Work, health and disability: improving lives
Work, health and disability: improving lives
We are seeking views on what it will take to transform employment prospects for disabled people and people with long-term health conditions.
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Social Science & Medicine (Elsevier BV)
David J. Roelfs et al. 2011
[3] Roelfs D J, Shor E, Davidson KW, Schwartz, JE. Losing life and livelihood: A systematic review and meta-analysis of unemployment and all-cause mortality. Social Science & Medicine 2011;72(6): 840–854.
The UK Government
[4] Cabinet Office. Analysis of the Annual Population Survey (APS) Wellbeing Data, Apr-Oct 2011. Available at: https://www.gov.uk/government/publications/wellbeing-andemployment (accessed October 2016).
Journal of Vocational Behavior (Elsevier BV)
Karsten I. Paul et al. 2009
[16] Waddell G, Burton AK. Is work good for your health and wellbeing; 2006; Rueda, S., Chambers, L., WIlson, M., Mustard, et al. Association of returning to work with better health in working-aged adults: a systematic review. American Journal of Public Health, 2012; 102, 541–56.; Paul KI, Moser K. Unemployment impairs mental health: Meta-analyses. Journal of Vocational Behavior, 2009; 74, 264–282.; Roelfs DJ, Shor E, Davidson KW, Schwartz JE. Losing life and livelihood: A systematic review and meta-analysis of unemployment and allcause mortality. Social Science & Medicine, 2011; 72(6), 840– 854.
World Health Organization
[17] Benach J, Muntaner C, Santana V. Employment Conditions and Health Inequalities. Final Report to the WHO Commission on Social Determinants of Health (CSDH) Employment Conditions Knowledge Network. 2007. http://www.who.int/social_determinants/themes/employmentconditions/en/ (accessed October 2016).
International Labour Organization
[18] ILO & Finnish Ministry of Social Affairs. The Economics of Health, Safety and Well-being. Barefoot Economics: Assessing the economic value of developing a healthy work environment; http://www.ilo.org/safework/info/publications/WCMS_110381/lang--en/index.htm (accessed October 2016).
[20] van Stolk C, Hofman H, Hafner M, Janta, B. Psychological Wellbeing and Work: Improving Service Provision and Outcomes. January 2014.A report by RAND Europe. https://www.gov.uk/government/publications/psychologicalwellbeing-and-work-improving-service-provision-and-outcomes (accessed October 2016).
Nordic Journal of Psychiatry (Informa UK Limited)
Juha Hämäläinen et al. 2005
International Archives of Occupational and Environmental Health. 2006;79(3): 193–8.; Hämäläinen J, Poikolainen K, Isometsä E, Kaprio J, Heikkinen M, Lindeman S and Aro H. Major depressive episode related to long unemployment and frequent alcohol intoxication. Nordic Journal of Psychiatry. 2005;59 (6): 486–491.; Voss M, Nylén L, Floderus B, Diderichsen F, Terry P D (2004) Unemployment and Early Cause-; Royal College of Psychiatrists: Mental Health and Work https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212266/hwwb-mental-health-and-work.pdf (accessed October 2016).
Joseph Rowntree Foundation
[24] Bivand, P. and Simmonds. The benefits of tackling worklessness and low pay. https://www.jrf.org.uk/report/benefits-tackling-worklessnessand-low-pay (October 2016).
[41] Green, F. Why Has Work Effort Become More Intense? Industrial Relations: A Journal of Economy and Society 2004; 43: 709-741.
UK Parliament Research Briefings
[59] National Health Service. NHS Five Year Forward View. https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfvweb.pdf (accessed October 2016).
Resolution Foundation
[65] Department for Work and Pensions and Department of Health. Work, Health and Disability Green Paper Data Pack; 2016..;’ Resolution Foundation. Retention Deficit: A new approach to boosting employment for people with health problems and disabilities. http://www.resolutionfoundation.org/wp-content/uploads/2016/06/Retention-deficit.pdf (accessed October 2016).
[66] van Stolk C, Hofman H, Hafner M. Janta B. Psychological Wellbeing and Work: Improving Service Provision and Outcomes. https://www.gov.uk/government/publications/psychologicalwellbeing-and-work-improving-service-provision-and-outcomes (accessed October 2016).
World Psychiatry (Wiley)
MARGARET HESLIN et al. 2011
England: 2 year follow-up of the Supported Work and Needs (SWAN) study, World Psychiatry, 2011; 10, 132–137.
British Journal of General Practice (Royal College of General Practitioners)
Mark Gabbay et al. 2011
[97] Gabbay M, Taylor L, Sheppard L, Hillage J, Bambra C, Ford F, et al. NICE guidance on long-term sickness and incapacity. British Journal of General Practice.Brit J Gen Pract. 2011; 61(584):206-7.
UK Parliament Select Committee Publications
[100] The Civil Service measures average working days lost (AWDL) per staff year, based on hours actually worked by employees. This produces a more accurate but generally higher absence figure than the AWDL per person figure used for external comparisons. Source: Department for Work and Pensions. Sick Leave: Written question – 29117. http://www.parliament.uk/business/publications/writtenquestions-answers-statements/writtenquestion/Commons/2016-03-01/29117/ (accessed October 2016). http://www.parliament.uk/business/publications/writtenquestions-answers-statements/writtenquestion/Commons/2016-03-01/29117/
The UK Government
[103] Although public sector bodies are required to publish employment data concerning protected characteristics under the Public Sector Equality Duty under the Equality Act 2010, https://www.gov.uk/guidance/equality-act-2010-guidance#public-sector-equality-duty.
[104] Organisation for Economic Co-operation and Development. OECD’s Sickness, Disability and Work, Breaking the Barriers; 2010.
Journal of Occupational and Environmental Medicine (Ovid Technologies (Wolters Kluwer Health))
Ivan Robertson et al. 2012
[108] Robertson IT, Leach D, Doerner N et al. Poor health but not absent: Prevalence, predictors and outcomes of presenteeism. Journal of Occupational and Environmental Medicine 2012 54: 1344–9. http://journals.lww.com/joem/Abstract/2012/11000/Poor_Health_but_Not_Absent__Prevalence,.6.aspx
Mayo Clinic Proceedings (Elsevier BV)
Tait D. Shanafelt et al. 2015
[109] Tait et al. Impact of Organizational Leadership on Physician Burnout and Satisfaction. Mayo Clinic Proceedings 2015: 90, (4); 432–440. http://www.sciencedirect.com/science/article/pii/S0025619615000713
The UK Government
[115] PricewaterhouseCoopers LLP. Building the case for wellness; 2008. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/209547/hwwb-dwp-wellness-reportpublic.pdf
The UK Government
[116] Steadman K., Wood M., and, Silvester, H. (2015). Health and Wellbeing at work: a survey of Employees 2014. DWP Research Report 901; 2015 https://www.gov.uk/government/publications/health-andwellbeing-at-work-survey-of-employees http://www.theworkfoundation.com/blog/2526/Working-forbetter-mental-health-results-from-a-survey-of-employees
The UK Government
[117] Sissons P, Barnes H, Stevens H. Routes onto Employment and Support Allowance DWP Research Report 774; 2011. https://www.gov.uk/government/publications/routesonto-employment-and-support-allowance-rr774
[120] http://ec.europa.eu/health/mental_health/eu_compass/reports_studies/disability_synthesis_2010_en.pdf. OECD. Sickness, Disability and Work: Breaking the Barriers. A synthesis of findings across OECD countries; 2010. http://ec.europa.eu/health/mental_health/eu_compass/reports_studies/disability_synthesis_2010_en.pdf.
