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In 2020 we came together as researchers, practitioners and experts in biopsychosocial approaches, as part of the It Pays to Care advocacy work from the Royal Australasian College of Physicians (RACP). This resource builds on the "It Pays to Care" framework, developed through the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) and RACP, drawing on our collective experience in evidence-based work injury management.

The biopsychosocial framework recognises that recovery and return to work are influenced by physical, psychological, and social factors. The last 5 to 10 years have seen significant advances in our understanding of psychosocial barriers and their impact on recovery. More importantly, research has identified effective approaches to manage these issues early, preventing the development of secondary mental health conditions, chronic pain and and prolonged work disability. These approaches have been shown to significantly improve outcomes for workers facing psychosocial barriers.

Several Australian workplaces and insurers and some schemes have adopted this approach. Our observations show that organisations implementing the full, evidence-based model achieve substantial improvements in return-to-work outcomes and cost reductions. Conversely, partial implementation often fails to deliver the expected benefits or results in significantly smaller gains. Screening alone, without effectively addressing identified barriers, does not improve outcomes.

We recognise that implementation is challenging, particularly within complex environments. Through this guide, we aim to support the industry by providing both the evidence base and practical guidance on implementation. While this model may not suit every insurer or scheme, it offers substantial opportunities for improving outcomes. We encourage all insurers and schemes to consider this option, explore their own business case for implementation, and where appropriate develop an approach that suits their particular organisation.

As experts in this field we have focused on supporting successful implementation. It has been encouraging to see the development of communities of practice, where organisations that have successfully implemented these approaches support others beginning their journey.

We understand that implementing this approach requires investment. Each organisation needs to explore their own implementation framework, barriers, business case and capability for change. These considerations will vary according to the particular organisation, their operating environment and appetite for improvement.

As professionals dedicated to improving outcomes in this field, we are committed to providing ongoing support, whether through communities of practice or as a resource for implementation advice. We look forward to seeing the continued evolution and adoption of evidence-based psychosocial matched care across the industry.

Dr Mary Wyatt       Professor Michael Nicholas      Dr Pam Garton     Associate Professor Ross Iles