Transforming Vocational Rehabilitation in

NZ: Findings from the post-implementation

review
Deborah Anselm
Category Manager, Vocational and Pain Management
Services
Accident Compensation Corporation

Acknowledgements
Jo Rae
Clinical Reviewer
ACC
Quentin Maclean & Janine Kilmartin
Supplier Managers
ACC
Dylan Cross & Emma Scheib
Research Advisors
ACC
Corrine de Bonnaire & Jane Falloon
Research New Zealand

ACC Lead Suppliers

Active
APM Workcare (NZ) Ltd
EPIC
Habit
Quality Rehabilitation Services Ltd
Southern Rehabilitation Institute
VocHealth NZ Ltd
Workrecovery
WorkRehab

Vocational Rehabilitation at ACC:

The Facts

Approximately 20,000 claims per year for vocational rehabilitation

Annual spend of NZ$30 million

Available to clients with both work and non-work injuries, who are in
employment at the time of their injury

National service delivered by 9 lead suppliers across New Zealand

Vocational Rehabilitation Service

Implemented on 1 March 2012 to deliver the following key objectives:

Earlier return to work, and better return to work outcomes for clients

A multidisciplinary, integrated approach to rehabilitation

Simplification and flexibility for clients, ACC staff and suppliers

Closer relationships with suppliers

Cost effective service delivery for ACC and suppliers

Sustainability for the Vocational Rehabilitation Market

Post-Implementation Review
Commissioned after 12 months to answer the following questions:
Is the service meeting its key objectives?
Whats working well?
Whats not working well, and what opportunities do we have for
improvement?
What can we learn for future service re-design projects?

The first 12 months: How are we

using the service?
Count of referrals by service - CM Network
800
SAW1
(VRS01)

700

SAW2
(VRS02)

PO line count

600
500

SAW4
(VRS04A)

400

SAW3
(VRS03)

300
200
100
0
Mar-12 Apr-12 May-12 Jun-12

Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13
PO creation month

The first 12 months: How are we

using the service?
Referral Behaviour - WR - National RIS Branch Network
No.
PO Lines
60
VRW03A

50

40
VRW03B
30

20
VRW02
10
VRW01
0
Mar-12

Apr-12

May-12

Jun-12

Jul-12

Aug-12

Sep-12

Oct-12

Nov-12

Dec-12

Jan-13

Feb-13

Mar-13

Apr-13

May-13

The client perspective

Overall, clients who had received VRS rated their providers positively

Professional in approach

Clearly explaining what they were doing and why

Taking their personal situation into account

Taking the seriousness of their injuries into account

Most clients who had RTW, had returned on their first attempt

Whats working well?

Package type

% of total SAW
referral volume

Overall % RTW

% RTW within
service timeframe

Median Days

SAW1

32%

83%

22%

39

SAW2

32%

91%

51%

41

SAW3

19%

91%

35%

53

SAW4

17%

83%

N/A

94

The move to a more integrated service delivery model is delivering

earlier return to work and better return to work outcomes for clients.

The integrated approach supports flexible and tailored services to meet

the individual return to work needs of clients

Whats working well?

Overall, we found positive perceptions of the new model

Supports innovation

Encourages efficiency

Focus on quality

Improved communication between ACC and suppliers

Supports more pro-active performance management

Opportunities for improvement

Variability in understanding leading to compromised service choices and

outcomes, and impacting financially on suppliers

More opportunities to use the service for Clients with longer term and more
complex return to work needs

Challenges

Level of change required

Development of strategic relationships trust and confidence takes time

Development of shared expectations

Alignment of drivers and incentives

Future Opportunities
Work Ready/Job Brokerage
How can we deliver more sustainable employment outcomes for clients
who have lost their jobs?
Integration with other services
Training for Independence
Pain Management

The value of review

Timely reminder about the importance of vocational rehabilitation

Provides focus for the future development of service

Allows for the development of shared understanding of key issues

Improved relationships with lead suppliers

Collaborative approach to service improvement

Key messages

Good use of vocational rehabilitation services contributes to better, safer

and more sustainable return to work outcomes for clients

We need to avoid short term thinking about vocational rehabilitation

Invest for client outcomes: Re-orientate from purely cost and duration,
and focus on achieving a sustainable and durable return to work outcome
for clients

Just do it: Engaging vocational rehabilitation services early will ensure a

safe, sustainable and durable return to work for clients

Thank you