WHU Consultation – Health is everyone’s business, proposals to reduce ill-health related job loss

WHU Consultation – Health is everyone’s business, proposals to reduce ill-health related job loss

Council for Work and Health members have actively contributed to the extensive research and debate resulting in this welcomed consultation initiative.  It is disappointing that many UK workers, particularly in small businesses, but even in large employers such as the NHS, have inconsistent access to good quality occupational health support when ill.  This exercise seeks to test ideas to enable more workers to get support when needed and hence reduce the numbers that face being unable to work due to resolvable issues. Council members will actively respond to this consultation and we urge as many as possible to contribute to this vital debate and support opportunity for change.

https://www.gov.uk/government/consultations/health-is-everyones-business-proposals-to-reduce-ill-health-related-job-loss

Consultation link:

https://getinvolved.dwp.gov.uk/work-and-health/consultation/

 

No Time To Lose (IOSH Campaign)

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Did you know that worldwide at least 38,000 people die every year from mesothelioma, a fatal asbestos-related cancer?

These deaths cause so much heartbreak and suffering. They leave huge holes in families; ones that can never be filled. Asbestos fibres are invisible to the naked eye, therefore it is so important for people to know where asbestos can be found, so these deaths can be prevented.

Taking place tomorrow, (05 July), Action Mesothelioma Day, brings together patients, carers, families and local dignitaries in Britain for services of remembrance and hope, commemorating the thousands of lives lost to mesothelioma. The day is organised by No Time to Lose (NTTL) supporter Mesothelioma UK.

To mark this important day, we will be attending the service at Leicester Cathedral to support Mesothelioma UK and to exhibit our new co-branded pocket cards. We are also joining forces with the international Asbestos Disease Awareness Organization by sharing resources through its Know Asbestos campaign website.

You can get involved in Action Mesothelioma Day too by:

  • downloading and distributing our free resources, to raise awareness of the risks.
  • signing-up to our pledge (if you haven’t already), to capture the key actions your organisation does, or plans to do, to manage carcinogenic exposures at work. Once your pledge has been approved, we will send you an IOSH certificate demonstrating your commitment.
  • supporting NTTL by communicating the campaign through your communications channels
  • following @_NTTL on Twitter and retweeting our tweets to help spread the word.

Many thanks for your continued support. Together we can beat occupational cancer.

Injustices faced by disabled people to be tackled head-on through a new package of measures ordered by the Prime Minister

Injustices faced by disabled people to be tackled head-on through a new package of measures ordered by the Prime Minister.

https://www.gov.uk/government/news/pm-launches-new-drive-to-tackle-barriers-faced-by-disabled-people

As part of her legacy as Prime Minister, Theresa May launched a package of cross departmental measures to “change the landscape for disabled people and to make sure there is always a level playing field for them”.  There are a range of proposals intended to “support disabled people in all phases of their life so that the pursuit of equality is a shared goal.”  These include higher accessibility standards for new housing, an overhaul of statutory sick pay, and greater workplace support to help ensure disabled people can fully participate in society.

Although the whole package of measures is important for the members of the Council for Work and Health, one of the most direct concerns “New employee rights to request workplace modifications on health grounds”.  We expect the detail of this to link to our resources on Workplace Modifications.  Dr Steve Boorman, Chair of the Council welcomed the announcement saying “Council Members have actively contributed to the “Improving Lives” agenda across all of its programmes. We look forward to supporting the opportunities, trailed in this announcement, to help support individuals in accessing good work and the health benefits this creates”.

 

 

Supporting cancer patients with work

Supporting cancer patients with work

Every two minutes someone in the UK is diagnosed with cancer.[1]

An estimated one in three people with cancer in the UK are of working age.[2]While not all of these will be in employment, Macmillan research has found that 87% of those in work when diagnosed with cancer say it’s important to them to continue working after diagnosis.[3]

The effect of cancer and its treatment on a person’s ability to work can vary widely. Factors can include the type and stage of cancer, the treatment and its side effects, and how the person copes with a life-altering event like a cancer diagnosis. While some people with cancer continue to work during their treatment, others may need time off or support to help them return to work, while others may need to leave the workplace completely.

