18 February 2012: Fit for Work UK (FfW UK) has today submitted its response to NICE’s consultation on the draft Quality Standard for rheumatoid arthritis, the set of criteria designed to drive and measure priority quality improvements for rheumatoid arthritis patients.
FfW UK welcomes many aspects of the Quality Standard, including its commitment to annual reviews of patient condition and the provision of self-management and educational support for patients. However, FfW UK raises concerns that despite the Government’s commitment to optimise employment outcomes of individuals with long-term conditions and the inclusion of ‘employment of people with long-term conditions’ as an indicator in the NHS Outcomes Framework, these regulations have not yet translated into clinicians’ day-to-day practice.
This is worrying as FfW UK’s study of 809 people diagnosed with a musculoskeletal disorder (MSD), published in December 2012, shows that maintaining work is a significant problem for people with MSDs. Three quarters of respondents to the survey who were retired said their condition had influenced their decision to leave the labour market, with the majority retiring before reaching the age of fifty-five. Within three years of diagnosis, half of people with rheumatoid arthritis are registered as work disabled. Inability to stay in work may have a further spillover effect into the wellbeing and financial stability of entire households. In the FfW UK study, 57.4 % of respondents who were not in work had been primary income earners before leaving their job.
FfW UK therefore proposes that NICE should enhance the service standards for diagnosis and management of rheumatoid arthritis by including in the Standard a measure of employment outcomes of individuals with rheumatoid arthritis, expressed as change in the proportion of people with rheumatoid arthritis in paid and unpaid work year on year. A local Clinical Commissioning Group measuring workability in a pilot study has highlighted the benefits of managing work outcomes in the primary care settings.
Professor Stevan Bevan, Chair of Fit For Work UK, commented:
“Employment is valued by many individuals living with rheumatoid arthritis, and those who are willing to continue working must be supported in their ambition. Too often such supports arrives unnecessarily late, when progress of disease may be hindering work ability and limiting job choices. Clinicians in primary and secondary care should be encouraged to monitor and manage work outcomes of patients with rheumatoid arthritis so as to maximise employment opportunities and improve quality of life for these individuals.”
Fit For Work UK is a campaigning coalition established in 2011 with the aim of promoting the awareness and treatment of musculoskeletal disorders (MSDs) so that they are treated and understood as manageable conditions – not disabling conditions. The Coalition brings together healthcare professionals, policy makers, employers, and patient representatives.