right help at the right time might just prevent us taking one step too far.

From Sun Up to Sun Down

By the time that you read this article, the chances are that the US Masters golf tournament will be over and all of the speculation about whether Rory Mcllroy or one of the other front runners will triumph will have been answered. In the run-up to the tournament, apart from spotting potential winners, one of the main stories revolved around Tiger Woods and his return to the competition trail following treatment for injury from physiotherapists and other health professionals.

Commenting on his comeback Tiger Woods said “People would never understand how much work I put into it to come back and do this again, it was sun up to sun down.” His comments are hardly surprising, given the champion he once was.

Getting to the top in any walk of life requires a measure of determination and hard work and getting back to ones best after a set-back requires an extra measure of grit and courage. But such courage is not simply confined to top sportspeople. The determination to improve, to get better, to overcome injury or other setbacks comes from within and can be found in all walks of life. It’s something which physiotherapists and other health professionals see on a daily basis. Octogenarians recovering from a hip replacement, children regaining the use of broken limbs following a fall, the middle aged recovering from a rather too strenuous gardening session in the spring weather; whatever the reason, when we set our minds to a task it is surprising how the results will follow.

It is one of the key motivators and rewards of being in the health profession; seeing others improve, watching them stretching themselves to the limit in a bid to return to fitness. It also can be one of the prime challenges; balancing people’s desire to return to ‘business as usual’ against their ability to recuperate. Get the balance wrong one way and overwork could lead to a setback. Swing the pendulum too far towards caution and the ability to return to maximum mobility could be lost forever.

Getting the balance right, deploying your professional skills to the benefit of patients is challenging but success can be personally rewarding. Discharging an individual from your care as they step out renewed to live as full a life as possible marks a success point in a busy profession. Sadly the procession of those in need is never-ending and physiotherapists, osteopaths, chiropractors and others could easily find themselves working from sun up to sun down in a bid to meet the ongoing demand.

Taking full advantage of time saving devices is one way to keep administration time down to a more manageable level. Electronic appointment booking, card payments, SMS text reminders, virtual assistant services; whatever the mix, finding ways to free up time will help busy health professionals to manage their day effectively. Who will win the Masters? We just don’t know but what we do know is that winning those everyday battles for fitness, fought by ordinary people of all ages, is for them every bit as important as any trophy could be.

On Your Feet Britain

On April 24^th 2015 (29 April 2016) the Get Britain Standing campaign in association with the British Heart Foundation is challenging British workers to sit less and move around at work more whilst raising money for heart research. Studies have shown that even those who are active at some times in the day can still damage their long term health by sitting for prolonged periods during the day.

This means that the daily jog to work may have benefits on one level but if you then sit without moving for hours at a time you are in danger of developing heart disease, type 2 diabetes or even some cancers.

Released in connection with the challenge, a survey of office workers revealed that 45% of women and 37% of men spend less than 30 minutes a day on their feet at work and that more than half regularly eat lunch at their desk. Apparently sitting for long periods affects the way in which the body controls areas such as sugar levels, blood pressure and the breakdown of fat so the challenge is on to regularly stand up and walk around.

That doesn’t necessarily mean that work will suffer as we look to our health. Suggestions from the On Your Feet team include standing up to take phone calls, walking to a colleague’s desk instead of phoning or e-mailing them and having standing or walking meetings.

Having said that, there are some professions in which having the chance to sit down for a few moments would be welcome. For example, when health professionals are faced with a continuing parade of patients through their practice, any time spent away from treatment can easily be taken up in paperwork rather than in looking after oneself. Whether you stand up a lot and need to sit down or sit down a lot and need to stand up, taking a few minutes out every now and then can help to reduce stress levels as well as give the body a much needed change of position.

This means that anything which can be done to reduce time taken on routine paperwork is time which can be better spent, either on further treatments or on ‘me time’. Online bookings, card payments, electronic patient notes, automatic appointment reminders; the list of potential time savers goes on.

But the best thing is that not only do these measures save time, they can also help to smooth out the working day. For example appointment reminders help to reduce no-shows whilst electronic note filing saves all that time looking for misplaced records. Given the pressure that the health service is under, it is tempting to plough all of that saved time back into patient treatment.

However, in the spirit of ‘physician heal thyself’ it is important that health professionals take regular breaks in order to stretch and move around, or simply to unwind the mind. It is inevitable that over the course of the day fatigue may set in, but the more we can take time to refresh the better we will feel at the end of the day and the better and more focused treatment we are able to give to our patients.

The Get Britain Standing campaign wants is to stand up, sit less, move more. Whether we need to follow their advice or whether sitting for a few moments would be a blessing; the important thing is that the campaign makes us think more about how we approach our working day.

The Rise in Health Literacy

Once upon a time the pronouncements of health professionals were treated as absolute. We attended their clinics and surgeries, described our symptoms and took whatever treatment was prescribed. Whilst in some ways unquestioning faith may have been easier for the health practitioners, it also meant that the level of health knowledge within the general population was fairly poor.

The result of this was that many diseases went undiagnosed until it was too late and ‘old wives tales’ were as likely as not to determine health levels in some districts. What was needed was a good dose of education; a way of helping the general population to be better informed about health issues.

Fast forward to the internet generation and we are all far more likely to be health aware. We can look up symptoms, check healthy diets and delve into treatment options for illnesses. In fact the only challenge facing us nowadays is to distinguish between the reputable sites and those which rely rather more on rumour and gossip than is good for us. Oh yes and having the strength of mind to work through the list of diseases associated with symptoms and be realistic rather than just plumping for the one at the top of the page or which looks most alarming. But in general being more aware of the course of illness and disease helps us to work with health professionals in designing a treatment plan which is appropriate for us.

And surfing our symptoms is not confined to the young. The rise of the silver surfer has resulted in the elderly also being more aware of what treatments are better for them. So much so that a recent BBC report revealed that regular internet use in older people was associated with good health literacy. In other words, the more familiar we are with surfing the more likely we are to research symptoms, ask for help in a timely manner, and engage with treatment.

But our increasing familiarity with the internet and associated technologies also has other benefits for health practitioners. Those who are used to surfing the web are more likely to accept time saving options such as online booking allied with pre-payment by card. This not only saves health practitioners time, it also is more likely to result in patients who show up for treatments. Additional reassurance can be gained by adding a SMS text reminder to the online booking system, prompting patients to attend appointments or to cancel in time for the slot to be refilled.

Linking in a pre-payment by card module to the booking system also enables practices to easily take a cancellation fee in the event of no-shows, bringing the added benefit of smoothing out cash flow. There are those who say that the ability to look up symptoms online can result in a generation of hypochondriacs but there have always been those who take their symptoms too seriously. What internet surfing does do is help practitioners and patients to work together to create the optimum solution and that can only be good for the health of the nation.

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Tag: health news