the case for supporting people with long term conditions in the workplace dr bill gunnyeon chief...

The case for supporting people with long term conditions in the workplace

Dr Bill Gunnyeon

Chief Medical Adviser

Department for Work and Pensions

Employment and Health Statistics

4 quarter average to June 2011

27.5 million employed/ self employed

730,000 off sick

26% with a health condition

or disability

30% with a health condition or disability

8.9 million inactive

50% with a health condition

or disability

2.4 million unemployed

Labour Force Survey; men and women, 16-64 ,GB

ME/CFS and the benefit system

Incidence in general population 0.1 - 0.2%

Proportion of ESA claims 0.4%

Significantly greater chance of being

allowed ESA

Why support people to stay in work?

Evidence Individual

Financial Status and self esteem Social contact Family impact Avoiding negative mindset

Employer Reducing absence and turnover Reputation Employee commitment Equality Act compliance

State Reduced flow from work to benefits Improved health outcomes Changing demographics

Lifestyle related conditions

Is work good for your health and well-being?Waddell and Burton 2006

Work is generally good for physical and mental health and well-being

Worklessness is associated with poorer physical and mental health

Work can reverse the adverse health effects of unemployment

Work can be therapeutic

The beneficial effects of work outweigh the risks

The beneficial effects of work are greater than the harmful effects of long term unemployment or prolonged sickness absence

“Vocational Rehabilitation – What Works for Whom and When” Waddell, Burton and Kendall 2008

VR is whatever helps someone with a health problem to stay at, return to and remain in work; it is an idea and an approach as much as an intervention or a service

Effective vocational rehabilitation requires both work-focussed healthcare and workplaces that are accommodating

There is a strong scientific evidence base for many aspects of VR

There is a good business case for VR and good evidence on its cost benefits

Most people with common health problems can be helped to return to work by following a few basic principles of healthcare and workplace management


Evidence Individual





Demographic changes present an increasing challenge

46%

47%

48%

49%

50%

51%

52%

53%

2008 2013 2018 2023 2028 2033

years

Pe

rce

nta

ge

Wkng Age under 40

Wkng Age over 40

2.5

2.6

2.7

2.8

2.9

3

3.1

3.2

3.3

2008 2013 2018 2023 2028 2033

years

Old Age Support Ratio

An ageing workforce

With more chronic or progressive diseases

Having to support more people ofpension age

00.20.40.60.8

11.21.4

2006 2033

years

m

Coronary heart disease diabetes


Evidence Individual





Chronic ill health

Healt

hy W

eig

ht,

Healt

hy L

ives

Healt

hy W

eig

ht,

Healt

hy L

ives

Obesity levels are too high, with significant impact on individuals, the health service and society as a whole

By 2050, if trends continue, 60% of men and 50% of women could be clinically obese (UK Foresight report)

HEALTH IMPACT

• 58% type 2 diabetes

• 21% of heart disease

• 10% of non-smoking related cancers

• 9,000 premature deaths a year in England

• Can reduce life expectancy and quality of life

COST

• National Health Service - £4.2bn

• Wider economy - £15.8bn

• Foresight estimates by 2050 costs to economy of £50bn

Overweight & obesity forecast trend 2007-2050

Government initiatives

GP education

Fit Note

Fit for Work pilots

OH advice services for SMEs

Sickness Absence Review

Improvements to WCA

Work Programme

Universal Credit

GPs’ attitudes towards patients’ health and work

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

GPs have a responsibilityto society to facilitate return

to work

Staying in/returning to workindicator of success

Helping people stayin/return to work is

important part of role

Worklessness isdetrimental to health

Work is beneficial forhealth

Somewhat/completely agree Somewhat/completely disagree

99% of GPs agree that “work is generally beneficial for people’s health”

99%

96%

88%

77%

66%

Source: GP Attitudes to Health and Work Survey

GPs’ attitudes towards patients’ health and work

7% 5% 6%10%

13% 12%

54%48%

42%

60%

36%

26%

0%

10%

20%

30%

40%

50%

60%

70%

Improved quality ofdiscussions with

patients aboutreturn to work

Improved advice Igive to patients

about their fitnessfor work

Increasedfrequency with

which I recommendreturn to work asaid to recovery

Helped my patientsmake a phasedreturn to work

Increased length ofmy consultations

Made no changesto my practice

Completely Agree Somewhat Agree Somewhat Disagree Completely Disagree

GP responses to the statement: The Fit Note has….

Source: GP Attitudes to Health and Work Survey

Sickness Absence and Rehabilitation Survey 2011 - EEF

20% indicated Fit Note had already reduced sickness absence

28% agreed Fit Note had improved quality of return to work discussions between line manager and employee

Proportion of companies contracted by GPs to ask about availability of adjustments doubled after Fit Note introduction

Reduction in proportion of employers identifying GPs as a barrier to rehabilitation from 39% in 2006 to 26% in 2010

Measures used in the last 12 months by employers to help keep employees with health problems in work or

facilitate their return to work

Source: Health and well-being at work: A survey of employers

Percentage of employers citing each

67

3

4

5

9

11

17

18

22

25

28

29

No measures provided

Job coach/ personal assistant

Building modifications

Other specialised equipment

Access to OH services

Different chairs/desks

Phased return to work

Extra breaks

Different duties

Reducing employee workload

Meetings with employees to discus extra help

Allowing reduced or different hours

Attitudes of working age adults to health and work

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Paid work isgenerally good for

physical health

Paid work isgenerally good for

mental health

Go to work with acold

Go to work if hadlong term backpain and back

was sore

Go to work if hadlong term

depression andwere feeling down

Per

cen

tag

e w

ho

ag

ree

84%

58%62%

91%83%

Government initiatives

GP education

Fit Note

Fit for Work pilots

OH advice services for SMEs

Sickness Absence Review

Improvements to WCA

Work Programme

Universal Credit

Summary

Chronic health conditions are an increasing challenge

The evidence for supporting people with chronic conditions to work for as long as possible is clear

Achieving this requires partnership between healthcare professionals, employers and individuals

Perceptions and behaviour are changing

But there is much still to do

the case for supporting people with long term conditions in the workplace dr bill gunnyeon chief...

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