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Matched care moves away from the commonly used methods, including:

•‘Wait and see’. Also referred to as ‘watchful waiting’, this is when healthcare providers or case managers opt not to proceed immediately with intervening for a condition, but to observe what happens to the person over time. This risks delay in dealing with risk factors which can be harder to change later.

•Stepped care. Stepped care is a sequential model for treatment — the least intensive interventions are used first and if there is a lack of improvement then treatment will gradually progress to more intensive treatments. This also risks delays and is not based on a comprehensive biopsychosocial assessment. It is more commonly thought of a ‘trial and error’ approach.

In some situations, these approaches may be useful. But in work injury management identifying and overcoming barriers early is vital. There are inherent delays that arise from trialling treatments before progressing to the next step and then repeating this cycle. It can increase frustration and reduce confidence in the healthcare process. Further, for psychosocial management, the longer barriers are in place the harder they become to overcome.

The elements of matched care

In the available research, matched care has incorporated 3 elements:

1.Individual psychosocial counselling

2.Extra workplace support

3.Extra healthcare support

It is possible that barriers to recovery and RTW can be overcome by only addressing one or 2 of these options as indicated in an individual case. However, systematic reviews of influencing factors have indicated that support across the domains of case management, workplace and healthcare is the most effective approach to improve these outcomes.[14]