It's Better at Work - ACC's workplace rehabilitation philosophy

‘Better at Work’ is the general name for ACC’s workplace rehabilitation philosophy. It reflects an international view, based on a growing body of research, which shows injured workers heal faster and avoid psychological impairment if they can safely recover in the workplace, or return to it as soon as possible after an injury.

The aim of ACC’s Better at Work philosophy is, therefore, to bring these benefits to injured clients. This will be achieved, over time, by:

improved work certification – so injured people can get back to work as soon as safely possible.
providing claim management services that support the Better at Work philosophy, these being ACC’s current Better at Work programmes – Stay at Work and Better@Work.
encouraging GPs to shift their approach from routinely providing time off work to routinely certifying clients as ‘fit for selected duties,’ where it is safe and practicable, because doing so will unlock the benefits of workplace rehabilitation for clients and their employers and GPs. To see how this works in practice, see the Better at Work Philosophy in action.

ACC Better at Work Services

Stay at Work (SAW)

Established in mid-2009, SAW services are delivered by a nationwide network of contracted SAW vendors. They receive referrals from ACC and actively work with the client, their GP and the employer to provide a tailored and coordinated approach to organising services designed to safely keep the patient at work, or return them to work as soon as possible.

The key features of the service are:

vendors have the flexibility to determine how and when service should be provided (within service guidelines), to meet each patient’s individual needs
emphasis is on early identification and removal of obstacles preventing early return to work
early intervention services are delivered quickly, within tight timeframes, to address patient needs
a collaborative approach is taken, with the SAW Co-ordinator involving the client, employer, primary treatment provider, whanau, GP and others to identify issues and develop solutions that will enable workplace rehabilitation
there are three different stages within the service, each tailored to meet the differing needs of clients
success is measured via ongoing and simultaneous assessment, evaluation and service.

More detailed information regarding SAW can be found in the SAW Clarification Guidelines (PDF 63K)

Service Design

There are three stages within the Stay at Work service based on the client’s level of complexity, taking risk and need into consideration:

Stage 1 – Early Return to Work
Stage 2 – Graduated Return to Work
Stage 3 – Continued Interventions

Clients can enter the service at Stage 1 or Stage 2. The stages are consecutive, and include a systematic process of assessment, planning, activities, monitoring and review. For more information, see Stay at Work service overview map (DOC 128K).

Stage 1 – Early Return to Work

Initial interventions are provided by the vendor where ACC has identified that the client has a low complexity injury (likely to be simple musculoskeletal injuries) and risk factors and requires support to facilitate their early return to work. This stage allows a maximum of one week to coordinate parties that need to be involved in facilitating successful early return to work for a client.

Stage 2 – Graduated Return to Work

Clients can enter the Stay at Work service at this stage or may in occasional cases be transitioned from Stage 1 (with approval from ACC). Clients who directly enter the service at Stage 2 are likely to require a more in depth level of assessment and documented planning to support their return to work. This may involve a gradual approach to returning to work, and monitoring progress towards a full return to pre-injury duties and hours of work.

Stage 3 – Continued Interventions

Stage 3 recognises that there are a small proportion of clients who require more extensive support and intervention to enable their return to work. Clients are not able to enter Stage 3 without having been through Stage 2. Entry to Stage 3 requires specific approval from ACC.

The Workplace Assessment written report remains available under Stay at Work, but is no longer the required entry point of the service.

Better@Work

Better@Work offers an early intervention and intense case management workplace rehabilitation service for all injured workers over 16 years of age who are enrolled in participating Primary Health Organisations (PHOs), excluding serious injuries and work place injuries with accredited employers.

Better@Work is a service prototype which was established in Taupo via Lake Taupo PHO in early 2009. Since then, it has been expanded to include Harbour Health, Waiora Healthcare and HealthWEST PHOs (north and west Auckland), and to the Hawkes Bay through Hawkes Bay PHO.

A decision on rolling out Better@Work nationwide will be based on a formal review of the prototype, which will take place in early 2011.

Service is provided by GPs, supported by Better@Work Coordinators employed by, or contracted to, the PHOs. Claims are allocated to the Better@Work service by PHO GPs based on criteria established by ACC. Better@Work Co-ordinators are supported by ACC Case Co-ordinators, who manage patients’ entitlements.

Better@Work Coordinators bring all parties together to identify suitable duties for injured workers and any supports required to help the patient safely stay in the workplace. They also help those certified as fully unfit to maintain normal routines, including contact with their workplace. The general practitioner sees the client every two weeks, updating their work certificate accordingly.

The goal of the service is to use a combination of best practice certification and active liaison between the client, their GP, the Better@Work Coordinator and the employer to keep people at work through the recovery period, or get them back to work as soon as is safe and practicable.

Better at Work resources

ACC has developed two resources to assist GPs and their patients with the Better at Work Approach. These resources can be downloaded, and the Patient resource can also be ordered.

Last updated: 20 January 2012