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Getting Britain’s workforce working: the crucial role of rheumatologists

April 15th, 2016 by FfW UK Secretariat

As Simon Stevens put it in his very first speech in his NHS England post:

“If like me you believe in a tax-funded NHS, you’ll want the Health Service to play its part in growing our nation’s economy, precisely so we can sustain public health services for generations to come.” [1]

No single specialty is in a position to make a bigger contribution to this agenda than rheumatology. Musculoskeletal disorders (MSDs) represent the single biggest cause of sickness absence in the UK, accounting for more than 30 million sick days taken in 2013. [2]

We know that much sickness absence due to MSDs is avoidable.  Provided with appropriate advice and support, many people could return to work.  Giving such support will however require a change in the mindset of healthcare professionals in two important ways.

Firstly, the misguided belief that work is somehow incompatible with long-term conditions needs to be fundamentally challenged. There is a growing evidence of the therapeutic benefits of work in general and for those with MSDs. In many cases, staying active and remaining in work not only bring physical benefits but can also make a world of difference to individuals’ self-confidence, self-esteem and mental wellbeing.

Secondly, work needs to become a clinical outcome for patients of working age.  Rheumatologists endeavor to return patients to functional capacity – for many this can and should include work. Rheumatologists need to ensure that work-related issues feature throughout the clinical episode. Patient surveys tell us that the issue of work comes up in conversations with healthcare professionals all too seldom. This has to change.

The management of MSDs can be a complex and expensive endeavour. If we want investment to be made in new diagnostics, treatments and workforce, we in the rheumatology community must also find ways to demonstrate return on that investment.

The inclusion of work in consultations does not cost much. Yet if implemented at scale, this small adjustment in the way that rheumatologists approach their conversations with their patients could make an enormous difference, not only to the health of the British workforce but to the British economy as a whole.

Dame Carol Black
Expert Advisor on Health and Work to the Department of Health & Principal of Newnham College Cambridge


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Joint Working

May 22nd, 2015 by Blogmaster

The health benefits of work have been well documented, and we know that many people with long-term conditions such as arthritis or who have a disability continue to work successfully.

Creative support measures can be instrumental in helping individuals with disabilities or long-term conditions remain in or return to the workplace. Reasonable adjustments such as flexible working, reduced hours, reallocating duties or location can improve the capacity of the employee to remain in the workplace, thus ensuring the employer retains their skilled member of staff.

In addition to these adjustments that can be agreed between employee and employer, the government’s Access to Work scheme has proved invaluable to many, providing funding for equipment, travel to work or for a support worker.

When employees find themselves off work due to a painful and debilitating musculoskeletal condition, they need timely diagnosis and support to help them return to work. For some the condition may be temporary, while others may find they have to adjust their lives to accommodate the onset of a disabling, long-term condition.

Chronic inflammatory arthritic conditions, such as Rheumatoid Arthritis, can be permanent and rely on a range of interventions from primary and secondary care to help the individual manage their condition in the workplace.  The prompt diagnosis of this type of arthritis can be crucial in preventing severe disability. It can cause irreversible joint damage, tendon rupture and loss of muscle. These gradually affect the range of movement of joints, which in turn has an impact on work and quality of life.

Arthritis Care’s Joint Working employability project in Scotland aims to support individuals to ‘Work Well With Arthritis’. In partnership with the Rheumatology Occupational health team within two NHS areas, the service offers a range of engagement options to suit the individual, including 1-1 meetings, email and / or telephone. Referrals are received from NHS staff, DWP, employers as well as self-referral.

The project aims to address the difficulties individuals face managing their condition in work and / or support their journey back into the workplace.

It is acknowledged that working with arthritis can be challenging, with fatigue, pain and stiffness cited as the main issues affecting people’s ability to work. Taking time off sick due to flares, problems with colleagues not understanding the condition, the need for specific adaptations and the effects of medication can leave individuals feeling anxious, isolated and overwhelmed.

