Dr Rob Hampton, PHE Health and Work Clinical Champion
One of the recommendations from the Improving Lives Command Paper published in November 2017 was the introduction of a Medical Champion for Work as a Health Outcome. In our conversations with patients, healthcare practitioners are used to asking questions about the lifestyle factors that underpin health such as diet, exercise, alcohol and smoking.
But there’s another important question that we need to consider: ‘How is work?’ This role aims to support colleagues in understanding the importance of work as a health outcome with guidance around having those conversations.
Good workis good for us. It isn’t just about gaining economic benefit but more to do with social connections, physical activity and intellectual challenge. There is clear evidence to show that good work helps us to be healthier and happier.
Conversely being out of work increases our patients’ risk of ill-health. Long-term unemployment increases the risk of limiting illness and worsening mental health and the longer we’re out of work; the more likely it is to impact on our health. Working can be considered a health outcome in itself, reflecting how well we are supporting individuals to adapt to or recover from their health challenges.
In general practice we have an opportunity to use our trusted relationships with the people we care for to help them maximize the health benefits of being in work.
This could mean preventing our patients from falling out of work, or for those who aren’t working because of a disability, medical condition or injury, helping them return at a time that’s right for them and their health.
It can all start with a conversation.
There’s so much we can do to help people stay in and return to work, from providing key information or boosting a patient’s confidence through to helping with pain management or coping with stress.
For example, clinicians can signpost to resources that charities have developed to help our patients, and their employers, to maintain good work and good health. Conditions covered by these resources include people with cancer, musculoskeletal pain, mental health problems and heart disease.
And crucially, we can make an impact even when our time with patients is limited.
As a Work and Health Clinical Champion I meet GP’s all over the country and I highlight the following key actions:
- Starting conversations about work– asking patients about their work is clinically useful in itself, but it can also open up an opportunity to talk about how important work is to them, how confident they are and whether their health is proving to be a barrier.
- Discussing reasonable adjustments– employers have a legal duty to consider reasonable adjustments but many people haven’t considered this as an option. We can raise awareness of opportunities that could be offered by an employer for instance flexibility around hours or changes to the working environment.
- Signposting or making referrals– There will be options emerging in your area that may include NHS or community provision, services linked to local job centers or information online. Social prescribing is emerging as a great referral route for such employment support
Work from the Improving Lives paper, is already under way to help one million people with long term physical and mental health conditions stay-in or return-to the workforce. This is an ambitious plan to change the landscape and move vocational rehabilitation closer to mainstream healthcare.
Ultimately we need to ensure that people are supported by employers that are committed to creating healthier workplaces and the right health and wellbeing support for their staff. We also want everyone to understand the importance of work as a health outcome and feel supported by a health system which promotes an understanding of good work and good health.