Rehabilitation challenges for the future nick kendall

Rehabilitation challenges for the future Nick Kendall Health services consultant, London www.kendallburton.com

Today: ‘celebration for rehabilitation’ ,[object Object],[object Object],[object Object],[object Object]

We’ve come a long way… ,[object Object],[object Object],[object Object],[object Object]

Injury Disease Damage Symptoms Treatment Cure Activity Work Military Battlefield Wounded Soldier Field Hospital ‘ Fighting Fit’ Industrial ‘ Battlefield’ ‘ Wounded’ Worker Worker’s Clinic ‘ Fully Fit’ for Work post - 1664 WW1 & WW2 post - WW2 Short History of Rehabilitation and Occupational Medicine

Standards ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Challenges ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Example: Vocational Rehabilitation ,[object Object],[object Object],[object Object]

Work is generally good for health and well-being, so… The imperative is to help people stay at, or return to work People who want to work should have the help they need (but this is not the same as ‘being made to work’)

[object Object],[object Object],[object Object],[object Object],[object Object],Vocational Rehabilitation: What works, for whom and when? Gordon Waddell, Kim Burton, & Nick Kendall: TSO Books, 2008 www.workingforhealth.gov.uk/documents/vocational-rehabilitation.pdf

Making a Difference  enabling and facilitating  disabling and sabotaging ,[object Object],[object Object],[object Object],[object Object],‘ do not let what you cannot do interfere with what you can do’ John Wooden

Work as part of recovery ,[object Object],[object Object],[object Object],[object Object],[object Object]

Accommodating Workplace ,[object Object],[object Object],[object Object],[object Object]

Accommodating Workplaces What is reasonable? Light duties Alternative duties Modified work Selected duties Duration - temporary vs. long-term

Hierarchy of Return to Work Goals ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Adapted from Kendall & Thompson, 1998

50-80% Baseline Graduated Approach to improve tolerance, build resilience Gradient Duration

Paradigm change, cultural shift Current: Shift to: Work is a ‘ risk ’ and (potentially) harmful to physical and mental health. Work is healthy, therapeutic & the best form of rehab. But Work can also be a hazard therefore therefore Advice to stay off work Sick certification Risk assessment ‘ Protect ’ person from work Advice & support to remain in/ return to work and Safe, healthy work

‘ work should be comfortable when we are well and accommodating when we are ill or injured’ Norton Hadler

Rehabilitation challenges for the future nick kendall

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Rehabilitation challenges for the future nick kendall