Joint Working aims to help each service user find what works best for them, reassuring them of their rights within the workplace, providing information and referral pathways to a range of support and services such as Access to Work, self-management courses, workplace adjustments, training or disability benefits.

Unfortunately, some people may not be able to continue working, and so the service can provide information and support to help them make the right decision for them or look at other employment options.

In partnership with the NHS Healthy Working Lives service, Joint Working also aims to raise awareness among employers, providing free Arthritis Awareness training or information for staff.

Being diagnosed with a chronic long-term condition is not something most people plan for, and there is considerable work to be done to help support those people in the workplace who have found themselves in this situation.

While advances in medical care help people to remain well enough to work, there is a need to address the lack of coordinated support for people entering a new phase of their life with a chronic condition.

Working with arthritis is achievable, if individuals are given the right support at the right time in their lives.

Judi Rhys
Chief Executive
Arthritis Care

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Pain and work

May 14th, 2015 by FfW UK Secretariat

It is estimated that by 2030, four out of ten working age people will have at least one chronic health condition, and some will have several. The most common symptom is pain with the mental and physical effects of pain. Further, in many individuals symptoms fluctuate, often unpredictably. This presents a challenge, to those who are affected, to their health professional advisers and especially to their employers.

I shall consider the effects of painful conditions on the lives of people of working age and ways in which those effects can be ameliorated.

First, the evidence is consistent and fairly strong that for most people, work – good work – is good for their physical health, their mental health and their overall wellbeing. And it is certainly true that good work can enable people to live lives that are fulfilling personally, socially and economically – helping to ensure their wellbeing.

This is no less the case for most people who are not wholly well or fit. Indeed, most people with long term health conditions, many of which are painful, do in fact work.

What are the effects of painful conditions on the lives of people of working age and how can those effects can be ameliorated and their wellbeing restored?

Except where there are obvious features such as deformity, altered posture or gait, or difficulty in movement or undertaking physical tasks the symptoms are subjective and their effects often difficult for employers and co-workers to fully understand.

Neither, of course, is pain solely a physical problem; always there are psychological and emotional elements. Anything one does might influence pain and the experience of that pain, and the consequences. Pain will trouble us to varying degrees depending on our mental state. Moreover, pain can influence that mental state.

The circumstances of working life and the personal and employment needs that must be met bring particular considerations into play.

Effective approaches to bring pain under control, make it tolerable, to enable the fullest possible working life depend on the attitudes and actions of many participants, first on skilled clinicians, in a range of specialties. But this aim cannot be achieved by clinicians alone. It requires close and sensitive collaboration with patients themselves. Without their keen, committed, informed participation the results will fall short. Often there must be acceptance of pain, importantly with the recognition that enhanced physical activity is not something to be endured but rather an essential part of coming to terms and rejecting unnecessary curtailment of activity that can still be rewarding and enjoyed.

The challenge is not just for any single part of our health and work system. If affected people are to have fulfilling working lives then facilitating entry to work, job retention and return to work after sickness absence must also be a concern of the welfare system and, crucially, of employing organisations.

There is compelling evidence that the conditions of work are themselves important and sometimes decisive factors in influencing both mental and physical health and overall wellbeing of working people. Further, there is a growing recognition among employers of the importance of employee health and wellbeing to the performance and reputation of their organisations, and a keen awareness of the costs when employee wellbeing is neglected.

However, for many the onus for self-managing a painful condition at work weighs too heavily, often at great cost to their personal lives at home, and their social lives. The effort to stay in work can compromise their physical health.

Recent research has revealed more fully the tension between wanting to continue to work, in the face of a struggle to manage the painful condition successfully. Being in work as a condition of effective self-management is often undermined as individuals seek to self-manage in that context. The report Self-management of chronic musculoskeletal disorders and employment captured the barriers that people with chronic musculoskeletal face in the workplace.

A central finding of the study was confirmation that work itself should be considered as a form of self-management. Individuals interviewed for the report found that partaking in work was an important way in which they managed several (often psychological) aspects of living with their painful condition.

