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August 19, 2010

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Three-year window to stop long-term sickness absence

The Government should be concentrating on trying to keep those currently vulnerable to long-term sick leave in work, rather than focusing on getting people who are already on long-term benefit back in employment.

This is the view of Professor Jill Morrison, who has carried out new research suggesting that people on long-term incapacity benefit because of mental-health problems could be identified by their GPs three years before they stop working.

The number of people claiming incapacity benefit and severe disablement allowance in the UK has increased by more than 300 per cent in the last 30 years, according to 2007 research for the Department for Work and Pensions, and Dame Carol Black has estimated the annual cost of long-term sickness absence to the UK economy at around £100 billion.

Professor Morrison, from the University of Glasgow’s School of Medicine, led a team of researchers from Manchester and Stirling universities and the NHS to examine variation in the prevalence of claims for incapacity benefit across general practices. The team also investigated whether it is possible to identify people with mental-health problems who are more at risk of becoming dependent on incapacity benefit based on their pattern of consulting behaviour in the doctor’s surgery.

They looked at data from the 1995, 1998 and 2003 Scottish Health Surveys and from the 1991-2007 British Household Panel Survey.

In contrast to previous research, which has suggested that huge inconsistencies exist in sickness-absence certification by GPs, Professor Morrison’s study concluded that no significant variation between general practices in levels of incapacity-benefit claimants existed “once population differences were taken into account”.

The results also pointed to a significant increase in the frequency of GP consultations for patients with mental-health problems in the three years prior to them claiming incapacity benefit.

However, the researchers concluded that, once such people are identified, “it is not clear what GPs can do to maintain these patients in work, if that is the most appropriate outcome for individual patients. Further work should concentrate on determining what outcomes are achieved by GPs who provide additional emotional or occupational support for patients identified as at risk of becoming dependent on long-term benefits.”

On the back of the research, Professor Morrison believes the current policy of getting people who are on long-term benefit back to work may not be very effective, as a large proportion of people on long-term sick leave are unlikely to return to employment. Instead, she argues that it would be better to identify patients who are currently at risk of ending up on long-term benefit and focus on keeping them in work.

She explained: “There will always be a proportion of people who are at such a low ebb that, unless there is a drastic improvement, it will be very difficult for them to be able to work. If they stop working, there’s a vicious circle where they have financial problems, and that brings on new worries and problems.

“The Government is looking at targeting people on the margins who, with extra support or encouragement, may be able to return to work. But I don’t think you can ever eradicate the problem.”

Her view was echoed by Dr Sayeed Khan, chief medical advisor for the EEF, who agreed that it is much better to focus on supporting people with mental-health problems, as well as those with chronic health problems and lung disease, stay in employment than trying to get them back into work once they have fallen into long-term unemployment.

Asked what can be done to ensure that people stay in work beyond the three-year risk period identified in the research, Dr Khan pointed out that the Royal College of General Practitioners had set up a National Education Programme on Health and Work for GPs to help doctors avoid signing patients off sick where possible.

To date, 2000 GPs have completed the training, which, according to Dr Khan, is focused on helping doctors “understand more about their patients’ needs and what their job entails to help them stay in work”.

The research is published in the British Medical Journal.

What makes us susceptible to burnout?

In this episode  of the Safety & Health Podcast, ‘Burnout, stress and being human’, Heather Beach is joined by Stacy Thomson to discuss burnout, perfectionism and how to deal with burnout as an individual, as management and as an organisation.

We provide an insight on how to tackle burnout and why mental health is such a taboo subject, particularly in the workplace.


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