[124] NHS England and NHS Improvement. NHS Operational Planning and Contracting Guidance 2017-2019. https://www.england.nhs.uk/wp-content/uploads/2016/09/NHSoperational-planning-guidance-201617-201819.pdf
The UK Government
[125] Hann M and Sibbald B. General Practitioners’ attitudes towards patients’ health and work, 2010-12. DWP Research Report 835; 2013 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207514/rrep835.pdf
The UK Government
[128] Coleman N, Sykes W, Groom C. What works for whom in helping disabled people into work? Working paper 120. Department for Work and Pensions; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/266512/wp120.pdf
Work Foundation
[140] Steadman K, Wood M, Silvester H. Health and Wellbeing at work: a survey of Employees 2014. DWP Research Report 901; 2015 https://www.gov.uk/government/publications/healthand-wellbeing-at-work-survey-ofemployeeshttp://www.theworkfoundation.com/blog/2526/Workin g-for-better-mental-health-results-from-a-survey-of-employees
[143] Goodwin N et al Integrated care for patients and populations: Improving outcomes by working together. A report to the Department of Health and the NHS Future Forum; 2012. http://www.kingsfund.org.uk/sites/files/kf/integrated-care-patients-populations-paper-nuffield-trust-kings-fund-january-2012.pdf
The UK Government
[144] Waddell G, Burton, K. Is Work Good for Your Health and Wellbeing? London: The Stationery Office; 2006. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/214326/hwwb-is-work-good-for-you.pdf
[147]Coulter A, Roberts S, Dixon A. Delivering better services for people with long term condition. The King’s Fund; 2013. http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/delivering-better-services-for-people-withlong-term-conditions.pdf
The UK Government
[148] Cole L. A survey of disabled working age benefit claimants. In House Research Report No 16. Department for Work and Pensions; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224543/ihr_16_v2.pdf
The UK Government
[149] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207514/rrep835.pdf
BMC Musculoskeletal Disorders (Springer Science and Business Media LLC)
Serena McCluskey et al. 2011
[150] McCluskey S. et al. The Influence of ‘significant others’ on persistent back pain and work participation: A qualitative exploration of illness perceptions. BMC Musculoskeletal Disorders 2011; 12:236. McCluskey, S. et al. Are the treatment expectations of ‘significant others’ psychosocial obstacles to work participation for those with persistent low back pain? Work 2014); 48:391-398. S. McCluskey et al. ‘I think positivity breeds positivity’: a qualitative exploration of the role of family members in supporting those with chronic musculoskeletal pain to stay at work. BMC Family Practice 2015; 16:85.
The UK Government
[151] Cole L. A survey of disabled working age benefit claimants. In House Research Report No 16. Department for Work and Pensions; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224543/ihr_16_v2.pdf
Social Science & Medicine (Elsevier BV)
David J. Roelfs et al. 2011
3 Roelfs D J, Shor E, Davidson KW, Schwartz, JE. Losing life and livelihood: A systematic review and meta-analysis of unemployment and allcause mortality. Social Science & Medicine 2011;72(6): 840–854.
The UK Government
People who are unemployed have higher rates of mortality 3 and a lower quality of life. 4 This is an injustice that we must address.
On page 9
4 Cabinet Office. Analysis of the Annual Population Survey (APS) Wellbeing Data, Apr-Oct 2011. Available at: https://www.gov.uk/government/publications/wellbeing-and-employment (accessed October 2016).
Journal of Vocational Behavior (Elsevier BV)
Karsten I. Paul et al. 2009
Being out of work is associated with a range of poor health outcomes. 16 Academics and organisations such as the WHO, 17 the ILO, 18 the OECD, 19 RAND Europe, 20 the Royal College of Psychiatrists 21 and NICE 22 all recognise that work influences health and health influences work.
On page 14
16 Waddell G, Burton AK. Is work good for your health and wellbeing; 2006; Rueda, S., Chambers, L., WIlson, M., Mustard, et al. Association of returning to work with better health in working-aged adults: a systematic review. American Journal of Public Health, 2012; 102, 541–56.; Paul KI, Moser K. Unemployment impairs mental health: Meta-analyses. Journal of Vocational Behavior, 2009; 74, 264–282.; Roelfs DJ, Shor E, Davidson KW, Schwartz JE. Losing life and livelihood: A systematic review and meta-analysis of unemployment and all-cause mortality. Social Science & Medicine, 2011; 72(6), 840–854.
World Health Organization
17 Benach J, Muntaner C, Santana V. Employment Conditions and Health Inequalities. Final Report to the WHO Commission on Social Determinants of Health (CSDH) Employment Conditions Knowledge Network. 2007. http://www.who.int/social_determinants/themes/employmentconditions/en/ (accessed October 2016).
International Labour Organization
Academics and organisations such as the WHO, 17 the ILO, 18 the OECD, 19 RAND Europe, 20 the Royal College of Psychiatrists 21 and NICE 22 all recognise that work influences health and health influences work.
On page 14
18 ILO & Finnish Ministry of Social Affairs. The Economics of Health, Safety and Well-being. Barefoot Economics: Assessing the economic value of developing a healthy work environment; http://www.ilo.org/safework/info/publications/WCMS_110381/lang--en/index.htm (accessed October 2016).
Academics and organisations such as the WHO, 17 the ILO, 18 the OECD, 19 RAND Europe, 20 the Royal College of Psychiatrists 21 and NICE 22 all recognise that work influences health and health influences work.
On page 14
20 van Stolk C, Hofman H, Hafner M, Janta, B. Psychological Wellbeing and Work: Improving Service Provision and Outcomes. January 2014.A report by RAND Europe. https://www.gov.uk/government/publications/psychological-wellbeing-and-work-improving-service-provision-andoutcomes (accessed October 2016).
Nordic Journal of Psychiatry (Informa UK Limited)
Juha Hämäläinen et al. 2005
We know that the longer a person is out of work the more their health and wellbeing is likely to deteriorate. 23 So, every day matters.
On page 15
23 Maier R, Egger A, Barth A, Winker R, Osterode W, Kundi M, Wolf C, Ruediger H. Effects of short- and long-term unemployment on physical work capacity and on serum cortisol. International Archives of Occupational and Environmental Health. 2006;79(3): 193–8.; Hämäläinen J, Poikolainen K, Isometsä E, Kaprio J, Heikkinen M, Lindeman S and Aro H. Major depressive episode related to long unemployment and frequent alcohol intoxication. Nordic Journal of Psychiatry. 2005;59 (6): 486–491.; Voss M, Nylén L, Floderus B, Diderichsen F, Terry P D (2004) Unemployment and Early Cause-; Royal College of Psychiatrists: Mental Health and Work https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212266/hwwb-mental-health-and-work.pdf (accessed October 2016).
Joseph Rowntree Foundation
Of course, work can also bring a range of other benefits which support mental and physical health and wellbeing. 24 It is the best route to raising the living standards of disabled people and people with a long-term health condition and moving them out of poverty.
On page 15
24 Bivand, P. and Simmonds. The benefits of tackling worklessness and low pay. https://www.jrf.org.uk/report/benefits-tackling-worklessnessand-low-pay (October 2016).
This change may bring benefits, for example enabling more flexible working to help people with health conditions stay in work, but can also have less positive effects like work intensification that may affect people’s ability to cope or adapt in work with a health condition. 41
On page 17
41 Green, F. Why Has Work Effort Become More Intense? Industrial Relations: A Journal of Economy and Society 2004; 43: 709-741.
UK Parliament Research Briefings
The patients’ organisation National Voices puts it clearly: personalised care will only happen when services recognise that patients’ own life goals are what count; that services need to support families, carers and communities; that promoting wellbeing and independence need to be the key outcomes of care; and that patients, their families and carers are often ‘experts by experience’. 59
On page 21
59 National Health Service. NHS Five Year Forward View. https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf (accessed October 2016).
Resolution Foundation
Evidence shows that employment outcomes for disabled people and people with long-term health conditions vary across different regions in the country. 65 There are significant opportunities to advance this agenda through a ‘place-based’ approach, unlocking the political capital and resources needed to drive innovation and deliver the system-wide response needed to improve outcomes and local growth.
On page 23
65 Department for Work and Pensions and Department of Health. Work, Health and Disability Green Paper Data Pack; 2016..;’ Resolution Foundation. Retention Deficit: A new approach to boosting employment for people with health problems and disabilities. http://www.resolutionfoundation.org/wp-content/uploads/2016/06/Retention-deficit.pdf (accessed October 2016).