Individuals also described how the invisible nature of pain meant that other people found it harder to understand their condition, and that they often were not offered support when they needed it. Some even described feigning alternative, more understandable, symptoms in order to communicate to others that they were unwell. Such experience raises the crucial, yet often overlooked relationships between employees and their line-managers, and also with their immediate colleagues.

Progress in these matters turns on such fundamental matters as workplace culture, senior leadership and line management skills. There is growing evidence of better understanding amongst employers, employees and health professionals of the benefits of good work on health. This heralds a wider culture change in attitudes to health and work. Among health professionals, for example, maintaining or returning to work is widely accepted as a desirable health outcome.

Dame Carol Black
Expert Advisor on Health and Work to the Department of Health & Principal of Newnham College Cambridge

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Launch of the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work

March 2nd, 2015 by Dr Karen Walker-Bone
Dame Carol Black at Centre launch

The official launch of the new Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work

Last Tuesday (February 17th 2015) saw the official launch of the new Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work. The vision of the funders was to respond to Professor Dame Carol Black’s key challenges from ‘Working for a Healthier Tomorrow’.  In her report, she recommended that the government should urgently take steps to create and strengthen the academic base in the UK and start to systematically collect high-quality data about health and work. In the absence of government resource, the Arthritis Research UK charity, in partnership with the Medical Research Council, decided to take the initiative and realise her vision with funding of £1.4 million over 5 years. This Centre will tackle research into musculoskeletal disorders (MSDs) and work, one of the top two causes of workplace disability.

MSDs are common. This is a very large group of conditions, consisting of milder ‘everyday’ conditions such as tennis elbow (epicondylitis), shoulder pain, back pain through to much more disabling long-term chronic conditions such as rheumatoid arthritis, ankylosing spondylitis and lupus. Numerically, many more working days are lost to the ‘pain’ conditions simply because so many more people experience these symptoms but for individuals, the chances of developing work disability are far greater if you are unlucky enough to have a diagnosis of e.g. rheumatoid arthritis or lupus. By far the most common form of arthritis worldwide is osteoarthritis, often dismissively regarded as an inevitable part of the ageing process, but a very common cause of pain and disability traditionally neglected by researchers. There is now growing recognition of the impact of osteoarthritis in terms of pain and disability and impaired quality of life, each of which will impact increasingly on society as we are all required to work to older ages. With this recognition, more research is being done to try and understand the mechanisms underlying osteoarthritis and identify ways to prevent and treat as well as reduce the impact of this condition.

The consortium are led from Southampton by Prof David Coggon (Director) and Dr Karen Walker-Bone (Deputy Director)

The consortium are led from Southampton by Prof David Coggon (Director) and Dr Karen Walker-Bone (Deputy Director)

The successful Consortium are led from Southampton by Prof David Coggon (Director) and myself (Deputy Director) working with 40 scientists from 20 institutions. Our plans are to use the resource mainly for junior research posts (8 PhD studentships and 2 post-doctoral fellowships). We will research four broad themes: regional pain (including low back pain); inflammatory arthritis; return to work after surgery for osteoarthritis and the older worker. More than 10 different projects are planned altogether with the common aim of reducing workplace disability from MSDs in a cost-effective way. There is much work to do: researchers have not been habitually measuring the impact of MSDs on work disability and there is a considerable amount of interaction to do with stakeholders, including employers and policy-makers.

For more information about the Centre and the specific projects, the website is:
The Centre are keen to engage with employers, employees, people with MSDs, trades unions and any other stakeholders and is receptive to ideas for research.

Dr Karen Walker-Bone
Deputy Director Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work

The consortium - Centre for Musculoskeletal Health and Work

The consortium - Centre for Musculoskeletal Health and Work

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Care planning and musculoskeletal conditions

December 1st, 2014 by LBoothman

People with long-term conditions spend far more time self-managing than they do in contact with healthcare services. In recognition of this, approaches that empower people to better manage their own health and wellbeing are well established in health policy:


  • The Five year forward view  said that “even people with long term conditions, who tend to be heavy users of the health service, are likely to spend less than 1 % of their time in contact with health care professionals. The rest of the time they, their carers and their families manage on their own.”  For the future it asserts “… we will do more to support people to manage their own health – staying healthy, making informed choices of treatment, managing conditions and avoiding complications.”


