1. The case for supporting people with long term conditions in the workplace Dr Bill Gunnyeon Chief Medical Adviser Department for Work and Pensions

2. 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

3. 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

4. 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

5. 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

6. “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

7. 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

8. Demographic changes present an increasing challenge An ageing workforce With more chronic or progressive diseases Having to support more people of pension age

9. 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

10. Chronic ill health

11. 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

12. GPs’ attitudes towards patients’ health and work 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

13. GPs’ attitudes towards patients’ health and work GP responses to the statement: The Fit Note has…. Source: GP Attitudes to Health and Work Survey

14. 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

15. 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

16. Attitudes of working age adults to health and work Percentage who agree 84% 58% 62% 91% 83%

17. 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

18. 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