For instance, evidence suggests that when a person faces both health and employment barriers, both should be addressed simultaneously, since there is no evidence that treating either problem in isolation is effective. 66 As an example, Individual Placement and Support, an integrated health and employment model, has demonstrated improved employment outcomes for those with severe and enduring mental health condition.
On page 25
66 van Stolk C, Hofman H, Hafner M. Janta B. Psychological Wellbeing and Work: Improving Service Provision and Outcomes. https://www.gov.uk/government/publications/psychological-wellbeing-and-work-improving-service-provision-and-outcomes (accessed October 2016).
World Psychiatry (Wiley)
MARGARET HESLIN et al. 2011
A UK evaluation found that chances of finding employment doubles for those who received this service. 67
On page 25
67 Heslin L, Howard M, Leese P, McCrone P. Rice C. Randomized controlled trial of supported employment in England: 2 year follow-up of the Supported Work and Needs (SWAN) study, World Psychiatry, 2011; 10, 132–137.
Centre for Analysis of Social Exclusion
And it should still focus on the impact that an individual’s health condition has on them – recognising that those with the greatest level of disability have the biggest labour market disadvantage. 85
On page 47
85 Rigg J. Labour Market Disadvantage amongst Disabled People: A longitudinal perspective. CASE paper No. 103. Centre for Analysis of Social Exclusion, London School of Economics; 2005.
British Journal of General Practice (Royal College of General Practitioners)
Mark Gabbay et al. 2011
in addition to being bad for employers and the economy in general, a prolonged period of sickness absence is bad for individuals – early intervention is important, 97 the longer someone is away from work, the harder it is for them to get back to work, and the greater the risk of them missing out on all the benefits that work can bring; 98 and
On page 53
97 Gabbay M, Taylor L, Sheppard L, Hillage J, Bambra C, Ford F, et al. NICE guidance on long-term sickness and incapacity. British Journal of General Practice.Brit J Gen Pract. 2011; 61(584):206-7.
UK Parliament Select Committee Publications
This investment has proved effective in bringing down civil service sickness rates: for example, sickness rates in the Department for Work and Pensions have fallen from 11.1 days per staff year in 2007 to 6.2 in 2016. 100 However, it is clear that more needs to be done.
On page 55
100 The Civil Service measures average working days lost (AWDL) per staff year, based on hours actually worked by employees. This produces a more accurate but generally higher absence figure than the AWDL per person figure used for external comparisons. Source: Department for Work and Pensions. Sick Leave: Written question – 29117. http://www.parliament.uk/business/publications/written-questions-answersstatements/written-question/Commons/2016-03-01/29117/ (accessed October 2016). http://www.parliament.uk/business/publications/written-questions-answers-statements/written-question/Commons/2016-03-01/29117/
The UK Government
Currently UK employers are not required to know the details about disability or sickness in their workforce. 103 If we are to realise our ambition of a healthy UK workforce with fewer people dropping out of work because of ill health, then we need to see all employers creating environments where employees feel able to disclose health issues and where employers act on that information to improve employee health.
On page 56
103 Although public sector bodies are required to publish employment data concerning protected characteristics under the Public Sector Equality Duty under the Equality Act 2010, https://www.gov.uk/guidance/equality-act-2010-guidance#public-sector-equality-duty.
Evidence suggests that seeing employers have success in hiring disabled people and people with health conditions can be a powerful way of motivating other employers to act. 104 Employeremployee networks and business-led initiatives therefore have a big role to play in influencing employers to recognise the talents of disabled employees and employees with health conditions and creating the momentum to support these employees excel.
On page 57
104 Organisation for Economic Co-operation and Development. OECD’s Sickness, Disability and Work, Breaking the Barriers; 2010.
Journal of Occupational and Environmental Medicine (Ovid Technologies (Wolters Kluwer Health))
Ivan Robertson et al. 2012
Where in place this has been linked with improved performance and wellbeing; where it isn’t it creates pressure among those who continue to work despite illness 108 and has been linked with stress, burnout and depression.
On page 62
108 Robertson IT, Leach D, Doerner N et al. Poor health but not absent: Prevalence, predictors and outcomes of presenteeism. Journal of Occupational and Environmental Medicine 2012 54: 1344–9. http://journals.lww.com/joem/Abstract/2012/11000/Poor_Health_but_Not_Absent__Prevalence,.6.aspx
Mayo Clinic Proceedings (Elsevier BV)
Tait D. Shanafelt et al. 2015
Where in place this has been linked with improved performance and wellbeing; where it isn’t it creates pressure among those who continue to work despite illness 108 and has been linked with stress, burnout and depression. 109
On page 62
109 Tait et al. Impact of Organizational Leadership on Physician Burnout and Satisfaction. Mayo Clinic Proceedings 2015: 90, (4); 432–440. http://www.sciencedirect.com/science/article/pii/S0025619615000713
The UK Government
Although our understanding of the effectiveness of different types of occupational health support in different settings is incomplete, there is some evidence that providing such support can lead to reduced sickness absence, boosted productivity and increased employee satisfaction. 115
On page 63
115 PricewaterhouseCoopers LLP. Building the case for wellness; 2008. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/209547/hwwb-dwp-wellness-report-public.pdf
The UK Government
A 2014 survey found 72% of public sector employees had access to occupational health support compared to 52% in the voluntary sector and 39% in the private sectors. 116
On page 63
116 Steadman K., Wood M., and, Silvester, H. (2015). Health and Wellbeing at work: a survey of Employees 2014. DWP Research Report 901; 2015 https://www.gov.uk/government/publications/health-and-wellbeing-at-work-survey-of-employees http://www.theworkfoundation.com/blog/2526/Working-for-better-mental-health-results-from-a-survey-of-employees
The UK Government
In addition, only around a third who had been in work prior to claiming Employment Support Allowance reported having access to occupational health support at work. 117
On page 63
117 Sissons P, Barnes H, Stevens H. Routes onto Employment and Support Allowance DWP Research Report 774; 2011. https://www.gov.uk/government/publications/routes-onto-employment-and-support-allowance-rr774
The UK Government
Furthermore, evidence shows that phased returns to work from sickness absence can see employees return quicker and stay in employment longer. 119
On page 64
119 See: Waddell, G. Waddell G, Burton K. Is Work Good for Your Health and Wellbeing? London: The Stationery Office; 2006. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/214326/hwwb-is-work-good-for-you.pdf
120 http://ec.europa.eu/health/mental_health/eu_compass/reports_studies/disability_synthesis_2010_en.pdf. OECD. Sickness, Disability and Work: Breaking the Barriers. A synthesis of findings across OECD countries; 2010. http://ec.europa.eu/health/mental_health/eu_compass/reports_studies/disability_synthesis_2010_en.pdf .
encouraged health and care services to plan their Sustainability and Transformation Plans 124 on ‘footprints’ which bring together health and care leaders to support the delivery of improved health and care based on the needs of local populations.
On page 69
124 NHS England and NHS Improvement. NHS Operational Planning and Contracting Guidance 2017-2019. https://www.england.nhs.uk/wpcontent/uploads/2016/09/NHS-operational-planning-guidance-201617-201819.pdf
The UK Government
However, although over 60% of GPs agree or somewhat agree that the fit note has improved the quality of their return to work discussions with patients, and over 90% agreed that helping patients to stay in or return to work was an important part of their role, 125 the fit note is not fully achieving what it set out to do.
On page 71
125 Hann M and Sibbald B. General Practitioners’ attitudes towards patients’ health and work, 2010-12. DWP Research Report 835; 2013 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207514/rrep835.pdf
The UK Government
Evidence shows that offering early support to individuals, including people with a health condition or a disability, can improve their chances of getting back to work. 128 Yet too often services for people with common conditions are not available when an individual needs them.
On page 72
128 Coleman N, Sykes W, Groom C. What works for whom in helping disabled people into work? Working paper 120. Department for Work and Pensions; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/266512/wp120.pdf
Work Foundation
Survey data suggests only 51% of employees have access to occupational health through their employer which can vary depending on their size. 140 There is also no standardised approach to the support that is offered.