  • The NHS Mandate is equally clear on the importance self-management, including a specific objective for the NHS become “dramatically better at involving patients and their carers, and empowering them to manage and make decisions about their own care and treatment.” As a step towards this, since 2013 it has included the ambition that everyone with a long term condition will be offered a personalised care plan.


Around 10 million people across the UK have a musculoskeletal condition, such as rheumatoid arthritis, osteoarthritis or osteoporosis. These are mainly long-term conditions, and many people live with their painful and fluctuating symptoms for decades. Musculoskeletal health is an important contributor to overall health and wellbeing, and symptoms including limited mobility and pain can make the impact of other long-term conditions, such as diabetes, cardiovascular disease or depression worse.

So it’s clear that there is huge potential and need for self-management by people with musculoskeletal conditions – but to what extent is this already happening? And how can we ensure that people with musculoskeletal conditions are included as approaches such as personalised care planning are more widely implemented?

  • An independent inquiry into patient centred care in the 21st century commissioned by the RCGP which reported this week proposed that “… the greatest gains of care planning may come from those who are at an earlier stage of their condition, where there is greatest scope for prevention of deterioration.” It recommended that Practices should follow a personalised care planning approach for all those patients in need of proactive care, with particular focus on at risk groups such as those with learning disabilities and patients with multiple conditions.”

How do people with musculoskeletal conditions, or people with musculoskeletal conditions and other morbidities, fit into this wider spectrum?


Table showing Care Plan possession by people with long term conditions

Table showing Care Plan possession by people with long term conditions


Our care planning and musculoskeletal health report builds on the outputs of a policy workshop, interviews with people with arthritis and healthcare professionals who have used care planning, and reviews of policy, clinical guidance and musculoskeletal standards of care. It considers aspects of the care planning process as it relates to people with musculoskeletal conditions including the healthcare professionals involved, the settings in which care planning can take place, and indicators to help identify people likely to benefit.


Our new analyses of national survey data indicate that, despite the Mandate commitment, just 12% of people with a musculoskeletal condition currently have a care plan. There is an opportunity for many more people to benefit. The report calls for:

  • Systems to deliver care planning to be designed to include those with musculoskeletal conditions and to identify and address musculoskeletal needs in patients with any long-term condition.
  • Professional bodies to ensure that the continued training of healthcare professionals involved in care planning includes core musculoskeletal skills.

For more information, or a copy of our report, please visit our website or contact us at

Dr Laura Boothman is policy manager at Arthritis Research UK


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The power of the personal account. How qualitative research offers important insights into the self-management of musculoskeletal conditions in the context of work. Part 2

September 9th, 2014 by Blogmaster

I wrote yesterday that work itself should be considered as a form of self-management . Likewise, there are numerous ways of self-managing one’s health condition at work. These were revealed by the study we published on Friday, the findings of which came from interviews with individuals living with a musculoskeletal disorder, and thus offered us unique insights..

Today, I am going to discuss another pertinent finding which revolves around the relationship between individuals with MSDs and their line managers. In order to manage their condition at work individuals sometimes needed adjustments to their job setup (e.g. changes to their workstation, alterations to responsibilities, or flexibility or changes to their hours). It was found that approaching one’s line manager to request adjustments was a complex process. For example, some participants saw it as a reciprocal exchange, whereby they could only ask for an adjustment if they had proven themselves and contributed sufficiently to the organisation.

Part of it I think is because I know that I’ve worked so hard and my employer and the one particular line manager knows how hard that I have worked.  So from that respect I know that she would always be very tolerant and that I could more or less ask her for anything [in terms of adjustments].”

Participant 2

It was found that other participants were reluctant to ask for adjustments from their line manager, citing fear of negative judgement and job loss as key contributors to this reluctance.

