Becky Spencer looks at the Government’s latest plans to keep those with a long-term health condition in employment and explains what employers can do to support and retain staff.

Recent news coverage of the Government’s plan to “Get Britain Working”  has focused on its aims to get people who are currently out of work due to long-term sickness back into employment. What hasn’t received much coverage is its other, equally important, aim of preventing people with a long-term health condition who are currently in work from having to leave the workforce as a result of ill health.

This is the focus of the Keep Britain Working Review which was launched by the Government in January. Led by former John Lewis boss Sir Charlie Mayfield, the review is examining:  the role of employers in creating and maintaining healthy and inclusive workplaces; what steps can be taken within the workplace to prevent people from becoming economically inactive due to ill health and how the Government can support employers to do this.

At the end of March, the review team published its first report which sets out what the review has discovered so far. The key points are:

• Many employers are strongly incentivised to retain their staff.  They are committed to promoting good health and to creating environments that prevent ill health from occurring, and support disabled people in the workplace
• Employers are generally investing more in employee health and wellbeing today than ever before
• Well trained, supportive line managers are key to keeping people in work
• Due to operational pressures, the financial incentive for employers to invest in retention of workers with long-term ill health is often weaker than recruiting a replacement.

Over the next few months, the review’s focus is on gathering evidence from employers, employees and other stakeholders about measures and initiatives that have worked in their workplace to keep people with long-term health conditions in work (an online portal will be set up for evidence to be submitted).

The review team will report back in the Autumn when it will make evidenced-based and practical recommendations that support employers to:

• Improve recruitment and retention of people with health conditions and disabled people
• Prevent people becoming unwell at work and better support good, healthy workplaces; and
• Undertake early intervention for sickness absence and increase returns to work.

Learning what works

If you are getting Deja-vu reading this, that’s because we have been here many times before. Successive governments over the last twenty years have tried to tackle this complex and challenging issue.

In 2008, Dame Carol Black published her groundbreaking Review of the health of Britain's working age population which called for a shift in attitudes to ensure that “employers and employees recognise not only the importance of preventing ill health, but also the key role the workplace can play in promoting health and wellbeing”.

The review led to the introduction of the electronic fit note and the Fit for Work service, which provided occupational health assessments and general health and work advice to employees and employers to help people stay in or return to work. However, the Fit for Work service closed in 2018 due to low referral rates and the fit note system, which was supposed to help people stay in work rather than be signed off sick, has failed to achieve its aims with over 90 per cent of fit notes issued signing people off work completely during a period of sickness.

Of course, employers haven’t sat by waiting for the Government to fix this growing issue. Many employers take the health of their workforce seriously. Why wouldn’t they? Poor employee health can have a huge financial cost for employers through lack of performance or a drop in productivity, sickness absence, loss of valuable experience when employees drop out of work, and recruitment costs to replace them.

So, what works?

• Flexible working: research by the Work Foundation which tracked the employment journeys of more than 9,000 UK workers for four years found accessing flexibility at work is key for those with health conditions being able to remain in work. Employees without any flexibility in their job roles were four times more likely to leave work after a health decline. Flexible working, such as reduced hours, spreading working hours across the week, changes to start and finish times, and working from home, allows workers with long-term health conditions to manage their work around it. Research has shown flexible working arrangements are particularly beneficial to those with mental health conditions and workers with physical health problems with symptoms that fluctuate on a day-to-day basis, such as arthritis and musculoskeletal conditions.

• Occupational health (OH) support: OH provision can help employers provide tailored support to manage employees’ health conditions on an individual basis, leading to better retention and return-to-work prospects, and improving business productivity which can be adversely impacted by sickness absence. However, around half the current UK workforce do not have access to OH support in their workplace, particularly employees in small and micro businesses.

• Workplace adjustments: Making adjustments to the way work is done, when it is done, or providing equipment, services or support to enable someone to do their work can help many people with long-term health conditions remain in work. Adjustments should be tailored to an individual employee’s needs to get the best results. Under the Equality Act 2010, employers have a legal duty to make “reasonable adjustments” for workers with a disability, which includes some people with a long-term health condition. A quarter of all people aged 16 to 64 in the UK have a long-term health condition that limits their day-to-day activities therefore classing them as disabled.

• Supportive line management: Many employees with chronic health conditions do not disclose their condition to their employer. Creating a workplace culture with good communication channels, where employees feel valued and trust that any health issue will be taken seriously, can encourage disclosure. This then allows an employer to take steps to help the employee manage their health condition at work and hopefully prevent them from having to leave the workforce as a result of ill health.

• Good return-to-work policies:  Long-term health conditions do not always lead to sickness absence from work but when they do the right return-to-work procedures provide an opportunity to engage with the employee about their health problem, with the aim of preventing further sickness absence. Good return-to work procedures include:  regular but not intrusive communication, phased returns, discussion about any adjustments needed to get the person back to work and to help them stay in work, as well as a plan for ongoing support. With the right support from their employer many people living with long-term health conditions stay in and succeed at work.

 
In the UK, there are currently more people in employment with a long-term health condition than there are receiving sickness benefits because of their health condition. In order to increase the number in work, the Government needs to come up with some simple, low-cost solutions that will help, and encourage, employers to invest in the health of their workforce.