Transcript Slide 1

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
8.9 million inactive
26% with a
health condition
or disability
730,000
off sick
50% with a
health condition
or disability
2.4 million unemployed
30% with a health
condition or disability
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?
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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
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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
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Effective vocational rehabilitation requires
both work-focussed healthcare and
workplaces that are accommodating
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There is a strong scientific evidence base for
many aspects of VR
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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
Why support people to stay in work?
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
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
Demographic changes present an increasing
challenge
53%
An ageing workforce
Percentage
52%
51%
50%
49%
48%
47%
Wkng Age under 40
Wkng Age over 40
46%
2008 2013 2018 2023 2028 2033
years
1.4
1.2
1
0.8
m
0.6
0.4
0.2
0
With more chronic or
progressive diseases
2006
2033
years
Coronary heart disease
diabetes
3.3
3.2
Having to
support more
people of
pension age
3.1
3
2.9
2.8
2.7
Old Age Support Ratio
2.6
2.5
2008
2013
2018
2023
years
2028
2033
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
Chronic ill health
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
Healthy Weight, Healthy Lives
• 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
99% of GPs agree that “work is generally beneficial for people’s health”
Work is beneficial for
health
99%
Worklessness is
detrimental to health
96%
Helping people stay
in/return to work is
important part of role
88%
Staying in/returning to work
indicator of success
77%
GPs have a responsibility
to society to facilitate return
to work
66%
0%
10%
20%
30%
40%
Somewhat/completely agree
Source: GP Attitudes to Health and Work Survey
50%
60%
70%
80%
90%
Somewhat/completely disagree
100%
GPs’ attitudes towards patients’ health and work
GP responses to the statement: The Fit Note has….
70%
60%
60%
54%
48%
50%
42%
36%
40%
26%
30%
20%
10%
7%
10%
13%
12%
6%
5%
0%
Improved quality of Improved advice I
Increased
Helped my patients Increased length of Made no changes
discussions with
give to patients
frequency with
make a phased
my consultations
to my practice
patients about
about their fitness which I recommend
return to work
return to work
for work
return to work as
aid to recovery
Completely Agree
Somewhat Agree
Source: GP Attitudes to Health and Work Survey
Somewhat Disagree
Completely Disagree
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
Percentage of employers citing each
Allowing reduced or different hours
29
Meetings with employees to discus extra help
28
Reducing employee workload
25
Different duties
22
Extra breaks
18
Phased return to work
17
Different chairs/desks
11
Access to OH services
9
Other specialised equipment
Building modifications
Job coach/ personal assistant
No measures provided
Source: Health and well-being at work: A survey of employers
5
4
3
67
Attitudes of working age adults to health and work
100%
Percentage who agree
90%
84%
91%
83%
80%
70%
62%
60%
58%
50%
40%
30%
20%
10%
0%
Paid work is
Paid work is
generally good for generally good for
physical health
mental health
Go to work with a
cold
Go to work if had Go to work if had
long term back
long term
pain and back
depression and
was sore
were feeling down
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