On page 76
140 Steadman K, Wood M, Silvester H. Health and Wellbeing at work: a survey of Employees 2014. DWP Research Report 901; 2015 https://www.gov.uk/government/publications/health-and-wellbeing-at-work-survey-ofemployeeshttp://www.theworkfoundation.com/blog/2526/Working-for-better-mental-health-results-from-a-survey-of-employees
Reviews of the research evidence by the King’s Fund and the Nuffield Trust conclude that “significant benefits can arise from the integration of services where these are targeted at those client groups for whom care is currently poorly co-ordinated”. 143
On page 78
143 Goodwin N et al Integrated care for patients and populations: Improving outcomes by working together. A report to the Department of Health and the NHS Future Forum; 2012. http://www.kingsfund.org.uk/sites/files/kf/integrated-care-patients-populations-paper-nuffield-trust-kingsfund-january-2012.pdf
The UK Government
Evidence shows that being in appropriate work is good for health and that being out of work can have a detrimental effect on health. 144 For health and care professionals, therefore, supporting an individual to be in work appropriate for them is central to delivering effective, personalised care and addressing a key social determinant of health.
On page 81
144 Waddell G, Burton, K. Is Work Good for Your Health and Wellbeing? London: The Stationery Office; 2006. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/214326/hwwb-is-work-good-for-you.pdf
The Kings Fund points to the ‘growing body of evidence which demonstrates that individuals who are empowered to manage their own condition are more likely to experience better health outcomes’. 147
On page 82
147 Coulter A, Roberts S, Dixon A. Delivering better services for people with long term condition. The King’s Fund; 2013. http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/delivering-better-services-for-people-with-long-term-conditions.pdf
The UK Government
For example, in 2013, 30% of disabled working age benefit claimants saw ‘attitudes of employers’ as a barrier to seeking work, finding work, or working more hours; 148
On page 86
148 Cole L. A survey of disabled working age benefit claimants. In House Research Report No 16. Department for Work and Pensions; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224543/ihr_16_v2.pdf
The UK Government
A study found that 4 in 10 GPs didn’t feel confident in dealing with patient issues around a return to work; 149
On page 86
149 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207514/rrep835.pdf
BMC Musculoskeletal Disorders (Springer Science and Business Media LLC)
Serena McCluskey et al. 2011
The UK Government
parents, carers and service providers can have misconceptions about working with a disability or long-term health condition, which can result in them advising against a disabled person or someone with a long-term health condition trying work for fear of it damaging their health; 150 and
On page 86
150 McCluskey S. et al. The Influence of ‘significant others’ on persistent back pain and work participation: A qualitative exploration of illness perceptions. BMC Musculoskeletal Disorders 2011; 12:236. McCluskey, S. et al. Are the treatment expectations of ‘significant others’ psychosocial obstacles to work participation for those with persistent low back pain? Work 2014); 48:391-398. S. McCluskey et al. ‘I think positivity breeds positivity’: a qualitative exploration of the role of family members in supporting those with chronic musculoskeletal pain to stay at work. BMC Family Practice 2015; 16:85. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207514/rrep835.pdf
The UK Government
For example, in a survey of working age disabled benefit claimants, only 23% thought work would be beneficial to their health compared to almost two thirds who thought work would make them better off financially. 151
On page 86
151 Cole L. A survey of disabled working age benefit claimants. In House Research Report No 16. Department for Work and Pensions; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224543/ihr_16_v2.pdf
The UK Government
Mae gan bobl sy'n ddi-waith gyfraddau marwoldeb uwch 3 ac ansawdd bywyd is. 4 Mae hwn yn anghyfiawnder y mae'n rhaid inni fynd i'r afael ag ef.
On page 8
4 Swyddfa'r Cabinet. Analysis of the Annual Population Survey (APS) Wellbeing Data, Apr-Oct 2011. Ar gael yn: https://www.gov.uk/government/publications/wellbeing-and-employment (mynediad mis Hydref 2016).
Journal of Vocational Behavior (Elsevier BV)
Karsten I. Paul et al. 2009
Mae bod yn ddi-waith yn gysylltiedig ag amrywiaeth o ganlyniadau iechyd gwael. 16 Mae academyddion a sefydliadau fel Sefydliad Iechyd y Byd, 17 yr ILO, 18 yr OECD, 19 RAND Europe, 20 Coleg Brenhinol Seiciatryddion 21 a NICE 22 yn cytuno bod gwaith yn ddylanwadau ar iechyd a bod iechyd yn ddylanwadu ar waith.
On page 13
16 Waddell G, Burton AK. Is work good for your health and wellbeing; 2006; Rueda, S., Chambers, L., WIlson, M., Mustard, et al. Association of returning to work with better health in working-aged adults: a systematic review. American Journal of Public Health, 2012; 102, 541–56.; Paul KI, Moser K. Unemployment impairs mental health: Meta-analyses. Journal of Vocational Behavior, 2009; 74, 264–282.; Roelfs DJ, Shor E, Davidson KW, Schwartz JE. Losing life and livelihood: A systematic review and meta-analysis of unemployment and all-cause mortality. Social Science & Medicine, 2011; 72(6), 840–854.
World Health Organization
17 Benach J, Muntaner C, Santana V. Employment Conditions and Health Inequalities. Final Report to the WHO Commission on Social Determinants of Health (CSDH) Employment Conditions Knowledge Network. 2007. http://www.who.int/social_determinants/themes/employmentconditions/en/ (mynediad Hydref 2016).
International Labour Organization
Mae academyddion a sefydliadau fel Sefydliad Iechyd y Byd, 17 yr ILO, 18 yr OECD, 19 RAND Europe, 20 Coleg Brenhinol Seiciatryddion 21 a NICE 22 yn cytuno bod gwaith yn ddylanwadau ar iechyd a bod iechyd yn ddylanwadu ar waith.
On page 13
18 ILO & Finnish Ministry of Social Affairs. The Economics of Health, Safety and Well-being. Barefoot Economics: Assessing the economic value of developing a healthy work environment; http://www.ilo.org/safework/info/publications/WCMS_110381/lang--en/index.htm (mynediad Hydref 2016).
Mae academyddion a sefydliadau fel Sefydliad Iechyd y Byd, 17 yr ILO, 18 yr OECD, 19 RAND Europe, 20 Coleg Brenhinol Seiciatryddion 21 a NICE 22 yn cytuno bod gwaith yn ddylanwadau ar iechyd a bod iechyd yn ddylanwadu ar waith.
On page 13
20 van Stolk C, Hofman H, Hafner M, Janta, B. Psychological Wellbeing and Work: Improving Service Provision and Outcomes. January 2014.A report by RAND Europe. https://www.gov.uk/government/publications/psychological-wellbeing-and-work-improving-service-provision-andoutcomes (mynediad Hydref 2016).
Nordic Journal of Psychiatry (Informa UK Limited)
Juha Hämäläinen et al. 2005
Gwyddom po hiraf y bydd unigolyn yn ddi-waith y mwyaf y bydd ei iechyd a'i les yn debygol o waethygu. 23 Felly, mae pob diwrnod yn bwysig.
On page 14
23 Maier R, Egger A, Barth A, Winker R, Osterode W, Kundi M, Wolf C, Ruediger H. Effects of short- and long-term unemployment on physical work capacity and on serum cortisol. International Archives of Occupational and Environmental Health. 2006;79(3): 193–8.; Hämäläinen J, Poikolainen K, Isometsä E, Kaprio J, Heikkinen M, Lindeman S and Aro H. Major depressive episode related to long unemployment and frequent alcohol intoxication. Nordic Journal of Psychiatry. 2005;59 (6): 486–491.; Voss M, Nylén L, Floderus B, Diderichsen F, Terry P D (2004) Unemployment and Early Cause-; Royal College of Psychiatrists: Mental Health and Work https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212266/hwwb-mental-health-and-work.pdf (mynediad Hydref 2016).
Joseph Rowntree Foundation
Wrth gwrs, gall gwaith hefyd gyflwyno amrywiaeth o fuddiannau eraill sy'n cefnogi iechyd meddyliol a chorfforol a lles. 24 Dyma'r ffordd orau o godi safonau byw pobl â chyflwr iechyd hirdymor neu anabledd a'u codi allan o dlodi.
