The Purpose and background to Study. The purpose of the study is to develop a new and more effective approach to the management of the return to work process in employees troubled by musculoskeletal symptoms. For the last decade, secondary prevention of persistent pain and unnecessary disability has been identified as a major challenge. The importance in particular of psychosocial obstacles to recovery been recognised (Hopkinkon Conferemce, 2005) and stimulated the Decade of the Flags Think-Tank and Conference at Keele University in 2007, where clinical, occupational and wider contextual factors were explored leading to a number of publications on clinical Yellow Flags (Nicholas et al, 2011) and occupational Blue flags (primarily perceptions of work (Shaw et al.,2009) and organisational factors (Main et al, 2013), the conclusions and recommendations from which are the subject of this abstract. Methods and results. There are insufficient workplace-focused RCTs, systematic reviews or meta-analyses from which to develop an evidence-based intervention strategy and narrative review of the clinical and organisation literature into the management of work disability and return-to-work was undertaken of research. The review considers evidence of the efficacy of interventions for addressing absenteeism and presenteeism, distinguishing worker-centred and workplace-centred interventions, and continues with consideration of new ways in which these challenges might be addressed. Conclusion. It recommends a shift from sickness management to the enhancement of well-being, with an evaluation of new organisational research into the psychology of engagement Implications for re-integrating the injured worker into the working environment, are considered not only from a biopsychological but also from a social perspective. The presentation will conclude with consideration of issues of implementation with design of interventions using strategies such as intervention-mapping, a focus on the determinants of behaviour change and advocation of an integrated approach to the optimisation of successful and sustained return to work. No conflicts of interest. No funding obtained. I confirm that the abstract has not been previously published in whole or substantial part not has it been presented at a national meeting