As a GP with an occupational medicine practice and long-term interest in the health of the working age population, I've always wanted to see better employment outcomes from mainstream healthcare.
Some 52% of people in the UK with a disability or a long-term health condition are in work, but there are still barriers to helping many more being included.
Fyodor Dostoevsky’s observation that: ‘Deprived of meaningful work, men and women lose their reason for existence; they go stark, raving mad’ may seem extreme, but the evidence for primary care is clear. Long-term worklessness increases our risk of physical and mental health problems – having a good job is generally good for our health.
Why is this important for GPs?
In my experience, GPs generally do not see their potential to motivate people back to the workplace.
Research from the fields of psychology and anthropology confirm that meaningful work contributes to an individual’s purpose in life and can enrich and fulfil their sense of self-worth. Our ability to motivate patients and help them reflect on unhealthy behaviours is well recognised and is a privilege of delivering holistic care.
Helping people with long-term physical and mental health conditions to remain in or return to work is one such area. Long-term health conditions can act as a barrier to gaining and retaining employment, which can have a devastating impact on individuals and their families, increasing the chance of an early death.
Most healthcare professionals have recognised the link between work and health. The 2019 Health and Work Consensus Statement for Action from The Academy of Medical Royal Colleges, the Royal College of Nursing and Allied Health Professions Federation sets out their commitment to support healthcare professionals in helping people to stay in or return to work.
This is a significant milestone to help embed this ambition into everyday practice. Not only does it demonstrate a shared vision; it also outlines four key actions to support healthcare professionals in proactively supporting this agenda.
The consensus statement is an important foundation for healthcare professionals to develop and improve skills that will help us have positive conversations around work in our day-to-day work.
Asking patients about work
As healthcare professionals, our time with patients is often limited, but making a brief, positive intervention can help people consider the importance of work to their health.
This can be as simple as asking patients 'How is work?' Not only can this give a snapshot of patients’ health and happiness at work; it can start a conversation that leads us to the most appropriate interventions or advice.
Two new resources are now available to help healthcare professionals with these conversations. The Work and Health e-learning from Public Heath England and Health Education England e-Learning for Healthcare provides quick and practical source for improved knowledge and practice.
The evidence-based modules include advice on work for people with mental health and musculoskeletal problems, cancer and other long-term conditions. Completing the modules provides CPD certification and should improve confidence in starting conversations to ensure that work is an outcome of our day-to-day care.
Meanwhile, the government commissioned the Council for Work and Health to produce Talking Work, a guide for discussing work and workplace modifications – this has received positive feedback from GP colleagues. The guide includes a simple checklist for having the health and work conversation, as well as case studies and examples of useful phrases to consider.
Health and work champions
In my role as a GP, I value these conversations to help people stay in or to return to work. I’m privileged to be one of three medical health and work champions for Public Health England. This role includes delivering training to GPs across the East Midlands around the importance of work to health, as well as on techniques to build confidence in addressing hurdles to vocational rehabilitation.
The Royal College of Occupational Therapists is also training occupational therapists to become voluntary PHE RCOT Health and Work champions, who will deliver peer-to-peer training on health and work across their trusts. Evaluation of the training shows significant improvements in trainees’ knowledge and confidence.
GPs rightly feel a sense of satisfaction when a patient is grateful for advice that changes their health prospects. Patients at risk of long-term worklessness are often doubtful at first, but if you recognise their doubts, support them with workplace modifications and stick with them for a few consultations, my experience is that most of the time, they go back to work and are genuinely grateful for you taking an interest in this aspect of their lives.
Good work is good for you – and with the right support and guidance, health professionals can help people to achieve their working potential and the health benefits this brings.
- Dr Hampton is a GP in Leicestershire and Public Health England medical champion for work as a health outcome