On page 14
24 Bivand, P. and Simmonds. The benefits of tackling worklessness and low pay. https://www.jrf.org.uk/report/benefits-tackling-worklessnessand-low-pay (mynediad Hydref 2016).
UK Parliament Research Briefings
59 Gwasanaeth Iechyd Gwladolational. NHS Five Year Forward View. https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf (mynediad Hydref 2016).
Resolution Foundation
Dengys tystiolaeth fod canlyniadau cyflogaeth i bobl ag anableddau a chyflyrau iechyd hirdymor yn amrywio ar draws rhannau gwahanol o'r wlad. 65 Mae cyfleoedd sylweddol i symud ymlaen â'r agenda hon trwy ddull 'ar sail lle', gan ddatgloi'r cyfalaf gwleidyddol a'r adnoddau sydd eu hangen i hybu arloesedd a darparu'r ymateb system gyfan sydd eu hangen i wella canlyniadau a thwf lleol.
On page 22
65 Adran Gwaith a Phensiynau a'r Adran Iechyd, Pecyn Data Papur Gwyrdd Gwaith, Iechyd ac Anabledd; 2016; 'Resolution Foundation'. Retention Deficit: A new approach to boosting employment for people with health problems and disabilities. http://www.resolutionfoundation.org/wp-content/uploads/2016/06/Retention-deficit.pdf (mynediad Hydref 2016).
Er enghraifft, mae tystiolaeth yn awgrymu pan fydd person yn wynebu rhwystrau iechyd a chyflogaeth, dylid mynd i'r afael â'r ddau ar yr un pryd, gan nad oes tystiolaeth bod trin naill ai broblem ar ei ben ei hun yn effeithiol. 66 Fel enghraifft mae, Lleoliad a Chefnogaeth Unigol, model iechyd a chyflogaeth integredig, wedi dangos gwell canlyniadau cyflogaeth ar gyfer y rhai â chyflwr iechyd meddwl difrifol a pharhaus.
On page 23
66 van Stolk C, Hofman H, Hafner M. Janta B. Psychological Wellbeing and Work: Improving Service Provision and Outcomes. https://www.gov.uk/government/publications/psychological-wellbeing-and-work-improving-service-provision-and-outcomes (mynediad Hydref 2016).
World Psychiatry (Wiley)
MARGARET HESLIN et al. 2011
Canfu gwerthusiad y DU bod y siawns o ganfod gwaith yn dyblu ar gyfer y rhai a oedd yn derbyn y gwasanaeth hwn. 67
On page 23
67 Heslin L, Howard M, Leese P, McCrone P. Rice C. Randomized controlled trial of supported employment in England: 2 year follow-up of the Supported Work and Needs (SWAN) study, World Psychiatry, 2011; 10, 132–137.
Centre for Analysis of Social Exclusion
A dylai ganolbwyntio o hyd ar yr effaith y mae cyflwr iechyd unigolyn yn ei chael arnynt – gan gydnabod mai'r rhai sydd â'r anabledd mwyaf sy'n wynebu'r anfantais fwyaf yn y farchnad lafur. 85
On page 45
85 Rigg J. Labour Market Disadvantage amongst Disabled People: A longitudinal perspective. CASE paper No. 103. Centre for Analysis of Social Exclusion, London School of Economics; 2005.
British Journal of General Practice (Royal College of General Practitioners)
Mark Gabbay et al. 2011
yn ogystal â bod yn wael i gyflogwyr a'r economi yn gyffredinol, mae cyfnod estynedig o absenoldeb oherwydd salwch yn wael i unigolion - maw ymyrraeth cynnar yn bwysig, 97 po fwyaf y bydd rhywun i ffwrdd o'r gwaith, yr anoddaf yw iddynt ddychwelyd i'r gwaith, a'r mwyaf fydd y risg na fyddant yn gallu manteisio ar yr holl fuddiannau a ddaw yn sgil gweithio; 98 a
On page 51
97 Gabbay M, Taylor L, Sheppard L, Hillage J, Bambra C, Ford F, et al. NICE guidance on long-term sickness and incapacity. British Journal of General Practice.Brit J Gen Pract. 2011; 61(584):206-7.
The UK Government
Ar hyn o bryd ni chaiff cyflogwyr y DU eu harolygu o ran anabledd na salwch yn eu gweithlu. 103 Os ydym am wireddu ein huchelgais o weithlu iach yn y DU gyda llai o bobl yn disgyn allan o waith oherwydd salwch, mae angen i ni weld pob cyflogwr yn creu amgylcheddau lle mae cyflogeion yn teimlo y gallant ddatgelu problemau iechyd a lle mae cyflogwyr yn defnyddio'r wybodaeth honno i wella iechyd cyflogeion.
On page 54
103 Er ei bod yn ofynnol i gyrff y sector cyhoeddus cyhoeddi data cyflogaeth yn ymwneud â nodweddion gwarchodedig o dan Ddyletswydd Cydraddoldeb y Sector Cyhoeddus o dan y Ddedd Cydraddoldeb 2010, https://www.gov.uk/guidance/equality-act-2010-guidance#publicsector-equality-duty.
Journal of Occupational and Environmental Medicine (Ovid Technologies (Wolters Kluwer Health))
Ivan Robertson et al. 2012
Lle bo hyn ar waith, mae wedi cael ei gysylltu â gwell perfformiad a lles; lle nad yw ar waith, mae'n creu pwysau ar y rheini sy'n parhau i weithio er gwaethaf salwch 108 ac mae wedi cael ei gysylltu â straen, gorweithio ac iselder.
On page 60
108 Robertson IT, Leach D, Doerner N et al. Poor health but not absent: Prevalence, predictors and outcomes of presenteeism. Journal of Occupational and Environmental Medicine 2012 54: 1344–9.
The UK Government
Er bod ein dealltwriaeth o effeithiolrwydd gwahanol fathau o gymorth iechyd galwedigaethol mewn lleoliadau gwahanol yn anghyflawn, ceir rhywfaint o dystiolaeth fod darparu cymorth o'r fath yn fuddiol o ran lleihau absenoldeb oherwydd salwch, hybu cynhyrchiant a gwella boddhad cyflogeion. 115
On page 61
115 PricewaterhouseCoopers LLP. Building the case for wellness; 2008. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/209547/hwwb-dwp-wellness-report-public.pdf
The UK Government
Canfu arolwg yn 2014 fod 72% o gyflogeion y sector cyhoeddus wedi manteisio ar gymorth iechyd galwedigaethol o gymharu â 52% yn y sector gwirfoddol a 39% yn y sector preifat. 116
On page 61
116 Steadman K., Wood M., and, Silvester, H. (2015). Health and Wellbeing at work: a survey of Employees 2014. DWP Research Report 901; 2015 https://www.gov.uk/government/publications/health-and-wellbeing-at-work-survey-of-employees http://www.theworkfoundation.com/blog/2526/Working-for-better-mental-health-results-from-a-survey-of-employees
The UK Government
Yn ogystal, dim ond tua thraean a oedd wedi bod mewn gwaith cyn gwneud cais am Lwfans Cyflogaeth a Chymorth Adroddodd cafodd fynediad i gymorth iechyd galwedigaethol yn y gwaith. 117
On page 61
117 Sissons P, Barnes H, Stevens H. Routes onto Employment and Support Allowance DWP Research Report 774; 2011. https://www.gov.uk/government/publications/routes-onto-employment-and-support-allowance-rr774
The UK Government
Hefyd, mae tystiolaeth yn dangos bod cynnig i gyflogeion ddychwelyd i'r gwaith yn raddol ar ôl absenoldeb oherwydd salwch yn golygu eu bod yn dychwelyd yn gynt ac yn aros mewn cyflogaeth am fwy o amser. 119
On page 62
119 See: Waddell, G. Waddell G, Burton K. Is Work Good for Your Health and Wellbeing? London: The Stationery Office; 2006. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/214326/hwwb-is-work-good-for-you.pdf
120 http://ec.europa.eu/health/mental_health/eu_compass/reports_studies/disability_synthesis_2010_en.pdf. OECD. Sickness, Disability and Work: Breaking the Barriers. A synthesis of findings across OECD countries; 2010. http://ec.europa.eu/health/mental_health/eu_compass/reports_studies/disability_synthesis_2010_en.pdf
annog gwasanaethau iechyd a gofal i gynllunio eu Cynlluniau Cynaliadwyedd a Thrawsnewid 124 ar sail 'olion traed' sy'n dwyn ynghyd arweinwyr iechyd a gofal er mwyn helpu i ddarparu gwasanaethau iechyd a gofal gwell yn seiliedig ar anghenion poblogaethau lleol.