The role of GPs

GPs can play an important role in supporting patients with work following a cancer diagnosis. The conversations they have with their patients – whether it’s while completing Fit Notes, during a Cancer Care Review or at another point in the patient’s cancer ‘journey’ – can empower them to discuss their needs with their employer. While GPs don’t need specialist knowledge of workplaces or occupational health, they can help their patients by supporting them to understand the potential impact of their cancer on their work life.

Resources for healthcare professionals and patients

Since the launch of the Council’s Talking Work: A guide for Doctors discussing work and work modifications with patientsearlier this year, Macmillan has developed some additional resources to support healthcare professionals to have conversations specifically about work and cancer. Our Work support route guides– separate versions of which are available for professionals based in England, Scotland, Wales and Northern Ireland – and our Supporting patients with work: 10 top tips guidehelp professionals to feel confident about discussing work with patients and signposting them onto further sources of support.

Macmillan has also created a dedicated team of work support advisers who can help people with cancer and those who care for them to understand their rights at work. The team provides information and guidance on talking to employers and negotiating adjustments and can answer questions on sick pay or taking time off. People with more complex needs can also be referred to one-off legal advice. The team is available Monday-Friday, 8am-6pm on 0808 808 0000. In addition, a wide range of information about work and cancer can be found by visiting macmillan.org.uk/work.

How to build conversations around work and cancer into practice

Along with Fit Note conversations, the Cancer Care Review provides an excellent opportunity to discuss work with patients. Macmillan has worked with each of the main GP IT providers to develop integrated, standardised cancer care review templates within EMIS Health, INPS vision and TPP SystmOne. These templates take a holistic approach to the discussion, covering conversations about employment, financial support and the clinical needs of the person living with cancer.

GPs can use these templates to guide them through conversations with people living with cancer. The templates are also a helpful way to ensure that appropriate information is coded back onto the patient file, as well as supporting signposting to further support, with embedded Macmillan information available to print.

Rebecca Coaker, Services Influencing Manager – Work and Cancer, Macmillan Cancer Support

We’re here to help people with cancer live life as fully as they can, providing physical, financial and emotional support. So whatever cancer throws their way, we’re right there with them.

 

[1]Estimated by calculating UK-wide incidence of about 360,000 new cases of cancer per year divided by the total number of minutes in a year.

[2]Estimated total prevalence of people in the UK aged 16 to 65. It is estimated based on UK complete prevalence of those aged 0 to 64 in 2015 derived from Maddams J, Utley M, Møller H. Projections of cancer prevalence in the United Kingdom, 2010-2040. Br J Cancer 2012; 107: 1195-1202. (Projections scenario 1). This was adjusted up to those aged 16 to 65 based on 21-year cancer prevalence in England (Transforming Cancer Services Team for London, NHS, National Cancer Registry and Analysis Service, PHE and Macmillan Cancer Support. 2017. Cancer Prevalence in England: 21-year prevalence by demographic and geographic measures. www.ncin.org.uk/about_ncin/segmentation). The proportion is based on UK complete prevalence in 2015 derived from Maddams J, Utley M, Møller H. Projections of cancer prevalence in the United Kingdom, 2010-2040. Br J Cancer 2012; 107: 1195-1202. (Projections scenario 1).

[3]YouGov Plc. Total sample size was 1507 PLWC respondents who were in work when diagnosed with cancer. Fieldwork was undertaken between 29/06/2018 – 22/07/2018. The survey was carried out online.

 

Cold Stress: The Dangers of Working Outdoors

What is Cold Stress? Is It Dangerous to Work in Extreme Cold Conditions?

The UK experiences a temperate oceanic climate in which apart from the relatively warmer months of June through September, it is mostly too cold to work in the outdoors without appropriate protective clothing. Working either outdoors in a cold environment or indoors in the refrigerated areas and warehouses over a long period of time may pose serious health threats. Over the last five years, 168,000 deaths due to cold-related illness were recorded in the UK alone, ranking it among the bottom three across Europe. There is a higher risk for people working in maritime, commercial fishing, agriculture, and construction.

While working in such cold conditions, internally, the human body has to work extra to maintain the core temperature of 98.6° F. When the body is unable to achieve it due to lack of proper clothing, exposed body parts, wet clothing, etc., it may fall prey to one or more of cold stress illnesses. Some of the most dangerous cold stress-related illnesses include but are not limited to frostbites, frostnip, chilblains, immersion foot, and trenchfoot.

