THE NOW WHAT-2 PROJECT: Rethinking return to work services for long-term sick listed employees

The NOW WHAT-2 project is asking a dual -now what- by challenging how return to work (RTW) services are designed, organised, and delivered, but also by enabling employees on long-term sick leave to restart their RTW-process. In Norway, one in three aged 18 and 67 years is not working. The Norwegian Labour and Welfare Service (NAV) uses 35% of the national budget, where the half goes to health-related benefits. Just a few of the employees on sick leave account for most of the sickness absence days, which make long-term sick leave a core problem to solve. With funding from the Directorate of Labour and Welfare, we have been challenging existing service delivery together with a wide range of professionals and institutions (NOW WHAT-1 project). Gaps between evidence and praxis has been identified. A test-version of a new add-on bio-psycho-social RTW-program integrates all three-intervention arenas; the workplace, social insurance office (NAV), and health care. The program common thread is about identifying and breaking down participation barriers. It applies new technology, e.g., a digital participation barrier tool, e-health interventions, workplace assessment, and an RTW-coordinator enabling integration of interdisciplinary competence between professional environments and intervention arenas. The program builds on effective RTW-programs from Canada, Netherland, and Denmark, and IPS from USA. We have designed six WPs for goal achievements: literature reviews and service innovation (WP1), feasibility studies (WP2) with mixed-method design testing the new program, randomized controlled trial (WP3), comparing the effectiveness of the program versus usual care, sub-group analyses (WP4) focusing on who benefit most from the program, process evaluation (WP5) covering service and organisational explanations for this, and revealing knowledge on how to scale and implement this program in diverse settings, and a cost-benefit and -effectiveness study (WP6) on societal savings from the new practice.

The NOW WHAT-2 project is asking a dual -now what- by challenging how return to work (RTW) services are designed, organised, and delivered, but also by enabling employees on long-term sick leave to restart their RTW-process. In Norway, one in three aged 18 and 67 years is not working. The Norwegian Labour and Welfare Service (NAV) uses 35% of the national budget, where the half goes to health-related benefits. Just a few of the employees on sick leave account for most of the sickness absence days, which make long-term sick leave a core problem to solve. During the last 3 years, with funding from the Directorate of Labour and Welfare, we have been challenging existing service delivery together with professionals and institutions (NOW WHAT-1 project). A beta-version of a new bio-psycho-social RTW-program integrates all three-intervention arenas; the workplace, social insurance office (NAV), and health care. The program builds on effective RTW-programs from Canada, Netherland, and Denmark, and IPS from USA. The program common thread is about identifying and breaking down participation barriers. It applies new technology, e.g. a digital barrier tools, e-health interventions, workplace assessments, and the RTW-coordinator to enable integration of interdisciplinary competence between professional environments and intervention arenas. Six work packages (WPs) seek goal achievements: literature reviews and service innovation (WP1), feasibility studies (WP2) with mixed-method design testing core intervention components, randomized controlled trial (WP3), comparing the effectiveness of the program versus usual care, sub-group analyses (WP4) focusing on who benefit most from the program, and process evaluation (WP5) finding service and organisational explanations for explaining effectiveness and revealing knowledge on how to scale and implement this program in diverse settings, and cost-benefit and -effectiveness study (WP6) on societal savings from the new practice.