1. by Spanning the Silos in Health of Investment Decision-Making
#MakeWorkCount
by Spanning the Silos in Health of Investment Decision-Making
Brussels 29/11/2016
Antonella Cardone, Executive Director, Fit for Work Global Alliance
The Work Foundation, Lancaster University

2. Linking Health & Work
Good Work has been shown to improve health outcomes
Good Health enables people to be productive workers
Lack of integration between health systems and employment and welfare policy

3. Contextual Factors of Workforce Health
Ageing workforce – 50+ twice as 25-. employment rate of older persons is predicted to raise from 50% in 2013 to 67% in 2016
Pension crisis – gap between the number of economically active vs inactive
Growing burden of chronic disease – up to 3 every 10 EU citizens suffer from a chronic disease that affects their ability to work & 50% of EU population report MSK pain. 50M have 2 or more conditions & mostly over 65

4. Musculoskeletal Disorders in the EU Workforce

5. A loss on average of over 10 working years
Multiple Sclerosis in the EU Workforce
people live with MS in the EU
MS affects people between the age of 20 and 40
37% of people with mild MS are in work
10 years after diagnosis 50% of people with MS will stay in work
15 years after the onset of MS, between 60% and 80% of patients will lose their jobs
35% of people with MS in Europe retire early because of the condition
A loss on average of over 10 working years

8. Early labour market withdrawal More social exclusion & poverty
Contextual Factors
More Chronic Illness
Later Retirement
Ageing Workforce
Reduced productivity
Early labour market withdrawal
More social exclusion & poverty
Poor Workforce Health
Increased burden on families & carers
Increased healthcare costs
Reduced tax revenue
Increased welfare spending
©The Work Foundation

9. Good Work & Recovery
“Work? For me it’s waking up in the morning. Work for me is doing something that you enjoy, because when you enjoy something, no matter how tired you are, you will get up and do it.” Working with schizophrenia, lived experience participant
“My health was a lot better then, it was a lot better, because I was doing a job that I was enjoying, obviously my health had improved.” Working with schizophrenia, lived experience participant
People’s aspirations are to have a girlfriend, a job, a new house. They don’t say “I want less symptoms”. Working with schizophrenia, Occupational Therapist

10. Work Should be a Clinical Outcome
Clinicians, employers and individuals too often focus on ‘Incapacity’ rather than ‘Capacity’
Work should be regarded as a clinical outcome of care – incentives & care protocols rarely reflect this principle
Good Work is Good for Health – can have therapeutic benefits (biopsychosocial model)

11. What is “Good Work”?

12. Work in Health Investment Decisions
Perspective taken in Health Investment Decisions:
In theory, Governments across Europe aim to take the societal perspective – which includes consideration of the impact of a healthcare intervention on the patient’s ability to work and the economic effect
In reality, we see that a health care system perspective is taken – covering only those costs and benefits of immediate relevance to the health care system.

13. Why is this?
Silo mentality
Individual departments and agencies of government tend to focus on the specific areas for which they are directly responsible

14. Health and Work Policy Stakeholders
Workforce health
Government – MOH, M. of Finance, M. of social A. & welfare, M. of Labour, etc.
Employers
Local government
Health bodies
Individuals
Business community (Chambers, Associations)
NGOs, Voluntary and charity sector
Health & social care professionals

15. Why spanning the silos?
Investment decisions under budget and resources constraints and must demonstrate value for money and possibly cost-savings
The return on the investment can be shown through productivity, job retention or RTW
Work can have therapeutic benefits
Early Interventions play a significant role beyond drugs and devices

16. Spanning the silos Mandate ‘Work as a Clinical Outcome’ of Treatment
Mandate ‘Work as a Clinical Outcome’ of Treatment
Changing the Scope of Economic Evaluations of Healthcare Intervention
Join up the work of Healthcare, Social Insurance & Employers – and placing patients at the centre of their care
Set up “gain sharing” or “shared savings” pilots

17. Health at a Glance 2016
Although health and labour market policies are often formulated independently of one another, this chapter has shown the need for greater intersectoral collaboration. Both labour market and health outcomes would greatly benefit from improved policy integration.

18. Thank you.
For more information: Antonella Cardone: