Prime Minister Rishi Sunak’s recently announced plans to reform the welfare system to “change the sick note culture” have met with controversy, with critics claiming that the language used may risk demonising those unable to work due to genuine ill health.
In this blog, we examine some of the themes from the prime minister’s speech from our perspective as an Occupational Health and Wellbeing provider, and ask how changes can best be managed to achieve the intended benefits.
“Good work can improve mental and physical health”. But what is “good work”?
A number of definitions have been offered. The Academy of Medical Royal Colleges state that
“‘Good’ work is engaging and rewarding, giving people a voice and treating them fairly.” (2019)
The Scottish Centre for Healthy Working Lives go further, defining 9 key elements of “good work”:
- job security
- pay is reflective of the role and its value, and is a balance between effort and reward
- work that prevents harm, ensuring a safe and healthy workplace
- physical work environment is safe, encourages productivity and prevents isolation
- design of the job allows an element of autonomy and control
- promotes good mental health and reduces stress
- balance between demand and control
- balances power between workers and employer
- encourages and supports good health, including a work life balance and appropriate career progression
When supporting employees to return to work, Innovate’s Occupational Health Advisors are guided by these principles of “good work” to advise on appropriate adjustments and accommodations. We understand that when all of these elements are present, a successful and sustained return to work is much more likely. Equally, if these conditions are not met, returning to work, or indeed remaining in work and maintaining good physical and mental health, is much more challenging.
The Health and Safety Executive acknowledge the importance of many of these factors in managing work related stress withing their management standards.
What are “the risks of over-medicalising the everyday challenges of life”?
Among the statistics quoted during the PM’s speech was the fact that around 50% of those economically inactive due to poor health reported mental health conditions. Anxiety and Depression were mentioned specifically as conditions which, while requiring appropriate treatment and support, need not always prevent sufferers from engaging with work.
The difficulty here lies in the huge range in severity of symptoms associated with these diagnoses. Terms like depression and anxiety can themselves be used in confusing ways. Both can refer to a clinically recognised illness which may seriously impact every element of the sufferer’s day-to-day life. But it is also very common for people without a clinical diagnosis to describe themselves as depressed or anxious.
The key to supporting cases like these then, is to focus on the impact on the sufferer, rather than the diagnosis. This is the approach taken by Innovate OH Advisors when providing advice on fitness to work. By comparing what an employee can do with the requirements of the role, we can focus on supporting a return to work at the earliest appropriate opportunity. This may include adjusting or reducing duties to support ongoing recovery, and so this “can do” approach supports reengagement with the good work mentioned above, and all the benefits that come with it.
Figures also indicate a sharp rise in conditions such as ADHD and Autism. Often referred to as “neurodivergent conditions”, these also exist on a continuum, and diagnosis alone gives little indication of how an individual is affected and what work-related functions they may struggle with. Our OH services can offer the appropriate expertise to not only identify an individual’s needs, but to help destigmatise a condition which is best viewed as just another form of diversity, rather than a medical condition.
94% of fit notes state “unfit to work”
It has been suggested that GPs may be reluctant to state patients are fit to do some type of work for fear of damaging the doctor-patient relationship. It is certainly true that GPs are under ever-increasing pressure to see more patients, leading to reduced consultation times which may limit the opportunity to explore what work a patient may be capable of.
By engaging with Occupational Health, employees can discuss their health challenges in depth and can be reassured that the impact of symptoms is taken fully into account when considering steps to return to work. Innovate advisors can then provide specific advice on adjustments to job tasks and accommodations such as a fully scheduled phased return to work plan. We often find that this provides employees with the reassurance to return to their GP who, once aware of the support available, is happy to approve a return to work.
Still plenty of challenges
The government’s proposals undoubtedly leave some questions. Several references have been made to ensuring those not working due to ill health get “the right support”. When it comes to helping people to manage health issues and return to work, it is our view that “the right support” must be timely, practical and tailored to the needs of the individual. Economic inactivity due to ill health may have increased dramatically since the COVID pandemic, but this has coincided with a significant increase in waiting times for treatments such as physiotherapy and talking therapies. Whether or not these statistics are directly linked, it seems clear that access to such services is essential to support those reporting a range of physical and mental health issues to return to work.
The last ten years have seen an increase in the role of employers in providing the right support to help their employees return to work rather that fall into prolonged worklessness. This trend seems set to continue. Through Innovate’s own in-house teams of physiotherapist and psychologists, we are able to provide employers with fast access to individually tailored support which is focussed on overcoming health barriers and helping employees back to work.
For information on how Innovate can support you and your employees to overcome health concerns and enjoy the benefits of good work, contact OH@Innovatehmg.co.uk