Health, disability and work; adapting to change in 2017

As we begin 2017, change is the only constant seen across the political world. But whilst the news may be dominated by the Brexit process and a certain presidential transition, it doesn’t mean that other policy areas aren’t witnessing new and unprecedented developments. The health at work landscape remains in flux, with those working within it scrambling to keep up with changing workforce and demographic trends.

Back in October the Departments of Health and Work and Pension’s Joint Unit published their Green Paper, a document containing policy proposals that aimed to help more people with disabilities and /or long term health conditions gain or stay in employment, reaffirming the Government’s manifesto commitment to halve the disability employment gap. The Green Paper is a wide-ranging document, containing some 91 pages (not including a lengthy additional data pack) that cover many different angles, and a lengthy consultation process on these proposals beckons. In such a substantial document the risk is that key changes and challenges facing health at work policymakers may be overlooked by consultees. So what should the immediate priority areas be?

Facing up to the reality of a health at work demographic time bomb should feature. In 2014, the average age of a person living in the UK exceeded 40 for the first time, with demographic projections showing that nearly one in seven of us will be over 75 by 2040. Society is slowly adapting to increased vitality of increasing numbers of these older people – many of whom now act, think and feel as if they are in the prime of their healthy working lives.  However, despite remarkable increases in longevity, the over 60s are still significantly more vulnerable to developing chronic conditions that can limit their ability to work. With this cohort’s number growing, a “pivot to retention” is required; enabling workers who either have a health condition, or are at significant risk of developing one, to stay in work longer is crucial to individuals and the economy’s future.

For employers, it can be easier to make adjustments to help an employee stay in work then to have them take costly sick leave or have to resign, meaning the loss of a team member and their skills (as well as the hassle and expense of recruitment). For the employee, staying in work means they avoid the costly and often difficult transition to a life without work, or one on disability benefits. Furthermore, increasing efforts to help retain workers with an age related health condition will normalise working into an increasing age; something that many of us working today will need to get used to. Policymakers must continue efforts to shift the focus onto retention to stop any increase in the flow of people leaving work due to ill health.

Policymakers will also have to adapt to changing workplace practices. The proportion of the population working casually through agencies or becoming self-employed has reached a record high, and much has been said about the ‘flexibility’ these jobs can offer. However, in reality this brings challenges as well as opportunities; self-employed or casual workers mostly do not get sick leave, or have the right to ask for adjustments, and are not allowed discretionary time off work to attend health appointments. In short, there are up to a million people missing out on health at work support, and this figure is likely to rise. This should be of huge concern for policymakers and requires urgent attention.

With an ageing population and changing working practices, transformation of the health at work policy environment is underway, bringing with it new risks to worker’s health. Accordingly, the biggest priority for change may be within organisational culture itself. The belief that the state is solely responsible for ensuring a worker’s health needs to be contested; employers have to take on more responsibility as a matter of urgency. There are many examples of employers taking good care of their workers’ health, but there are many more that cannot, or will not adapt, particularly within the small and medium sized enterprise (SME) sector. Retention of workers, and expansion of access to in-work health support, must become standard practice in order to meet the growing need. There are signs from the Green Paper that this is happening; large parts of the document consultation are dedicated to determining how it can be made easier for employers to adapt better health at work policies. Partly reflecting Government ideology and part reflecting the realities of change, this shift towards mandatory workplace engagement could define health at work policy for the coming decades.  Employers, take heed…!

The Government, for its part, will need to do more to assist with these changes, whether by the carrot or the stick. Policymakers need to respond to the challenges of an ageing population, increasing numbers working within non-traditional employment, and continued low uptake of health at work support by employers. Adapting to these changes will help to equip the UK with a healthy workforce able to meet the challenges 2017 will surely bring; failure to do so may spell trouble, both for individuals with health conditions and the wider economy.