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Stephen  Bevan

NICE to examine employers’ role in improving the health of employees – but what about the other parts of the puzzle?

Authors: Stephen Bevan Professor Stephen Bevan

16 July 2013

The National Institute for Health and Clinical Excellence (NICE) has today finished its consultation on the draft scope of new public health guidance on “workplace policy and management practices to improve the health of employees”. This guidance, aimed at line managers and HR professionals in all sectors of business, will give advice on promoting employee wellbeing, including managing sickness absence and return to work.

This is a vital area for NICE to be looking at. As Fit for Work coalition member Steve Boorman blogged in June, at a recent think tank event on employers and health, an overwhelming number of speakers pointed to competence and capability of management and leadership as a key factor of people remaining in work. It is encouraging that this guidance is being developed and it comes soon after the announcement that the government has finally asked NICE to go beyond this traditional healthcare system perspective to take more of a societal perspective, as I blogged last month.

While employers have a key role in helping people with long-term conditions like musculoskeletal disorders (MSDs), better support from line management is only one part of addressing this issue.  It is absolutely vital to build better integration between health and work and to involve healthcare practitioners in the employment outcomes of their patients.

The Department for Work and Pensions took an important step in this direction last week, announcing a two year pilot scheme that will give people on Employment and Support Allowance (ESA) – the main benefit for people with long-term conditions or who are disabled – regular appointments with healthcare professionals with the aim of removing barriers to work.

However, the same links are not being made by the Department of Health and NHS England.  For example, although employment is a measured outcome in the National Outcomes Framework, it is not part of the Clinical Commissioning Groups Outcome Indicator Set (CCG OIS).  Healthcare practitioners are currently not being supported and incentivised to treat health as a clinical outcome.

Helping people with long-term conditions to return to or remain in work is an important issue; the impact of long-term conditions on work and productivity is only going to grow.  Just MSDs cause 7.5 million days lost due to work-related ill health each year[i], while up to 40% of people with rheumatoid arthritis leave work within five years of diagnosis[ii]. Rheumatoid arthritis alone costs the economy £1.8 billion a year in sick leave and work related disability[iii].

This is an area that no one stakeholder can tackle alone. We hope that the current Health Select Committee Inquiry on the Management of Long Term Conditions will prompt action from NHS England to join employers and the DWP in addressing this issue.


[i] Stress, depression or anxiety and musculoskeletal disorders accounted for the majority of days lost due to work-related ill health, 10.4 and 7.5 million days respectively

[ii] The Work Foundation: Management of Long Term Conditions- The Work Foundation’s submission to the Health Committee, March 2013 Available at:

[iii]  “We estimate that the Rheumatoid arthritis costs the NHS around £560 million a year in healthcare costs with the majority of this in the acute sector. The additional cost to the economy of sick leave and work-related disability is £1.8 billion a year”. National Audit Office, Services for people with rheumatoid arthritis, July 2009

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