“I don’t know [why I haven’t asked for adjustments], I just feel that there’s a lot of people looking for work. I just don’t want to cause any waves, I’d rather have the attention away from me.”

Participant 10

These findings have implications for how support is offered to individuals, and highlights the barriers that need to be overcome in order for individuals to receive the adjustments they need: the receipt of adequate support cannot be contingent on an individual having had the opportunity to build a solid relationship with their line manager.

The report’s recommendations (pp.85-90) detail how all stakeholder groups can do more to support the self-management of chronic conditions in the workplace, a selection of which follow:

  • The government must do more to support individuals working in smaller organisations, which often do not have the resources to provide appropriate support. Increasing awareness of, and participation in, Access to Work is one way to begin increasing this support.
  • The government can also do more to incentivise healthcare professionals to consider and treat individuals with MSDs in a holistic way, including offering support and guidance around their working lives. By including work as an outcome in the CCG Outcomes indicator set steps can be made towards this goal.
  • Employers need to understand their responsibilities to people with disabilities and long term health conditions, including the provision of reasonable adjustments. Employers should also create opportunities to discuss an employee’s condition which is separate to discussions about performance, so that managing their condition is not tied up with their ability as an employee.
  • Line managers should be proactive in seeking out information about MSDs, and in asking the employee how they can be supported to do their job. Line managers should also consider the importance of supporting mental as well as physical health: living with an MSD is not restricted to managing the physical symptoms of the condition.
  • Healthcare professionals need to understand how crucial it is to provide individuals with quick diagnoses and appropriate medication regimes as quickly as possible. It is only when these are set in place that individuals can begin to learn to manage their condition, including in the context of work.

It is by conducting interviews with individuals with lived experiences of managing their MSD in work that the nuances of the challenges faced can be revealed. It is hoped that solutions will be enacted that are equally sensitive to these complexities.

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The power of the personal account. How qualitative research offers important insights into the self-management of musculoskeletal conditions in the context of work. Part 1

September 9th, 2014 by FfW UK Secretariat

Work itself should be considered as a form of self-management. This is the central finding of the study that The Work Foundation and Fit for Work UK launched on Friday, 5 September  entitled “Self management of chronic musculoskeletal conditions and employment”. Individuals whom we interviewed for the report found that partaking in work was an important way in which they managed several (often psychological) aspects of living with an MSD. However, the onus for managing one’s condition at work weighed far too heavily on the individual, and participants often described foregoing their home lives, social lives, and compromising their physical health to stay in work. Work as self-management was often being undermined as individuals struggled to self-manage in the context of work.

Other stakeholders have a far greater role to play in supporting self-management, and notable among those are the government, healthcare professionals, and employers. It was only through conducting an interview based study, and talking directly to individuals, that this tension between wanting to continue to work, yet often struggling to manage one’s condition successfully, could be revealed to the researchers.

Interview studies of course have their limitations. They are designed to provide depth rather than breadth meaning that statistical representativeness is foregone. The researchers are also far more ‘present’ in that they conduct and then analyse the interviews themselves meaning it is even more important that they are aware of how they may bias the results. However, this research demonstrates the power of speaking directly to individuals with lived experience of the phenomena being studied. There were some specific, very striking findings, which would be unlikely to have arisen if individuals living with chronic MSDs had not been interviewed.

Take the implications of the invisible nature of the condition, for example. Due to MSDs often not having easily visible external symptoms, individuals described how this meant others found it harder to understand their condition, and that they often were not offered support when they needed it. Some participants even described feigning alternative, more understandable, symptoms when in fact they felt unwell because of their MSD, in order to communicate to others that they were unwell.

People wouldn’t know [I had arthritis].  Sometimes that can go against me, because it’s a bit like you’re trying to do something and then you know that you’re struggling to do something.  And people go.. they don’t accept it.”

Participant 13

Sometimes I would.. if I’m not well, if things are a bit on top of me, in front of my colleagues I will say to them I have a headache, rather than go about the arthritis thing.”

