Webinars

Slide 1

Nikki Davies

Croeso/Hello, a warm welcome and thank you for listening to our Understanding and Managing Musculoskeletal Conditions webinar, some of you may know them as MSK’s.​

We hope you enjoy the session and can take away some new information back to your organisation. ​

​My name is Nikki Davies, myself and my colleague Rhian Gleed will be talking you through the webinar. ​

Slide 2

The aim of this Webinar is to enable you to develop your skills and confidence so you can address MSK health conditions in your workplace by having a better understanding and knowledge of different aspects of MSKs​

​We’re here to help employers understand and effectively manage MSK health conditions in the workplace.​

• We’ll look at how MSKs impact both current and future health and wellbeingand We’ll equip you with strategies for effectively managing MSK risks in a maturing
• And firstly just to clarify that MSKs/MSDs are interchangeable terms and stand for Musculoskeletal Conditions or Musculoskeletal disorders​

Slide 3

So what is an MSK?

MSK Conditions affect bones, joints, muscles, tendons and the tissues that connect them they are associated with pain and impaired physical function.​

• They may be acute and short-lived for example due to injuries, recurrent such as back pain, and some are long-term.​
• They are more common as people get older.
• And some MSK problems are directly related to work activities such as repetitive tasks, twisting, stretching, incorrect lifting/lack of lifting equipment or due to badly designed or set up workstations which leads to poor posture, twisting, stretching and so on​.
• Many people have MSK problems that happen independently of work but may affect their ability to work or are made worse by work activities.​
• MSK and mental health problems are often interrelated.​

Slide 4

Rhian Gleed

There is a broad spectrum of MSK conditions which generally fit into 3 groups:​

• Inflammatory conditions such as rheumatoid arthritis and juvenile inflammatory arthritis​
• Conditions of MSK pain such as a result of injury, osteoarthritis and back pain​
• Also bone health – osteoporosis and fragility fractures

The Labour Force Survey for 2021/22 found that lower limb disorders accounted for 21% of work-related MSK conditions in the UK, 37% of those were Upper Limb and Neck conditions and back problems accounted for 42% of work-related MSK conditions.​

Slide 5

We’re going to have a quick look at some statistics to show why this matters –

This slide shows that in the UK roughly 1/3 of the adult population live with an MSK condition in all 4 devolved nations.

Slide 6

​The annual statistics published by the Health and Safety Executive (HSE) in November 2023 show that in Wales there are around 25,000 work-related MSK ill health cases annually. ​

​So this leads to an average of 0.7 million workdays being lost annually, due to work-related MSKs with many associated costs. ​

​So we ask what the costs are

• Direct costs include sick pay.​
• Indirect costs include lost productivity.​
• Retraining costs due to staff turnover.​
• And not forgetting there are intangible costs, affecting people’s quality of life.​

​These statistics show the substantial impact of work-related ill health and MSKs, both in Wales and across the UK. The financial, productivity, and personal implications highlight the importance of addressing these issues in the workplace environment.​

​Slide 7

This can help staff stay healthy and remain in work for longer, you can avoid or reduce extended periods of ill health and related absence.​

​But creating an open, inclusive culture starts from the top, where senior management should actively show they care about the wellbeing of all employees, no matter their role.​

​On a personal level, there are psychological barriers. These include accepting limitations due to a condition and finding ways to adapt work. ​

​It can be frustrating and scary when tasks become challenging. Pain can also lead to feelings of anxiety and low mood. ​

​There’s often a worry about what the future holds and a fear that continuing to work might make things worse in the long run.

