Worklessness due to ill health
Prof Ewan Macdonald of SHW's Healthy Working Lives Group discusses the issue of people with health conditions falling out of work, and the importance of preventing rather than treating worklessness
Recent publicity about the issue of workers with health conditions falling out of work is welcome. A seminar hosted by the Society of Occupational Medicine on 13 October 2022, with the Bank of England and Institute of Employment Studies, highlighted this further.
In the UK there is a lack of competent advice for workers with health problems, because of low levels of occupational health coverage. The evidence is that organisations and individuals who have access to occupational health have lower rates of falling out of work.
Most workers in their 50s and 60s will have health issues dealt with by GPs or in hospital. But an overloaded NHS does not have time to address the employment implications of an individual’s condition. In addition, hospitals are organised in silos dealing with different issues such as respiratory, cardiac, gastroenterological, Mental health etc; while GPs (in the short time they have with their patients) can generally only deal with one issue at a time.
Research from University of Glasgow has shown that the number of medical conditions people have strongly predicts the likelihood of failing to return to work. So what can be done about this?
Occupational Health (OH) can identify who is at risk and the potential for a proactive intervention rather than waiting for worker’s health to deteriorate and fall out of work (once an individual has left work it is much more difficult to rehabilitate someone to work). We should aim to have universal access to OH for all workers; and, individuals in their 50s should have health screening in workplaces to identify their risk of job loss so that interventions can be proactive rather than reactive.
This approach does not just rely on more doctors and professionals who are trained in OH, as they are not always available. Occupational therapists, physiotherapists and psychologists are also an important resource.
Finland is an example of where this is being done proactively – it has almost universal OH and is introducing a system whereby workers who have been treated in hospital and discharged to OH. This shortens sickness absence individuals have and leads to successful outcomes - in one study it halved the sickness absence of individuals who had spinal surgery.
In the UK actions should be taken to create a system of providing everyone with access to OH – preventing rather than treating worklessness.
Prof Ewan Macdonald
Head of Healthy Working Lives Group, Public Health, UofG
Chair, Academic Forum for Work and Health
First published: 18 October 2022