Participant 10

These findings regarding the invisibility of the condition led the report to make several recommendations, including the need to employers and line managers to be more proactive in providing support, as sometimes individuals would be unwilling to come forward and identify their MSD as being the source of their problems. In my next blog, I’m going to explore the report further by discussing a subsequent set of findings related to the self-management of chronic conditions in the context of work – the crucial, yet often overlooked, relationship between workers and line-managers.

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People with chronic MSDs compromising their health to keep their jobs, new report reveals

September 5th, 2014 by FfW UK Secretariat

The government, the NHS, and employers are failing to provide the necessary support for people with chronic MSDs (musculoskeletal disorders)* to stay in work. This is according to a new report released today (Friday 5th September) by Lancaster University’s Work Foundation and the Fit for Work UK Coalition. The findings also indicate that some patients are putting their health at risk to hold on to their jobs.

Update: Commenting on the report, Sue Browning, deputy chief executive of the CSP, said: “Physiotherapists are experts at keeping people healthy in work, or facilitating a return after sickness absence, and it is very important that employers provide staff with fast access to occupational health services (…) The NHS should also make self-referral to physiotherapy available across the country”. Read the full statement of Sue Browning on the Chartered Society of Physiotherapy website.

Professor Stephen Bevan, director of the Centre for Workforce Effectiveness at The Work Foundation and founding president of Fit for Work UK, said: “Workers with MSDs often find themselves fighting a lonely battle to remain in work. The government, employers and clinicians should make it a priority to support them to remain in employment after diagnosis”.

Currently, Britain is losing 30.5 million working days a year to MSDs, which are the leading cause of sickness absence, according to the Office for National Statistics (ONS)**. Today’s paper shows that employers, in particular small organisations, have little knowledge about government schemes such as “Access to Work” and are insufficiently prepared to manage chronic conditions in the workplace. Many workers admit to being reluctant to ask for help from their line managers for fear of stigma, negative judgement and job loss. Others said they had to involve their union to get the necessary support or move into self-employment.

The interviews conducted for the report released today highlight that, unless action is taken, individuals’ health conditions and quality of life will continue to be damaged by work, with some leaving the labour market prematurely. The consequence of the status quo is an increase in productivity loss, sickness absence and, ultimately, the welfare bill.

One employee interviewed in the report said: “Last year, the team were very understaffed some individuals went off sick. I think the pressure to try and do other people’s jobs as well as your own just got too much for me. It was a very stressful time to me and that made my illness a lot worse”. Another explained: “It’s a bit rule by fear in this department these days. They’ll try and get rid of you if you’ve been off too long with your health”.

Kate Summers, research officer at The Work Foundation, commented: “Individuals with chronic MSDs will go to great lengths to remain in work. They will give up aspects of their family and social life, and they will even take roles below their skill set. This is because work can bring many benefits – be they financial, psychological or social. These benefits are undermined if individuals are working in a environment that is not good for their health”.

The report makes four recommendations:
1. The government should increase participation to initiatives like “Access to Work” and should provide extra assistance for employees working in small and medium enterprises;
2. The government should also ensure that work is viewed as a “clinical outcome” by clinicians and invest in more “specialist nurse” roles;
3. Employers should consider all necessary workplace adjustments and offer career development opportunities for people with chronic MSDs;
4. Clinicians should view it as part of their role to ask patients about their work lives.

The authors of the paper also added that they welcome the government’s new Health and Work Service in England and Wales, but that it needs to focus on sustained return to work outcomes.

