eTHOS

eTHOS is a multicentre, 2-arm, parallel group, open randomised controlled pilot trial of a complex intervention. 

Participants will be randomised in a 1:1 ratio between the two arms of the study and will be followed up for 12 months. 

The overall aim of this research is to determine whether a hospital-based staff health clinic incorporating screening for musculoskeletal, mental and cardiovascular health with appropriate referrals is effective and cost-effective in reducing absenteeism and presenteeism.

The aim of this pilot trial is to test the feasibility of a definitive RCT evaluating the effectiveness and cost-effectiveness of a complex intervention in reducing absenteeism and presenteeism in NHS staff, comparing a hospital-based staff health screening and referral clinic with usual care.

Three NHS Hospital Trusts including urban and rural district general hospitals are taking part in the pilot study: University Hospitals Birmingham NHS Foundation Trust (UHB), Birmingham Women’s and Children’s NHS Foundation Trust (BWCH) and Wye Valley NHS Trust (WVT)

INCLUSION CRITERIA:

• Must be employee of one of the participating NHS Trusts (an employee is defined as any individual employed (i.e. undertaking work for payment) by the participating Trust)

EXCLUSION CRITERIA:

• Previous attendees of the current QEHB pilot screening clinic
• Volunteers (excluded as they are not undertaking paid work with absenteeism records)
• Currently taking part in other research studies

 Participants will be randomly allocated to go into one of two groups: 

1 – Intervention group: Participant will attend a staff health clinic. It will consist of two stages:

(1) a screening assessment for musculoskeletal, mental and the NHS health check (as per guidelines) for those aged 40 years and over or a lifestyle check (BMI, exercise levels, smoking, alcohol) for those who are younger

(2) appropriate advice and/or referral of screen positives to appropriate services for management as per NHS/NICE recommendations.

 2 – Control group: This means that participant will not take part in the Staff Health Clinic but could visit occupational health department or their GP.

There are a large number of objectives, as this is a feasibility study:

PRIMARY OBJECTIVES:

1. Recruitment rate to the trial,
2. Referral rate to services for participants randomised to the intervention arm,
3. Uptake rate of those services.

 SECONDARY OBJECTIVES:

1. Describe the characteristics of participants recruited and assess the generalisability of the participants compared with the whole hospital staff
2. Describe the results of intervention screening assessments
3. Describe the referrals recommended and the uptake rates of each of these
4. Describe lifestyle behaviours relevant to screening intervention advice and recommendations
5. Describe and assess the feasibility of measuring the outcomes relating to the definitive RCT
6. To obtain an estimate of the standard deviation of the proposed primary outcomes for the definitive RCT
7. Assess levels of contamination between intervention and usual care arms
8. Describe and explain the fidelity to the intervention and evaluate the barriers and enablers to participation, explored in process evaluation
9. Explore the views, experiences and satisfaction of participants and those delivering the health checks
10. Quantify the costs of undertaking the screening service and its consequences
11. Explore the feasibility of such a service in other NHS and external settings e.g. ambulance service, GP practices, commercial organisations, explored in the process evaluation

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