Slide 8

Employers have both a legal and moral responsibility to invest in the MSK health of their employees. ​

​When it comes to MSKs and the Health and Safety Executive legislation there are many aspects to consider – for example the management regulations, manual handling, Display Screen Equipment, vibration, and workplace welfare – but it’s not just manual handling or working with Display Screen Equipment that needs to be considered. ​

​You may need to revisit your risk assessments with involvement from employees, to think about the work activities mentioned earlier, such as twisting or repetitive tasks, to ensure all potentially harmful activities have been included in the assessments and controls are put in place.​

​You may also wish to consider carrying out a body mapping exercise with your employees this looks at aches and pains which might not otherwise be reported or considered and it generates new discussions about workplace MSK risks​

​However –  ​

It is very important to recognise that people with MSK conditions may not consider themselves to be disabled. ​

​In a recent study only 32% with MSK conditions reported that they considered themselves to be disabled due to their MSK condition. ​

​This can have consequences in the workplace, as several legal duties around employment are based on the definition of disability in the Equality Act (2010). ​

​People who don’t view themselves to be disabled may be more likely to miss out on relevant workplace protection and support. Awareness raising by employers is vital!​

​By investing in the physical well-being of your workforce, employers empower individuals to lead productive and fulfilling work life balances

​Slide 9

These are steps that we can all take to maintain healthy productive lives, reduce the risk of developing MSKs and better manage our health.​

​It’s about encouraging your employees to make healthier choices to lower the risk of developing MSKs and prevent falls​

​Physical Activity​

• Bust the myths on physical activity – having a MSK condition doesn’t mean

NO physical activity.

• Exercise builds muscle bulk and strengthens bones and regular exercise and resistance training are particularly beneficial.

​You may wish to promote the Chief Medical Officers physical activity guidelines to your employees. The same guidelines are now adopted by all 4 devolved nations and follow a life course approach covering: Under-5s, Children and Young people, Adults and Older Adults so 65 plus. ​

For Adults aged 19 to 64 year the main message to promote is that ​

• For good physical and mental health, aim to be physically active every day. Any activity is better than none, and more is better still.​
• Do activities to develop or maintain strength in the major muscle groups. For example Heavy gardening, carrying shopping, or resistance exercise. ​
• Ideally complete at least 150 minutes per week of moderate intensity activity for example brisk walking or cycling; or shorter durations of more intense exercise.​

These are simple messages you can share with your employees.

Slide 10

So what is the link between unhealthy eating and MSK’s?

• Unhealthy eating increases the decline in MSK health – a lack of protein contributes to loss of muscle mass, reducing strength and increasing risk of falls​.

• Low levels of vitamin D are associated with poor muscle strength and weaker bones​.

• Obesity and excess weight directly affects weight bearing joints such as Hips and knees​.

If you haven’t already, then look at and promote the Healthy Weight Healthy You website for adults in Wales within your workplace. ​

Healthy Weight Healthy You is part of the NHS, providing free and tailored information and support and arose from the Welsh Government Long Term Strategy to Reduce Obesity in Wales – Healthy Weight: Healthy Wales (2019)​.

This tool provides self-directed support for achieving or maintaining a healthy weight, offering a range of information and resources they can be tailored to individual needs. ​

It provides free access to information, support and resources on:​

• Understanding weight and your weight management journey​
• Food and Drink​
• Physical Activity​
• Emotional Health and Wellbeing​and also Making long-term behaviour change.​

Slide 11

So a few facts and figures on the links between Smoking, Tobacco and MSKs​

• Tobacco can trigger an immune system in the lungs that spreads to the joints.​
• People that smoke are more likely to develop rheumatoid arthritis​.
• People who smoke report more pain than those that don’t smoke​.
• Smoking is associated with up to a 40% increase in the risk of hip fractures amongst men​.
• Smoking has a greater impact on reduced bone mineral density among postmenopausal women​.

If you haven’t already then promote Help Me quit within your workplace and think about how you can support your employees if they wish to give up smoking.​

Alcohol can add to weight gain and poor food choices and alcohol and drug misuse can lead to poor lifestyle choices​.