The report is being previewed on Friday at the conference “Self care & resilience: How we can care?” organised by the College of Medicine at the King’s College, in London

– ENDS –

Notes to the Editors:

1. Kate Summers, research officer, is available for interviews, briefings and written comment.
3. The paper is part of a national campaign led by Fit for Work UK, informing the public debate on dealing with the growing burden of MSDs and calling for coordinated action across all main political parties in the UK.
4. *Musculoskeletal disorders (MSDs) cover around 200 disorders that affect the joints, bones, muscles and connective tissues. MSDs include back pain, arthritis, osteoarthritis, ankylosing spondylitis, injuries caused by trauma, such as fractures, and other conditions that are the result of genetic or developmental abnormalities, as well as bone and soft tissue cancer.
5. ** The “Sickness Absence in the Labour Market” report.
6. The Fit for Work UK Coalition is an active partnership of healthcare professionals, policymakers, employers and advocacy groups founded in 2007. It supports people with long-term conditions, particularly musculoskeletal conditions. Their members are: AbbVie, the Arthritis and Musculoskeletal Alliance (ARMA), BT Group, Capita, the Chartered Society of Physiotherapy (CSP), National Ankylosing Spondylitis Society (NASS), National Rheumatoid Arthritis Society (NRAS), The Work Foundation, and the Royal College of General Practitioners (RCGP).
7. Lancaster University’s Work Foundation transforms people’s experience of work and the labour market through high quality applied research that empowers individuals and influences public policies and organisational practices. The Work Foundation is part of Lancaster University – an alliance that enables both organisations to further enhance their impact.

Media enquiries:

Ioana Piscociu,, 020 7976 3526, for urgent out-of-hours enquiries: 0755 178 14 06.

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Major health & productivity challenge facing UK workforce

July 22nd, 2014 by FfW UK Secretariat

Politicians across all main political parties have today (21 July 2014) been challenged to respond to the growing burden of ill-health in the UK’s workforce. Fit For Work UK – a coalition of healthcare professionals, policymakers, employers and patient groups – has warned that by 2030, almost half of UK workers will have at least one chronic health condition which will affect their work productivity and, as a result, the competitiveness of the UK economy.

In its call to action, Is the UK Fit for Work?: Confronting the challenge of UK workforce health, the coalition argues that the costs of ill-health in the UK workforce will far exceed the current £100 billion estimate1 as long-term sickness absence, ‘presenteeism’ (attending work when ill) and work disability rise over the next twenty years. An ageing workforce and later retirement are also forecast to increase the proportion of workers leaving employment early as a result of their health.

Research already highlights the growing challenge the UK’s economy faces with around 17 million people of working-age – roughly half of the workforce – believed to face at least one long-term health condition by 2030.2 In the light of this, the coalition believes the UK urgently needs to tackle the problem with the following five-point plan:

  •  A comprehensive cross-government strategy and programme for health and work
  •  Clear national leadership with the appointment of a National Clinical Director for Health & Work
  •  Accessible information for people with long-term conditions to help them stay in work
  •  Measures that capture health and return to work in NHS frameworks, and incentivise clinicians to regard return to work as a clinical outcome of care
  •  Effective incentives to reward healthcare providers who support people with long-term conditions to return to work

Commenting on Fit For Work UK’s call to action, its President, Professor Stephen Bevan, said: “Over the next 20 years an increasing proportion of the ageing UK workforce will retire later and develop chronic illnesses. The UK requires urgent action now to prevent this trend developing into a crisis of public health and impaired labour productivity.  It is only by developing a cross-government strategy and improving the dissemination of the tools needed to empower people with long-term conditions, that this challenge can be met.”

Fit for Work Coalition member Prof Karen Middleton, CEO of the Chartered Society of Physiotherapy, commented: “Government policy focuses on reducing welfare costs, but there are millions of people in work whose ill-health threatens their job security and productivity. Simple, early and joined-up action, such as commissioning self-referral physiotherapy services, to help workers to manage conditions such as musculoskeletal disorders – the cause of 35m lost working days each year – can save money and improve the quality of working lives for millions.”


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Negative social attitudes towards young people with chronic health conditions leaves seven out of ten feeling more vulnerable to job loss

November 19th, 2013 by FfW UK Secretariat

Seven out of ten (72%) young people with chronic health conditions felt at risk of unemployment during the recession, while 97% attend work when ill due to fear of job loss. This is according to a report by Fit for Work UK, written by The Work Foundation, and  published on 13  November. The findings reveal that negative social attitudes towards chronic conditions, in schools and amongst employers, are leaving many young people at risk of low earnings and exclusion from the labour market.