On page 67
124 NHS England and NHS Improvement. NHS Operational Planning and Contracting Guidance 2017-2019. https://www.england.nhs.uk/wpcontent/uploads/2016/09/NHS-operational-planning-guidance-201617-201819.pdf
The UK Government
Er bod dros 60% o feddygon teulu yn cytuno neu'n cytuno i raddau bod y nodyn ffitrwydd wedi gwella ansawdd eu trafodaethau â chleifion ynghylch dychwelyd i'r gwaith, a bod dros 90% yn cytuno bod helpu cleifion i aros mewn gwaith neu ddychwelyd i'r gwaith yn rhan bwysig o'u rôl, 125 nid yw'r nodyn ffitrwydd yn cyflawni'r hyn y bwriadwyd iddo ei gyflawni yn llawn.
On page 69
125 Hann M and Sibbald B. General Practitioners' attitudes towards patients' health and work, 2010-12. DWP Research Report 835; 2013 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207514/rrep835.pdf
The UK Government
Dengys tystiolaeth y gall cynnig cymorth cynnar i unigolion, gan gynnwys pobl â chyflwr iechyd neu anabledd, wella eu siawns o ddychwelyd i weithio. 128 Eto i gyd, yn rhy aml o lawer, nid oes gwasanaethau i bobl â chyflyrau cyffredin ar gael pan fydd eu hangen ar unigolyn.
On page 70
128 Coleman N, Sykes W, Groom C. What works for whom in helping disabled people into work? Papur gwaith 120. Adran Gwaith a Phensiynau; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/266512/wp120.pdf
Work Foundation
sy'n gallu amrywio yn dibynnu ar faint y cyflogwr. 140 Nid oes dull gweithredu safonol yn bodoli ar gyfer y cymorth a gynigir.
On page 74
140 Steadman K, Wood M, Silvester H. Health and Wellbeing at work: a survey of Employees 2014. DWP Research Report 901; 2015 https://www.gov.uk/government/publications/health-and-wellbeing-at-work-survey-ofemployeeshttp://www.theworkfoundation.com/blog/2526/Working-for-better-mental-health-results-from-a-survey-of-employees
Mae adolygiadau o dystiolaeth ymchwil gan the King's Fund a'r Nuffield Trust yn dod i'r casgliad canlynol: “significant benefits can arise from the integration of services where these are targeted at those client groups for whom care is currently poorly co-ordinated”. 143
On page 76
143 Goodwin N et al Integrated care for patients and populations: Improving outcomes by working together. A report to the Department of Health and the NHS Future Forum; 2012. http://www.kingsfund.org.uk/sites/files/kf/integrated-care-patients-populations-paper-nuffield-trust-kingsfund-january-2012.pdf
The UK Government
Dengys tystiolaeth fod bod mewn gwaith addas yn dda i iechyd pobl ar y cyfan ac y gall bod yn ddiwaith gael effaith andwyol ar iechyd. 144 Felly, i weithwyr iechyd a gofal proffesiynol, mae helpu unigolyn i fod mewn gwaith sy'n briodol iddo yn hollbwysig er mwyn darparu gofal personol, effeithiol a mynd i'r afael ag un o'r prif benderfynyddion cymdeithasol o ran iechyd.
On page 78
144 Waddell G, Burton, K. Is Work Good for Your Health and Wellbeing? London: The Stationery Office; 2006. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/214326/hwwb-is-work-good-for-you.pdf
Mae The Kings Fund yn cyfeirio at 'the growing body of evidence which demonstrates that individuals who are empowered to manage their own condition are more likely to experience better health outcomes'. 147
On page 79
147 Coulter A, Roberts S, Dixon A. Delivering better services for people with long term condition. The King's Fund; 2013. http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/delivering-better-services-for-people-with-long-term-conditions.pdf
The UK Government
Er enghraifft, yn 2013, credai 30% o hawlwyr budd-daliadau anabl o oedran gweithio fod 'agweddau cyflogwyr' yn rhwystr i chwilio am waith, dod o hyd i waith, neu weithio oriau hwy; 148
On page 84
148 Cole L. A survey of disabled working age benefit claimants. In House Research Report No 16. Department for Work and Pensions; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224543/ihr_16_v2.pdf
The UK Government
Yn ôl astudiaeth, nid oedd 4 o bob 10 meddyg teulu yn teimlo'n hyderus wrth ddelio â materion dychwelyd i'r gwaith gyda chleifion; 149
On page 84
149 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207514/rrep835.pdf
BMC Musculoskeletal Disorders (Springer Science and Business Media LLC)
Serena McCluskey et al. 2011
gall fod gan rieni, gofalwyr a darparwyr gwasanaethau camsyniad o weithio gyda phobl anabl a phobl â chyflyrau iechyd hirdymor, a all arwain iddynt cynghori yn erbyn unigolyn anabl neu rywun â chyflwr iechyd hirdymor i beidio â cheisio gweithio rhag ofn y bydd yn niweidiol i'w hiechyd; 150 a
On page 84
150 McCluskey S. et al. The Influence of ‘significant others' on persistent back pain and work participation: A qualitative exploration of illness perceptions. BMC Musculoskeletal Disorders 2011; 12:236. McCluskey, S. et al. Are the treatment expectations of ‘significant others' psychosocial obstacles to work participation for those with persistent low back pain? Work 2014); 48:391-398. S. McCluskey et al. 'I think positivity breeds positivity': a qualitative exploration of the role of family members in supporting those with chronic musculoskeletal pain to stay at work. BMC Family Practice 2015; 16:85.
The UK Government
Er enghraifft, mewn arolwg o hawlwyr budd-daliadau anabl o oedran gweithio, dim ond 23% oedd yn teimlo y byddai gweithio'n fuddiol i'w hiechyd o gymharu â bron i ddwy ran o dair ohonynt a oedd yn teimlo y byddai gwaith yn eu gwneud yn well eu byd yn ariannol. 151
On page 84
151 Cole L. A survey of disabled working age benefit claimants. In House Research Report No 16. Department for Work and Pensions; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224543/ihr_16_v2.pdf
Social Science & Medicine (Elsevier BV)
David J. Roelfs et al. 2011
3 Roelfs D J, Shor E, Davidson KW, Schwartz, JE. Losing life and livelihood: A systematic review and meta-analysis of unemployment and allcause mortality. Social Science & Medicine 2011;72(6): 840–854.
The UK Government
People who are unemployed have higher rates of mortality 3 and a lower quality of life. 4 This is an injustice that we must address.
On page 8
4 Cabinet Office. Analysis of the Annual Population Survey (APS) Wellbeing Data, Apr-Oct 2011. Available at: https://www.gov.uk/government/publications/wellbeing-and-employment (accessed October 2016).
Journal of Vocational Behavior (Elsevier BV)
Karsten I. Paul et al. 2009
Being out of work is associated with a range of poor health outcomes. 16 Academics and organisations such as the WHO, 17 the ILO, 18 the OECD, 19 RAND Europe, 20 the Royal College of Psychiatrists 21 and NICE 22 all recognise that work influences health and health influences work.
On page 13
16 Waddell G, Burton AK. Is work good for your health and wellbeing; 2006; Rueda, S., Chambers, L., WIlson, M., Mustard, et al. Association of returning to work with better health in working-aged adults: a systematic review. American Journal of Public Health, 2012; 102, 541–56.; Paul KI, Moser K. Unemployment impairs mental health: Meta-analyses. Journal of Vocational Behavior, 2009; 74, 264–282.; Roelfs DJ, Shor E, Davidson KW, Schwartz JE. Losing life and livelihood: A systematic review and meta-analysis of unemployment and all-cause mortality. Social Science & Medicine, 2011; 72(6), 840–854.