Mental Health – be aware that:​

• Good mental health is required to provide the motivation and energy to be physically active​.
• There is a vicious cycle between low mood and pain and people with back pain and depression experience greater pain than those with back pain alone​.
• Mental health conditions can increase likelihood of developing some MSK conditions.
• You need to raise awareness of MSK health and promote healthy lifestyles and encourage employees to undertake healthy behaviours to minimise their risk of developing MSK symptoms. ​
• So think about how you ensure a joined up approach to supporting your employees by explaining the links to MSK health and the lifestyle risk factors, resources and campaigns.​

Slide 12

Nikki Davies

Line mangers are integral in the interactive cycle of prevention, promotion and support when it comes to MSK health. ​
​
They need to be suitably and sufficiently trained to manage staff and raise their skills so that they can tackle issues such as injury to staff and sickness absence with confidence. Training in return to work interviews, together with general management skills, time management and effective communication training should be part of the induction programme for any new managers. Line managers are the first line of support when an employee experiences MSK difficulties which may affect their work and their wellbeing so they themselves will need MSK training.

Slide 13

In this diagram, we can observe three key options designed to empower both employees and line managers within an organisation. These options are as follows:

• Prevent: This approach focuses on proactively identifying and mitigating potential challenges or obstacles that might hinder employee performance or engagement. By preventing issues before they arise, the organisation ensures a smoother workflow and reduces the likelihood of conflicts or setbacks.
• Promote: The goal here is to actively encourage and support behaviours, practices, and initiatives that drive success and well-being among employees and line managers. This could include recognising and rewarding outstanding performance, promoting professional development opportunities, and fostering a culture of collaboration and innovation. By promoting positive actions, the organisation cultivates a motivated and engaged workforce.
• Support: This is about offering the necessary resources, tools, and assistance to employees and line managers to help them succeed in their roles. Support can take many forms, such as providing access to training, offering mentoring or coaching, and ensuring that employees have the resources they need to perform their jobs effectively. By supporting employees, the organisation helps them overcome challenges and achieve their full potential.

Together, these three options—Prevent, Promote, and Support—create a comprehensive framework for empowering employees and line managers, leading to a more productive, motivated, and resilient workforce.

Slide 14

​So we are going to look at these in a bit more detail individually

Firstly, Prevent – overarching and complimentary robust policies should be in place with the emphasis on supporting staff and preventing ill health​

​​You should have adequate resources for safety:​ Such as Statutory and Mandatory Training for MSKs:​

• Don’t be afraid to go above legal obligation not just off the shelf manual handling and DSE training.

• Consider is there is there enough time & equipment allocated to tasks to ensure safe task execution.

​Clear Reporting Procedures:​

• ​Report risks/incidents/near misses.​
• Recognising and mitigate risks.
• Also identifying patterns and taking action.

Engaging Staff & Investigation:​

• ​Seek staff input in to all aspects of MSK prevention and policy making/risk assessment and body mapping as Rhian has mentioned is a useful conversation starter or refresher with staff.
• When Investigating incidents with staff include near misses and encourage staff to inform and take action to prevent future recurrence.

Monitor Control Measures:​

Don’t rely on a risk assessment that was carried out years ago being in place so everything must be ok?​

Slide 15

Promote – This is where we are keen for you to take more action – especially on the lifestyle factors that can aggravate MSK’s. Revisit how you run campaigns and events throughout the year – as we have mentioned add MSK health into your stop smoking or healthy eating campaigns to reinforce messages at different times of the year, Campaigns and events will be available on our website​.

Have Open discussions​ and

• Encourage Lifestyle Chats with champions where appropriate​
• Incorporate wellbeing in to employees appraisals​​
• Foster Positive MSK Attitudes and focus on can dos​
• Promote a culture of health prevention​.
• Inform staff about support available to them.

Communicate Available Services​ whether this be Occupational Health & Physio Info​

• Third sector/Gp’s and fit note​
• Or Employee assistance programmes​

REMEMBER – even those employees that don’t have an MSK maybe a carer or have a family member that does and you can signpost and support these employees too to have a wider community benefit outside of your organisation​

Slide 16

Lastly moving onto support there are overlaps here with Support we mean​

Flexible Solutions for Workers with MSK Conditions:​

​Have relevant reasonable adjustments to Enable work continuation.​

• Support can be provided directly by you but there is also much support available from the public and voluntary sectors which we will​ look at in the next slide.

