The costs and benefits of active case
\nmanagement and rehabilitation for
\nmusculoskeletal disorders

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

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