World Health Organization
17 Benach J, Muntaner C, Santana V. Employment Conditions and Health Inequalities. Final Report to the WHO Commission on Social Determinants of Health (CSDH) Employment Conditions Knowledge Network. 2007. http://www.who.int/social_determinants/themes/employmentconditions/en/ (accessed October 2016).
International Labour Organization
Academics and organisations such as the WHO, 17 the ILO, 18 the OECD, 19 RAND Europe, 20 the Royal College of Psychiatrists 21 and NICE 22 all recognise that work influences health and health influences work.
On page 13
18 ILO & Finnish Ministry of Social Affairs. The Economics of Health, Safety and Well-being. Barefoot Economics: Assessing the economic value of developing a healthy work environment; http://www.ilo.org/safework/info/publications/WCMS_110381/lang--en/index.htm (accessed October 2016).
Academics and organisations such as the WHO, 17 the ILO, 18 the OECD, 19 RAND Europe, 20 the Royal College of Psychiatrists 21 and NICE 22 all recognise that work influences health and health influences work.
On page 13
20 van Stolk C, Hofman H, Hafner M, Janta, B. Psychological Wellbeing and Work: Improving Service Provision and Outcomes. January 2014.A report by RAND Europe. https://www.gov.uk/government/publications/psychological-wellbeing-and-work-improving-service-provision-andoutcomes (accessed October 2016).
Nordic Journal of Psychiatry (Informa UK Limited)
Juha Hämäläinen et al. 2005
We know that the longer a person is out of work the more their health and wellbeing is likely to deteriorate. 23 So, every day matters.
On page 14
23 Maier R, Egger A, Barth A, Winker R, Osterode W, Kundi M, Wolf C, Ruediger H. Effects of short- and long-term unemployment on physical work capacity and on serum cortisol. International Archives of Occupational and Environmental Health. 2006;79(3): 193–8.; Hämäläinen J, Poikolainen K, Isometsä E, Kaprio J, Heikkinen M, Lindeman S and Aro H. Major depressive episode related to long unemployment and frequent alcohol intoxication. Nordic Journal of Psychiatry. 2005;59 (6): 486–491.; Voss M, Nylén L, Floderus B, Diderichsen F, Terry P D (2004) Unemployment and Early Cause-; Royal College of Psychiatrists: Mental Health and Work https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212266/hwwb-mental-health-and-work.pdf (accessed October 2016).
Joseph Rowntree Foundation
Of course, work can also bring a range of other benefits which support mental and physical health and wellbeing. 24 It is the best route to raising the living standards of disabled people and people with a long-term health condition and moving them out of poverty.
On page 14
24 Bivand, P. and Simmonds. The benefits of tackling worklessness and low pay. https://www.jrf.org.uk/report/benefits-tackling-worklessnessand-low-pay (October 2016).
This change may bring benefits, for example enabling more flexible working to help people with health conditions stay in work, but can also have less positive effects like work intensification that may affect people’s ability to cope or adapt in work with a health condition. 41
On page 16
41 Green, F. Why Has Work Effort Become More Intense? Industrial Relations: A Journal of Economy and Society 2004; 43: 709-741.
UK Parliament Research Briefings
The patients’ organisation National Voices puts it clearly: personalised care will only happen when services recognise that patients’ own life goals are what count; that services need to support families, carers and communities; that promoting wellbeing and independence need to be the key outcomes of care; and that patients, their families and carers are often ‘experts by experience’. 59
On page 20
59 National Health Service. NHS Five Year Forward View. https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf (accessed October 2016).
Resolution Foundation
Evidence shows that employment outcomes for disabled people and people with long-term health conditions vary across different regions in the country. 65 There are significant opportunities to advance this agenda through a ‘place-based’ approach, unlocking the political capital and resources needed to drive innovation and deliver the system-wide response needed to improve outcomes and local growth.
On page 22
65 Department for Work and Pensions and Department of Health. Work, Health and Disability Green Paper Data Pack; 2016..;’ Resolution Foundation. Retention Deficit: A new approach to boosting employment for people with health problems and disabilities. http://www.resolutionfoundation.org/wp-content/uploads/2016/06/Retention-deficit.pdf (accessed October 2016).
For instance, evidence suggests that when a person faces both health and employment barriers, both should be addressed simultaneously, since there is no evidence that treating either problem in isolation is effective. 66 As an example, Individual Placement and Support, an integrated health and employment model, has demonstrated improved employment outcomes for those with severe and enduring mental health condition.
On page 24
66 van Stolk C, Hofman H, Hafner M. Janta B. Psychological Wellbeing and Work: Improving Service Provision and Outcomes. https://www.gov.uk/government/publications/psychological-wellbeing-and-work-improving-service-provision-and-outcomes (accessed October 2016).
World Psychiatry (Wiley)
MARGARET HESLIN et al. 2011
A UK evaluation found that chances of finding employment doubles for those who received this service. 67
On page 24
67 Heslin L, Howard M, Leese P, McCrone P. Rice C. Randomized controlled trial of supported employment in England: 2 year follow-up of the Supported Work and Needs (SWAN) study, World Psychiatry, 2011; 10, 132–137.
Centre for Analysis of Social Exclusion
And it should still focus on the impact that an individual’s health condition has on them – recognising that those with the greatest level of disability have the biggest labour market disadvantage. 85
On page 46
85 Rigg J. Labour Market Disadvantage amongst Disabled People: A longitudinal perspective. CASE paper No. 103. Centre for Analysis of Social Exclusion, London School of Economics; 2005.
British Journal of General Practice (Royal College of General Practitioners)
Mark Gabbay et al. 2011
in addition to being bad for employers and the economy in general, a prolonged period of sickness absence is bad for individuals – early intervention is important, 97 the longer someone is away from work, the harder it is for them to get back to work, and the greater the risk of them missing out on all the benefits that work can bring; 98 and
On page 52
97 Gabbay M, Taylor L, Sheppard L, Hillage J, Bambra C, Ford F, et al. NICE guidance on long-term sickness and incapacity. British Journal of General Practice.Brit J Gen Pract. 2011; 61(584):206-7.
UK Parliament Select Committee Publications
This investment has proved effective in bringing down civil service sickness rates: for example, sickness rates in the Department for Work and Pensions have fallen from 11.1 days per staff year in 2007 to 6.2 in 2016. 100 However, it is clear that more needs to be done.
On page 54
100 The Civil Service measures average working days lost (AWDL) per staff year, based on hours actually worked by employees. This produces a more accurate but generally higher absence figure than the AWDL per person figure used for external comparisons. Source: Department for Work and Pensions. Sick Leave: Written question – 29117. http://www.parliament.uk/business/publications/written-questions-answersstatements/written-question/Commons/2016-03-01/29117/ (accessed October 2016). http://www.parliament.uk/business/publications/written-questions-answers-statements/written-question/Commons/2016-03-01/29117/
The UK Government
Currently UK employers are not required to know the details about disability or sickness in their workforce. 103 If we are to realise our ambition of a healthy UK workforce with fewer people dropping out of work because of ill health, then we need to see all employers creating environments where employees feel able to disclose health issues and where employers act on that information to improve employee health.
On page 55
103 Although public sector bodies are required to publish employment data concerning protected characteristics under the Public Sector Equality Duty under the Equality Act 2010, https://www.gov.uk/guidance/equality-act-2010-guidance#public-sector-equality-duty.
Evidence suggests that seeing employers have success in hiring disabled people and people with health conditions can be a powerful way of motivating other employers to act. 104 Employeremployee networks and business-led initiatives therefore have a big role to play in influencing employers to recognise the talents of disabled employees and employees with health conditions and creating the momentum to support these employees excel.
On page 56
104 Organisation for Economic Co-operation and Development. OECD’s Sickness, Disability and Work, Breaking the Barriers; 2010.
Journal of Occupational and Environmental Medicine (Ovid Technologies (Wolters Kluwer Health))
Ivan Robertson et al. 2012
Where in place this has been linked with improved performance and wellbeing; where it isn’t it creates pressure among those who continue to work despite illness 108 and has been linked with stress, burnout and depression.
