This second round national comparative clinical audit measured change in how well occupational health (OH) professionals were detecting and managing depression in long‐term sickness absence cases and implementing the long‐term sickness absence guidance since the first audit round.
The audit subsequently formed part of the National Quality Improvement Programme (NQIP) and was available to all OH services in the UK from August 2013.
- The average length of sickness absence at the audited appointment was 8 weeks, however 30% of cases had been off sick for least 12 weeks and 5% had been absent for over 6 months. NHS trusts need effective systems for early referral to OH for staff on long-term sick.
- The proportion of cases assessed for signs and symptoms of depression rose from 58% in 2008 to 67% in 2010. This increase was particularly marked for cases where the presenting diagnosis was a physical one (15% to 52%). A diagnosis of depression should be considered in staff on long-term sickness absence, including where they present with a physical illness.
- In both audit rounds 70% of cases were asked if they thought workplace factors had contributed to any depression (in 2010, 57% of these cases thought that workplace factors had contributed compared with 64% in 2008). In 2010 there was an increase in the frequency and quality of assessments for depression. Scope remains for OH professionals to ask more often about core symptoms of depression, suicidal thoughts, alcohol use and work factors.
- Of the 1,757 cases entered into the audit who were receiving or waiting to receive physiotherapy, the employer provided this treatment for 382 (22%). 2,215 cases were receiving, or waiting to receive, psychotherapy, and this was being provided by the employer for 1,169 (53%). Therapy services provided by employers are being accessed by staff on long-term sickness and are likely to contribute to an earlier return to work.
- Temporal analysis suggests that greater progress was made by OH services where at least one member of the service attended an implementation event. Audit data can show where change is necessary and what progress has been made. National, regional and local activities support individuals and services to make these changes.