So, the question of how one can prevent the risk of developing cold stress arises. Wearing layered clothing with a warm woollen cap or hoodie is a good start. Stay hydrated and eat high-calorie food to maintain energy all day. Check out this infographic from Emtraining Solutions that entails various illnesses related to cold stress and other ways to prevent them.

 

Don’t sleep on it!

Don’t sleep on it!

Excessive daytime sleepiness (EDS) is the main focus of DVLA concern with people diagnosed with Obstructive Sleep Apnoea (OSA), a condition in which sufferers experience significant periods of not breathing, while they are asleep during to airway obstruction.  Inadequate oxygenation of the body from OSA is bad for general health.  Lack of deep sleep leads to those affected being fatigued and falling asleep easily during the day (even if they are not aware of OSA). Drivers who suffer from Sleep Apnoea must notify DVLA to get their condition reviewed and controlled before they can go on driving. DVLA are solely concerned about falling asleep while driving, not other health issues including exacerbation of diabetes or the increased tendency to heart disease and/or stroke.

Some reports suggest that about 20 per cent of adults suffer a significant degree of EDS, although OSA is only one cause. A far bigger cause is disturbed sleep due to things like shift work and caring duties for infants and sick dependants involving waking nights.

ESS (Epworth Sleepiness Scale) and AHI (Apnoea Hypopnoea Index) scores are used by medical practitioners to assess tendency to EDS.  Some research suggests that ESS results are subjective and sleep specialists warn against them as wholly reliable assessments of EDS. Other research suggests that there is no clear correlation between AHI and ESS scores.

In assessing the risk of sleepiness while driving, AHI is a not very reliable measure for tendency to EDS.  Arguably, were a better tool available and widely adopted, the DVLA might reduce its fixation on OSA. Many more ‘at risk’ drivers might be brought into the DVLA medical surveillance net, while at the same time releasing from continuing medical surveillance some OSA suffers who do not suffer significant EDS. Sleepiness, however, is a very transient and subjective state for which there are few reliable markers.

Medical practitioners should be made more aware of other non OSA related causes of EDS and arguably, where these cannot be brought under satisfactory control, DVLA should be informed as they are in cases where significant OSA is diagnosed.

At present the duty to inform DVLA about OSA is triggered by medical diagnosis. Opinions and guidance vary as to whether, once diagnosed, the OSA suffer should cease driving until given permission to resume by DVLA. DVLA stress that the primary duty not to drive while unfit from any cause rests with the driver. More publicity about sleep and driving may cause some drivers not to go to their doctors for fear of being suspended from driving while awaiting treatment – but in practice this fear is unfounded. Treatment, such as using CPAP (continuous positive airway pressure) equipment at night is available via NHS sleep clinics and with a bit of practice is quite easy to use. It can quickly help the OSA sufferer to feel a whole lot better and have a lot more energy. More guidance is still needed for employers and potential sufferers.  Responsible drivers need to pay more attention to ‘sleep hygiene’ and to finding ways of remaining alert when at the wheel. They need to be prepared to discuss sleepiness issues with their doctors and not be afraid of being caught in the DVLA medical surveillance net.

Sleepiness and road safety have been a big part of RoSPA’s policy and campaigning work on managing Occupational Road Riskcampaigns for nearly twenty years. (See our advice to employers at https://www.rospa.com/road-safety/resources/free/employers.) The key message is that employers must not cause their drivers to drive tired. It needs an intelligent approach. Anyone who feels sleepy at the wheel, regardless of the cause, knows they are becoming impaired and must stop and recover until they are safe to proceed.

RoSPA’sNational Occupational Health Safety Committee (which brings together the main institutional stakeholders in this area) has begun work on tackling fatigue in the workplace. This is not only highly topical because of its links to mental health and ‘wellness’ but its impact on safety and accidents in the workplace have generally been underplayed up to now. New guidance however is now available in the form of the HSE fatigue risk index (see http://www.hse.gov.uk/research/rrhtm/rr446.htm).

ROSPA are thinking about producing some guidance on OSA and Employment (‘OSA and your job’ perhaps?), helping both sufferers and their managers to better understand the issues involved and to avoid over-the-top, excessively risk averse responses that might lead them to exclude OSA sufferers from certain roles ‘on health safety grounds’. Talking to specialists and consultants reveals how reluctant many of their patients are to reveal to their employers that they have had an OSA diagnosis.   There is undoubtedly a lot of prejudice and misinformation in the workplace about this issue, and about fatigue and sleepiness generally – which, of course, goes a lot wider than OSA. ‘cat napping’, as an essential coping mechanism in the workplace, (especially for older workers who make up a bigger proportion of the workforce these days) ought to be a widely understood and accepted coping mechanism, not seen as an outlandish idea.