Small changes can be effective:​

• Finding adaptive ways to complete a task or shortening the time spent on a task,​ they may want rotate their tasks with colleagues​.
• And having regular breaks are some easy examples ​to put in place.

Collaborate with Occupational Health and Wellbeing Services:​

• ​​Utilise EAP and Mental Health Support.
• Understanding staff returning to work that may have a fit note that hasn’t covered the mental health impact of being off work or having a long term MSK – discuss this with returning staff they need mental health support/signposting​.

It is important to Recognise that Chronic Pain and Medication may have side effects​ which may affect their job role and recognise MSK’s impact on the whole person.​

Rehabilitation and return to work​

Self-management is an important approach to be used in conjunction with any support provided by the employer or healthcare professionals.

You need to ask

• What support your employees need​, then you can signpost employees to knowledge and support that will enable them to manage their conditions​
• Providing reasonable adaptations​-adjustments and adaptations provide individual support related to an employee’s specific problem to enable them to work to their potential and review what is contained in their Fit Note.​

Slide 17

If you only get one thing out of today’s presentation, please make sure you take note of you relevant in work support service provider.

So what is the In-Work Support Service?​

The In-Work Support Service is a free service that  provides rapid access to tailored occupational therapy, physiotherapy and psychological therapy, it is designed to help employed or self-employed people return to work or manage a health condition in work due to a:​

• Mental health problem; or​
• Musculoskeletal problem.​

People can contact the service and speak directly to a specialist adviser. A GP or employer (or any other interested party) may also signpost an employee towards the service.​

The In-Work Support Service also offers free support and training directly to businesses in the private and third sector, who often lack access to occupational health services.​

A programme of training is available to help employers identify the wellbeing needs of the workforce, and implement a tailored programme of measures designed to improve wellness at work, including training workshops and wellbeing treatments.​

So where is your In Work Support Service located?

• Rhyl City Strategy covers the areas in North and West wales as can be seen by the green circle icons on the map. If a person lives in, or a business is based in Carmarthenshire, Anglesey, Conwy, Flintshire, Neath Port Talbot, Pembrokeshire, Swansea or Wrexham.​
• Case UK is the service provider for  South east and Valley areas which can be seen by the purple icon on the map  and covers areas such as Bridgend, Blaenau Gwent, Merthyr Tydfil, Torfaen and Vale of Glamorgan​.
• MIND is the service provider If a person lives in, or the business is located in Powys​.

Slide 15

And lastly

Access to work: UK wide DWP programme that offers a free service that can help you get or stay in work if you have a physical or mental health condition or disability.​

 

The support you get will depend on your needs. Through Access to Work, you can apply for:​

• A grant to help pay for practical support with your work.
• Support with managing your mental health at work.
• Money to pay for communication support at job interviews.​
• Links and contact for all of these available services are on our website.

Slide 16

This action checklist is taken from the BITC MSK toolkit. Please take time to look at this yourselves and reflect how useful it will be in your workplace, looking at all aspects of MSK health from senior commitment and early intervention it provides a useful starter to review what you currently have in place for MSK management.

Slide 17

Diolch, thanks you for listening, we hope you have found this webinar beneficial.

All of our contact details are presented on the slide and you can sign up to our E-bulletin to keep in touch with us and our lasts news by scanning the QR code.

Nikki Davies- Thank you.

Rhian Gleed- thanks

Abbreviations

1. BITC – Business in the Community
2. DWP – Department of Working Pensions
3. HSE – Health and Safety Executive
4. MSDs – Musculoskeletal Disorders
5. MSK – Musculoskeletal
6. NHS – National Health Service
7. UK – United Kingdom