NHS Case Study

NHS innovation developed in Norwich helps tackle £400 million cost of back pain.

A two-year NHS project undertaken by Norwich's Centre for Occupational Health has won a national award for its role in helping tackle the £400 million a year cost of nurses with back problems.

Hilary Winch, occupational health nurse manager at the Centre for Occupational Health, part of the Norfolk and Norwich University Hospitals NHS Foundation Trust, was presented with the outstanding NHS Occupational Health Service for Staff award from Dr Kit Harling, Director of NHS Plus, for the development of the Norwich Back Pal kneeling stool.

The category was one of 13 in the 2008 Excellence in HRM Awards organised by the Healthcare People Management Association. The project submitted was the development of the Norwich Back Pal kneeling stool. The two-year project was undertaken to improve the working posture of community district nurses who were spending long periods of time kneeling when applying leg dressings in patient's homes. The stool was developed following a significant rise in referrals to the occupational health centre for back and knee pain experienced by these staff.

Hilary said; "As the senior occupational health nurse adviser employed by the Norfolk and Norwich University Hospital providing services to the Primary Care Trusts in Norfolk I worked with the PCT's manual handling adviser in the design and subsequent commissioning of the manufacture of a specialist kneeling stool.

"Kneeling stools have been available for years but they were identified as being too bulky, too heavy, difficult to clean, unreliable folding mechanisms, not height adjustable and therefore did not meet the needs of community based nurses."

A company, Carbonlite Medical Technology, was found who had developed a folding stool. Following months of work and consultation with the company, a lighter weight, wipe-able, height adjustable, folding product was developed. This product has since been subjected to rigorous tests and is now available for sale.

NHS Norfolk has now bought a large number of stools for their district nurses and the Occupational Health team at the Norfolk and Norwich University Hospitals NHS Foundation Trust have seen a reduction in the number of back and knee pain being presented to the department.

The project was named as a winner at the HPMA awards ceremony on 12th June 2008. The judging panel liked the way that Hilary had identified a problem, researched solutions and assisted in the development of a product which is clearly successful.

Innovation of the Year

Publication: The Safety & Health Practitioner / Publication Date: 01-OCT-07

Although Norfolk Primary Care Trust's Norwich Back PAL Kneeling Stool is a short-term trial, there are lots of other possibilities for other healthcare practitioners to use it too, the judges said. Indeed, the HSE has commissioned two of its senior ergonomists to carry out further research as evidence of good working practice and safety investment.

The most widely documented manual handling concern among the Trust's 28 district nurses was the unsupported kneeling posture adopted during patient leg dressing. While the district nursing staff seemed instinctively aware that some sort of kneeling stool to reduce back and lower-limb strain was required, there was nothing commercially available to suit their needs.

The Carbonlite Medical Technology Company was commissioned to manufacture and quality-assure a product to the Trust's specification. Once developed, tested, trialled and manufactured, the Trust purchased 60 of the stools. The stool is described as small and compact, and very strong and lightweight with a padded seat for comfort, the stool has a safe working load of 20 stone.

When the entry was submitted the stools had been in use for four weeks and had resulted in greater postural awareness among staff, improvements in working postures, and increased staff comfort levels.

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