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Professor Dame Carol Black DBE MD FRCP MACP FMedSci
Principal of Newnham College, Cambridge, expert advisor on health and work
Professor Dame Carol Black DBE MD FRCP MACP FMedSci

Fluctuating conditions, fluctuating support?

Authors: Professor Dame Carol Black DBE MD FRCP MACP FMedSci

22 January 2015

It is estimated that by 2030, four out of ten working age people will have at least one chronic health condition, and some will have several. In many of them the symptoms will fluctuate, often unpredictably. This can present a challenge both to them and to their employers.The health of the working age population is high on the government agenda, championed through the cross-departmental health, work and wellbeing policy programme. My report, Working for a Healthier Tomorrow, highlighted the extent and burden of chronic conditions in the workforce and their impact on working life. 

The health, work and wellbeing programme has made good progress in widening understanding of the need to promote and safeguard the health of working age people, and improving the health support available to enable sustained working life. Fit For Work is a new service designed to strengthen this programme and will be launched shortly.

Particular difficulties are presented by fluctuating health conditions. Their unpredictability is a substantial problem when making arrangements are being made to provide appropriate support. Symptoms are subjective and their effects often difficult for employers and co-workers to fully understand.
Unsurprisingly employers are often concerned that a fluctuating condition means less reliable attendance, with absence at short notice and reduced productivity. There may be a tendency to presenteeism. Worst of all there may be premature exit from the labour market.

I therefore welcome a new paper from The Work Foundation’s Health at Work Policy Unit. The paper considers how policy could better support employers in meeting the needs of affected employees who, with the right support, can continue to make a valued contribution. 

 Among the measures employers will need to consider are:

  • Adjustments to the type of work, often on a temporary basis
  • Introducing greater flexibility in the hours worked or the location work takes place in, e.g. allowing people to work at home.
  • Reviewing sickness absence policies to include part-time sick leave options

The challenge is not for employers alone. We also look to the NHS and health professionals and the welfare system. If affected people are to have fulfilling working lives then we must ensure that ‘workability’ is a treatment goal for clinicians, and that facilitating job retention and return to work are aims of the welfare system too.