The Role Of Occupational Health (OH)
Occupational Health is a branch of medicine dealing with the relationship between health and work. The current high levels of economic inactivity due to people with long-term health conditions could be reduced by having access to advice and assessment by occupational health professionals.
OH professionals help people remain in work when they have developed a health condition, or to supporting those seeking work in suitable jobs that will help, not hinder, their health. However, less than half of employees have access to OH.
For those in employment occupational health can help to prevent health conditions caused or made worse by work and also support those with health conditions falling out of work.
OH also offers an evidence-based approach using ROI tools such as https://evolveworkplacewellbeing.org/business-calculator, avoiding risk of “wellbeing washing”.
Work is an important contributor to good physical, mental and economic health. Evidence suggests that unemployment can lead to poor health for an individual and both this and the next generation of their family. Disabled people are disproportionately affected by unemployment.
Integrating work coaches and disability employment advisors into primary care where they can reach patients more easily and also link up with health professionals to provide more holistic support is drawing dividends. Barriers to working are multifold and social factors can be a significant contributor both to sickness absence and unemployment which can precipitate ill health.
Early results indicate that work coaches and Disability Employment advisors can provide a range of support and advice on work related, financial, housing and managing dependents whilst being able to refer to Occupational Health for selective patients which reduces the burden on GP’s and NHS in terms of prescriptions, number of GP appointments and ill-health burden resulting from unemployment.
Background
The UK is (on average) less productive than many developed countries, including Germany, France, and the US. This is the so-called ‘productivity puzzle’.
We know that around 10% of those in work have a long-term health condition, and many others may have occasional health problems that affect their work. Ill health is the main reason for the change in economic activity in the last two years:
Government should be concerned with the absolute levels of economic inactivity which have been ignored for years. This may be related to individuals waiting for NHS treatment, but there are also structural issues e.g. due to the underuse of Fit Notes in primary care, a gateway to longer term sickness absence. It can often be good for people’s health to work, when work is suitable and there are appropriate adjustments, as it keeps people active and engaged with others.
The UK also has low levels of economic activity relative to other developed countries with a recent increase relative to other countries, and relative to trend. A proactive approach to tackling these barriers is essential to ensure disabled people and individuals with health conditions can work and do not lose their job during a period of ill health. many of these people want to re-enter the labour market:
The Government’s focus should therefore now be on employment support to a) improve ‘inflows’ and b) prevent ‘outflows from the employment market, with a key role played by employers and occupational health at each stage.
Outflows
There has not only been an increase in people leaving work due to ill health, but also an increase in the ‘at work but struggling’ group with durations of sick leave increasing. The longer the spell of sickness absence, the less likely it is that the individual will ever return to work. key issues are Musculoskeletal³ and Mental health issues and Older workers leaving for retirement. Just over half of people with long-term health conditions or disabilities do work, so we can do a lot more to help people stay/get back to work. Occupational Health (OH) professionals can provide support for people to stay in work, through appropriate adjustments, tailored phased returns and advice to both employee and employer.
Inflows
There are not enough people coming back to work after illness. There is an increase in the number of people who have never worked due to ill health (mainly younger). Many people’s health gets worse once out of work, which strengthens the argument for a far better, personalised, and tailored return to work support for those currently inactive (esp. the significant percentage who want to work). Many people in their 50’s who have left the labour force have said that they would come back for the right job. OH could play a bigger role in supporting those out of work to find the right, appropriate work for them by greater join up with GP’s, work coaches and others.
³Toolkit available https;//www.som.org.uk/msk-work-network