Recent studies indicate that unemployment is almost twice as high amongst  young people with chronic conditions than that of their peers (24% of 16-24  year olds with a work-limiting disability are unemployed, compared to 14% of those without a disability). Today’s report, Life and employment opportunities of young people with chronic conditions, captures the scale of the obstacles young people face and makes a series of practical recommendations to schools, employers, policy makers and clinicians.

In a foreword to the report, Dame Carol Black, Co-President of the Fit for Work Coalition, said: “This report takes a look at this challenge at a time when youth unemployment in the UK is at worryingly high levels. It captures very well the scale of the obstacles faced by young people with long-term, chronic or fluctuating conditions as they seek to make the transition from education and employment – and then to develop and thrive in the workplace.”

Kate Summers, co-report author, said: “Youth unemployment can cause serious psychological scarring and our research shows that problems often begin for young people with a chronic condition before entering a first job. We know from our findings that stigma towards people with chronic conditions can also result in self-stigma. Almost 93% of those surveyed indicated that the condition affected their confidence.

“We are calling on the Department of Education to provide improved education to young people about chronic conditions in order to reduce stigma. Healthcare professionals need to be incentivised to consider work as an outcome of successful treatment and employers should play a greater role in shaping the skills of young people, as well as identifying and establishing workplace adjustments.”

Further results from the survey revealed that:

  • 68% believed their chronic condition affected their job satisfaction
  • 61% said their condition stopped them reaching their full potential at work
  • 57% said their chronic condition affected their career progression
  • 57% said their condition had prevented them from pursuing their preferred career
  • 50% said their condition prevented them from looking for a different job
  • 29% had difficulty remaining employed
  • 27% thought their chronic condition inhibited access to training and development

The report was previewed last week at the National Rheumatoid Arthritis Society Health Champion Awards attended by Linda Riordan MP and Home Secretary, Theresa May MP, and Members of Parliament.

Notes to editors

1.   Professor Stephen Bevan and members of the Fit for Work Coalition are available for interviews, comment and briefings.

2.   The full report, Life and employment opportunities of young people with chronic conditions by Stephen Bevan, Ksenia Zheltoukhova, Kate Summers, Zofia Bajorek, Lisa O’Dea and Jenny Gulliford can be obtained from The Work Foundation press office in advance or downloaded from from 00.01hrs on 13 November 2013.

3.    The sample size of young people with chronic conditions aged 18-25 years comprised of 247 responses acquired from an online questionnaire of individuals in patient groups and 16 face- to-face interviews.

4.    Fit for Work UK is a partnership of individuals and organisations, including The Work Foundation, Arthritis and Musculoskeletal Alliance, British Telecom, Chartered Society of Physiotherapy, National Ankylosing Spondylitis Society, National Rheumatoid Arthritis Society and the Royal College of General Practitioners. The Fit for Work UK Coalition is supported by a grant from AbbVie.

5.    The Work Foundation aims to be the leading independent, international authority on work and its future, influencing policy and practice for the benefit of society. The Work Foundation is part of Lancaster University – an alliance that enables both organisations to further enhance their impact

6.   The paper was  previewed by Professor Steve Bevan, Founding President of the Fit for Work UK Coalition, at the National Rheumatoid Arthritis Society Health Champions Awards on November 6th 2013, sponsored by Linda Riordan MP and attended by the Home Secretary, Theresa May MP, among other Members of Parliament.  The awards celebrate innovative practice by healthcare professionals and highlight it to policymakers.  The event was attended by HCPs, MPs and members of NRAS.

7.   NRAS (National Rheumatoid Arthritis Society) aims to provide information and support for

people with rheumatoid arthritis (RA), their families, friends and carers, and health professionals with an interest in RA. For further information, please visit

 Media enquiries:

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