On page 61
108 Robertson IT, Leach D, Doerner N et al. Poor health but not absent: Prevalence, predictors and outcomes of presenteeism. Journal of Occupational and Environmental Medicine 2012 54: 1344–9. http://journals.lww.com/joem/Abstract/2012/11000/Poor_Health_but_Not_Absent__Prevalence,.6.aspx
Mayo Clinic Proceedings (Elsevier BV)
Tait D. Shanafelt et al. 2015
Where in place this has been linked with improved performance and wellbeing; where it isn’t it creates pressure among those who continue to work despite illness 108 and has been linked with stress, burnout and depression. 109
On page 61
109 Tait et al. Impact of Organizational Leadership on Physician Burnout and Satisfaction. Mayo Clinic Proceedings 2015: 90, (4); 432–440. http://www.sciencedirect.com/science/article/pii/S0025619615000713
The UK Government
Although our understanding of the effectiveness of different types of occupational health support in different settings is incomplete, there is some evidence that providing such support can lead to reduced sickness absence, boosted productivity and increased employee satisfaction. 115
On page 62
115 PricewaterhouseCoopers LLP. Building the case for wellness; 2008. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/209547/hwwb-dwp-wellness-report-public.pdf
The UK Government
A 2014 survey found 72% of public sector employees had access to occupational health support compared to 52% in the voluntary sector and 39% in the private sectors. 116
On page 62
116 Steadman K., Wood M., and, Silvester, H. (2015). Health and Wellbeing at work: a survey of Employees 2014. DWP Research Report 901; 2015 https://www.gov.uk/government/publications/health-and-wellbeing-at-work-survey-of-employees http://www.theworkfoundation.com/blog/2526/Working-for-better-mental-health-results-from-a-survey-of-employees
The UK Government
In addition, only around a third who had been in work prior to claiming Employment Support Allowance reported having access to occupational health support at work. 117
On page 62
117 Sissons P, Barnes H, Stevens H. Routes onto Employment and Support Allowance DWP Research Report 774; 2011. https://www.gov.uk/government/publications/routes-onto-employment-and-support-allowance-rr774
The UK Government
Furthermore, evidence shows that phased returns to work from sickness absence can see employees return quicker and stay in employment longer. 119
On page 63
119 See: Waddell, G. Waddell G, Burton K. Is Work Good for Your Health and Wellbeing? London: The Stationery Office; 2006. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/214326/hwwb-is-work-good-for-you.pdf
120 http://ec.europa.eu/health/mental_health/eu_compass/reports_studies/disability_synthesis_2010_en.pdf. OECD. Sickness, Disability and Work: Breaking the Barriers. A synthesis of findings across OECD countries; 2010. http://ec.europa.eu/health/mental_health/eu_compass/reports_studies/disability_synthesis_2010_en.pdf .
encouraged health and care services to plan their Sustainability and Transformation Plans 124 on ‘footprints’ which bring together health and care leaders to support the delivery of improved health and care based on the needs of local populations.
On page 68
124 NHS England and NHS Improvement. NHS Operational Planning and Contracting Guidance 2017-2019. https://www.england.nhs.uk/wpcontent/uploads/2016/09/NHS-operational-planning-guidance-201617-201819.pdf
The UK Government
However, although over 60% of GPs agree or somewhat agree that the fit note has improved the quality of their return to work discussions with patients, and over 90% agreed that helping patients to stay in or return to work was an important part of their role, 125 the fit note is not fully achieving what it set out to do.
On page 70
125 Hann M and Sibbald B. General Practitioners’ attitudes towards patients’ health and work, 2010-12. DWP Research Report 835; 2013 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207514/rrep835.pdf
The UK Government
Evidence shows that offering early support to individuals, including people with a health condition or a disability, can improve their chances of getting back to work. 128 Yet too often services for people with common conditions are not available when an individual needs them.
On page 71
128 Coleman N, Sykes W, Groom C. What works for whom in helping disabled people into work? Working paper 120. Department for Work and Pensions; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/266512/wp120.pdf
Work Foundation
Survey data suggests only 51% of employees have access to occupational health through their employer which can vary depending on their size. 140 There is also no standardised approach to the support that is offered.
On page 75
140 Steadman K, Wood M, Silvester H. Health and Wellbeing at work: a survey of Employees 2014. DWP Research Report 901; 2015 https://www.gov.uk/government/publications/health-and-wellbeing-at-work-survey-ofemployeeshttp://www.theworkfoundation.com/blog/2526/Working-for-better-mental-health-results-from-a-survey-of-employees
Reviews of the research evidence by the King’s Fund and the Nuffield Trust conclude that “significant benefits can arise from the integration of services where these are targeted at those client groups for whom care is currently poorly co-ordinated”. 143
On page 77
143 Goodwin N et al Integrated care for patients and populations: Improving outcomes by working together. A report to the Department of Health and the NHS Future Forum; 2012. http://www.kingsfund.org.uk/sites/files/kf/integrated-care-patients-populations-paper-nuffield-trust-kingsfund-january-2012.pdf
The UK Government
Evidence shows that being in appropriate work is good for health and that being out of work can have a detrimental effect on health. 144 For health and care professionals, therefore, supporting an individual to be in work appropriate for them is central to delivering effective, personalised care and addressing a key social determinant of health.
On page 80
144 Waddell G, Burton, K. Is Work Good for Your Health and Wellbeing? London: The Stationery Office; 2006. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/214326/hwwb-is-work-good-for-you.pdf
The Kings Fund points to the ‘growing body of evidence which demonstrates that individuals who are empowered to manage their own condition are more likely to experience better health outcomes’. 147
On page 81
147 Coulter A, Roberts S, Dixon A. Delivering better services for people with long term condition. The King’s Fund; 2013. http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/delivering-better-services-for-people-with-long-term-conditions.pdf
The UK Government
For example, in 2013, 30% of disabled working age benefit claimants saw ‘attitudes of employers’ as a barrier to seeking work, finding work, or working more hours; 148
On page 85
148 Cole L. A survey of disabled working age benefit claimants. In House Research Report No 16. Department for Work and Pensions; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224543/ihr_16_v2.pdf
The UK Government
A study found that 4 in 10 GPs didn’t feel confident in dealing with patient issues around a return to work; 149
On page 85
149 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207514/rrep835.pdf
BMC Musculoskeletal Disorders (Springer Science and Business Media LLC)
Serena McCluskey et al. 2011
The UK Government
parents, carers and service providers can have misconceptions about working with a disability or long-term health condition, which can result in them advising against a disabled person or someone with a long-term health condition trying work for fear of it damaging their health; 150 and
On page 85
150 McCluskey S. et al. The Influence of ‘significant others’ on persistent back pain and work participation: A qualitative exploration of illness perceptions. BMC Musculoskeletal Disorders 2011; 12:236. McCluskey, S. et al. Are the treatment expectations of ‘significant others’ psychosocial obstacles to work participation for those with persistent low back pain? Work 2014); 48:391-398. S. McCluskey et al. ‘I think positivity breeds positivity’: a qualitative exploration of the role of family members in supporting those with chronic musculoskeletal pain to stay at work. BMC Family Practice 2015; 16:85. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/207514/rrep835.pdf
The UK Government
For example, in a survey of working age disabled benefit claimants, only 23% thought work would be beneficial to their health compared to almost two thirds who thought work would make them better off financially. 151
On page 85
151 Cole L. A survey of disabled working age benefit claimants. In House Research Report No 16. Department for Work and Pensions; 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224543/ihr_16_v2.pdf
The UK Government
Mae gan bobl sy'n ddi-waith gyfraddau marwoldeb uwch 3 ac ansawdd bywyd is. 4 Mae hwn yn anghyfiawnder y mae'n rhaid inni fynd i'r afael ag ef.
On page 8
4 Swyddfa'r Cabinet. Analysis of the Annual Population Survey (APS) Wellbeing Data, Apr-Oct 2011. Ar gael yn: https://www.gov.uk/government/publications/wellbeing-and-employment (accessed October 2016).