The following is an excerpt from the executive summary of ‘Health and Work Champions: a Pilot Training Programme’, (Martin et al. Feb 2018). I am highlighting it because it has relevance to MSers and MS-related HCPs. HCPs are being fingered as part of the unemployment problem; “healthcare practitioners, who may consider that giving advice to refrain from work is part of their duty of care“.
Is it inevitable that MS will lead to early unemployment or medical retirement? What has been your experience with your MS team? Have they helped try and keep you employed? Any suggestions to help?
“Ill-health among working-age people costs the UK economy £100bn a year in sickness absence (DWP and DH, 2016). Unemployment is not only costly for society but also bad for health because of its association with greater physical and mental health morbidity and mortality (Janlert, 1997; Martikainen and Valkonen, 1996; Waddell and Burton 2006).
The Royal College of Occupational Therapists (RCOT) and Public Health England (PHE) share a common aim to close the disability employment gap and support people who wish to remain in work or return to work after illness, injury or disability. Hence, they have jointly set up the Health and Work Champions Project, which features peer-to-peer education to shift healthcare culture in relation to work and health. This project features as an example of good practice in both the original Government Green paper about employment and disability (DWP and DH 2016) and the follow-up command paper Improving Lives: the Future of Work, Health and Disability (DWP and DH 2017).
Research suggests that unhelpful misconceptions around work and health can sometimes be reinforced by healthcare practitioners, who may consider that giving advice to refrain from work is part of their duty of care (Wade and Halligan, 2004; Mowlam and Lewis, 2005; Pires et al, 2006). Healthcare professionals’ attitudes and beliefs in this area may influence the outcome of rehabilitation (Bishop, 2008) and it is reported that they do not routinely address work issues (Moore, 2011).
A shift is therefore required that would see it become routine practice across healthcare to use employment as a useful functional outcome of healthcare interventions and a clinical tool for assessing a patient’s/service user’s recovery/or adaptation to illness or injury. Asking questions about staying in or return to employment will become standard practice for all healthcare professionals. The project aimed to use Health and Work Champions to facilitate the shift while also providing the Champions with leadership roles in their employing organisations to raise their profile and utilise their expertise in occupation, health and wellbeing.
Evidence suggests that most health care professionals tend to base practice decisions on entry-level education and personal experience (Schreiber et al, 2005). They typically solve clinical problems through consulting with their peers and opinion leaders before examining empirical evidence, which supports the choice of a Champion’s model with opportunities for interpersonal interaction, when promoting quality improvements in routine clinical practice (White, 2011). “