If you have experience in tackling problems experienced by workers in getting enough good quality sleep we’d like to hear from you.

Roger Bibbings MBE CFIOSH

Partnership Consultant RoSPA                                             May 2019

 

Work Modifications wins an award!

Work Modifications wins an award

The Council for Work and Health is delighted that the Talking Work project has won the Vocational Rehabilitation  Association’s (VRA) Innovation, Research and Education Award for 2019.   The lead researcher Dr Devdeep Ahuja received the award during the VRA symposium on 1st May 2019 at Birmingham.

In supporting the nomination, Richard Cienciala, Deputy Director, DWP/DHSC Work and Health Unit praised the collaborative approach taken by the Council and commented that the “Talking Work” checklist “should be an invaluable tool to support doctors in their work-related conversations and in advising on reasonable adjustments.”

 

https://vrassociationuk.com/vra-awards-2019-winners-gallery/

 

 

 

Do Fit Notes always Fit the Problem?

Do Fit notes always Fit the Problem?

 

Minister Matt Hancock recently launched the NHS Long Term Plan that highlighted our need to address the high rates of employment sickness absence due to musculoskeltal (MSK) problems and/or mental ill health.

 

Let’s look at some stats: 9 to 10 million GP Fit Notes are signed annuallyin England alone. A colossal number, likely to be taking an inordinate amount of precious GP time, particularly when 80% of these are used by employees as evidence of their illness for their employer as required by HR policies. 93% of GP Fit notes say that the person is not fit for work. Surely it’s time for another approach that chimes with the upcoming changes in GP Surgeries?

 

Work related problems are mainly identified in GP surgeries which are already taking the strain of high patient demand with a shrinking workforce. So it is great news that the NHS Long Term Plan sets out to expand the multi disciplinary team (MDT) workforce in GP surgeries to help meet demand. Ambitious pilots using allied health professionals (AHPs) like occupational therapists, paramedics and physiotherapists have shown safe, cost effective results that patients and families welcome. Seeing an AHP as a First Contact Practitioner from your GP surgery is going to become more the norm.

 

Which leads me back to my question….do Fit Notes always fit the problem? So, if you were off work, would you use a confidential work clinic based in your GP surgery? You may be surprised to learn that a growing number of patients are doing just this and using newly opened clinics in Southampton and South Pembrokeshire. Occupational Therapy Led Vocational Clinics are for people who are in employment and struggling with MSK and/or mental health problems. A safe space where they can talk through what work difficulties they face and how these may be resolved. Everybody gets an AHP Health and Work Report which can be shared with the employer with advice about how work modifications could keep the person in work.

 

  • Does the patient get individualised work and symptom management advice? Yes
  • Does the employer get more detailed, accurate info about how to support staff? Yes
  • Can the employer use the AHP Health and Work Report as evidence for statutory sick pay? Yes.
  • Does it cut down on GP time writing GP fit notes? Yes but …

 

…..to embed this new approach, we need employers to understand that there are alternatives to the traditional GP Fit Note. If they and the employee want to use alternative evidence than the GP fit note, this is available now and the legislation allows it.

 

So the question for employers may be ….would you prefer a detailed report saying how someone can stay at work by an AHP or a GP fit note just saying they are not fit for work? The answer will depend on the clinical situation of course, but the AHP Health and Work Report can provide the clear instructions that employers often crave.

 

Full results of the Occupational Therapy Led Vocational Clinics will be available in March 2020. These Clinics are one of 19 initiatives across the UK selected to receive funding from the Work and Health Challenge Fund.

 

#OTVoc.

#WHChallengeFund

Genevieve Smyth

Professional Adviser

Royal College of Occupational Therapists

 

BREAKING NEWS! Talking Work

Talking Work – the Council for Work and Health’s online resource for GPs to help them complete Fit Notes is the subject of a newly published (paid) news story on GP online – the everyday resource for general practitioners and the website for GP magazine. Talking Work was developed with funding from the government’s Work and Health Unit as part of their 2017 Command Paper strategy to enable one million additional people with disability or long term illness to return to or remain in work.

To view the article click link