Addressing musculoskeletal disorders in the workplace

06 Oct 2017
Sarah Clarke

Addressing musculoskeletal disorders in the workplace

This post, written by C3’s Ina Andersson, is based on a piece of work carried out by C3 creating case studies showcasing workplace health initiatives across a range of companies and organisations. We’ll be sharing these case studies over the next few months through our blog.



Examination of data as part of Britvic’s employee wellbeing programme showed that musculoskeletal disorders were a key cause of staff absence – so Britvic decided to implement a service to prevent, address and treat employees’ musculoskeletal problems. The service fast-tracks employees’ concerns via a telephone physiotherapist assessment that takes them through a stepped care programme. Employees using the service have fed back positively, and Britvic has also seen a positive impact on employee sickness-absence rates.



Britvic has a long history of offering employee benefits such as health and dental care.  With changes in people’s lifestyles and the demands of working life, Britvic considered it important to prioritise the provision of musculoskeletal support.



Help takes the form of a musculoskeletal support line as part of a healthcare helpdesk, enabling employees to access the most appropriate treatment for their problems. It also supports employees in increasing physical activity and addressing lifestyle factors that may be contributing to the problem.

Britvic also has an Absentee Policy that supports employees by offering a discretionary company sick pay scheme in addition to statutory sick pay.



Initially across the eight Britvic UK sites: two offices, four factories, and equipment and distribution centres.  Britvic’s employee programme has since extended to its global Business Units.



The 1,850 people employed by Britvic UK benefit from the support line, which was set up as part of Britvic’s employee wellbeing programme and in collaboration with its occupational health partners.



Britvic has had a healthcare plan for many years and started reporting on it in its first sustainable business report in 2008.  Since then, Britvic has launched a comprehensive employee wellbeing programme across its Business Units, looking at causes, prevention and lifestyle changes.  Its extensive employee wellbeing programme now follows the guidelines of Public Health England’s (PHE) programmes including Change4Life and One You and the programme is reported on and published annually as part of Britvic’s sustainable business report on the company website.



Britvic set up a support line for employees and promoted the number and procedure via its intranet, workplace booklets and posters. By using the service, instead of having to visit a GP for a referral, employees can directly contact the musculoskeletal support line, where a trained physiotherapist will assess them over the phone and take them through a stepped care programme:

  • Step 1: Assessment and self-help information
  • Step 2: Case management and guided self-help
  • Step 3: Telephone physiotherapy
  • Step 4: Face-to-face treatment
  • Step 5: Functional rehabilitation or specialist intervention

It also has a preventative function, supporting employees to increase physical activity and improve their lifestyles to combat their specific problems. The approach used is a ‘biopsychosocial’ approach, which aims, where possible, to address health issues before they arise by providing help and advice for employees. The approach takes into consideration underlying issues such as fitness levels (fit for purpose), ergonomic assessments and the management of attitudes and beliefs to pain and exercise, and aims to help employees get back to work as quickly as possible.



As a result of the service, Britvic has seen a reduction in sickness absences and increased early-return-to-work rates and provided sensitive case-management to long-term absentees.

Data from 1 April–30 June 2016 show that the highest reason for referral was ‘Spinal Related Musculoskeletal’ with 16 per cent of all new referrals being contributed to back pain, a total of 37 patients were referred in this period, all to the Rapid Access Physiotherapy Service, with a service utilisation of 100 per cent.  Approximately 96 per cent of patients were referred for physiotherapy, 40 per cent were managed with exercise and advice alone (including ongoing self-management) and the average number of treatments per case was just over five treatments. Five is the average number of sessions required to obtain a good clinical outcome.

From 2014, Britvic’s absence data shows that incidences of sickness for musculoskeletal reasons decreased from 104 to 91 and the number of sick days taken has steadily decreased from 826 in 2014 to 563 in 2016.

Following the success and positive feedback received from employees on the support line, Britvic further extended its wellbeing and Employee Assistance Programmes to include mindfulness, physical-activity challenges and a Cycle to Work Scheme, as well as encouraging healthy lifestyles through healthy diet and hydration.

In 2015 Britvic surveyed its employees about the healthcare service and particularly the musculoskeletal support line. 90 per cent of respondents rated the quality of service provided as excellent or good, 98 per cent of respondents felt the staff they spoke to had either excellent or good knowledge of the Britvic Healthcare Plan and 92 per cent of those surveyed believed the speed at which their call was answered was excellent or good.

It was great being able to speak to a physiotherapist the same day without having to wait for a GP appointment. I was e-mailed some exercises that I could start straight away and the case manager and physiotherapist were in regular contact with me to make sure I was seeing the right improvements; which I’m pleased to say I was.

– Britvic employee


I decided to have a go at cycling to lose weight and regain fitness and the Cycle to Work scheme offered through Benefits was a key driver towards me taking the plunge and buying a bike.  This has had a huge effect on my life and I’ve now ridden all over the country – in excess of 16,000 miles.  Without the employee wellbeing programme at work I would not have made these lifestyle changes.

– Britvic employee in the 2016 Great Place to Work survey



In 2014 musculoskeletal issues were 33.5 per cent of all healthcare claims, 14 per cent of all absence and 42 per cent of occupational health referrals.  Britvic wants to reduce musculoskeletal problems even further and to score better on the wellbeing section of the Great Place to Work survey, so that all employees know where to go to for healthy lifestyle advice and healthcare when they need it, but also for employees to know how to better manage their own health and make informed choices towards healthier lifestyles.


The future

Britvic now has a framework across all their business units for employee wellbeing, incorporating five pillars: Consumption, Cardio, Composure, Financial Wellbeing, and Social Wellbeing. These pillars are used to shape the wellbeing strategy across the business as well as local initiatives and interventions with employees, and drive improvements in these five key areas.  An example of the UK specific programme in 2016 was ‘Wake Up to Wellbeing’ which focused on eating right, state of mind, moving more, watch the pennies, and time well spent.

Britvic operates in a world where companies compete for talent, and leading companies in the food and drink sectors are investing heavily in employee wellbeing.  Britvic wants to continue to:

  • be an employer of choice – to attract people who consider health and wellness important, as a non/beyond-salary related reward; and
  • improve employee productivity – healthier employees will make better decisions and be more productive.


Interested in more workplace health case studies? We’ve also written about Serco and Nestlé


This work was carried out by C3 and supported by the Health Foundation.