Review into vocational rehabilitation services

In mid-2010 the WorkCover Board initiated an independent review to assess the use of vocational rehabilitation services in the WorkCover Scheme. In addition, the Board agreed a new Strategic Direction 2011-16 which has a clear focus on delivering the best outcomes for injured workers, employers and the South Australian community.

The increasing use of vocational rehabilitation services and no significant improvement in return to work outcomes for injured workers had been of concern to the Board. Consequently, John Walsh, workers compensation expert, from PricewaterhouseCoopers was commissioned to assess the outcomes achieved by the use of vocational rehabilitation services in the current case management context.

The report highlighted a number of issues that were contributing to poor return to work outcomes. It also outlined a range of key interventions that could improve the experience and outcomes for individuals and overall Scheme performance.

The key findings of the report were:

• Fee structures do not encourage short term and targeted vocational rehabilitation (F)
• The vocational rehabilitation market needs to be defined by quality and skill (Q)
• A strong regulatory influence is required (R)
• Limited upfront strategic case management and early referral (EI)
• Capability enhancement required by the claims agent (Q)

These key findings can be broadly grouped into four areas of action:

1. Fees (F)
2. Quality and capability (Q)
3. Regulatory (R)
4. Early intervention (EI)

In addition to the key findings, other areas for improvement were identified including the volume and appropriateness of referrals, the system of triage, incentives for employers and the increased use of rehabilitation and return to work coordinators.

According to the report, there is no simple solution and jurisdictions around Australia are grappling with these challenges and the remedies are not immediate. That said, effective case management remains the key in any successful service delivery model to injured workers and Walsh emphasises that human interface in the case management process is central to achieve good return to work outcomes.

Following receipt of the report, the WorkCover Board recognised immediate action was required and has approved a schedule of activities to address the key findings, which are outlined below.

The activities – some of which will be undertaken immediately and others which will occur over the longer term include - :

• better defining quality and skill within the rehabilitation industry
• improving regulatory influence
• ensuring capability improvements in case management; and
• changing the fee structure to reward improved outcomes.

The report also recommended a number of ‘pilots’, however due to the potential of an agent tender process being undertaken in 2012, they have not been incorporated into the schedule of activities.

Both WorkCover and Employers Mutual have committed to delivering these actions and the WorkCover Board will closely monitor their implementation.

WorkCover’s role will focus on ensuring adequate regulatory and remuneration frameworks for Employers Mutual and providers are in place. Employers Mutual role will be to operationalise the necessary change into its business practices.

WorkCover Board chair statement [22 KB]

Vocational rehabilitation - Schedule of activities 2011 and beyond [20 KB]

PwC review into vocational rehabilitation report [468 KB]