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Fit For Work EuropeThe Work Foundation

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Archive for the ‘Policy’ Category

Care planning and musculoskeletal conditions in the UK

Wednesday, December 3rd, 2014

Commenting on the NHS Mandate and the latest findings of Arthritis Research UK, Dr Laura Boothman, Policy Manager, says:

“Our new analyses of national survey data indicate that, despite the Mandate commitment, just 12% of people with a musculoskeletal condition currently have a care plan. There is an opportunity for many more people to benefit.” Read more on The Work Foundation blog.

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Posted in Early Intervention, Europe, Musculoskeletal Disorders, Policy | Comments Off on Care planning and musculoskeletal conditions in the UK
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Fit for Work Europe Preparing for the Latvian Presidency of the EU Council

Tuesday, July 22nd, 2014

On 1st January 2015 the Latvian Government assumes the Presidency of the EU Council. It does so at a crucial time, with economic recovery painfully slow and unevenly distributed among EU Member States, and with jobs (especially for the young) and productivity all high on the agenda. In addition, the new Commission will still be very new and only just beginning to establish its core priorities. This places the Latvian Presidency in a potentially very interesting position and, last week, I spent two days in the beautiful capital city of Riga meeting members of our Latvian Fit for Work Coalition and Health Ministers in the Latvian Health Ministry to discuss ways in which Fit for Work Europe can play an active part in shaping the priorities and content of the Latvian Presidency.

Daiga Behmane - Project Lead, Fit for Work Latvia

Daiga Behmane – Project Lead, Fit for Work Latvia

My visit was hosted by Daiga Behmane, Project Leader of the Latvian Fit for Work Coalition, President of the Latvian Association of Health Economics and lecturer at Riga Stradins University. Daiga brings considerable experience and insight to the work of the Coalition and is well-placed to bring the Fit for Work messages alive to stakeholder in Latvia about early intervention, the need to prioritise health as a clinical outcome and the need to regard health spending which leads to improved workability as an investment rather than a cost. These were some of the messages which Daiga and I took to the Deputy Under-Secretary of State for Health, Egita Pole, and some of her senior officials. We discussed whether some of these principles might be reflected in the priorities of the Latvian Presidency as well as our plans to run a high level event on chronic conditions and work – featuring MSDs – as part of the Presidency programme.

In other meetings I enjoyed an excellent discussion with Prof Daina Andersone of Pauls Stradins Clinical University Hospital, a very eminent Latvian rheumatologist who has strong views about the need to treat young people with inflammatory MSDs as early as possible to help them manage their conditions and successfully move from education to employment. I also met with Dr Jelena Reste. Jelena is an Occupational Physician at Riga Stradins University and a member of the Latvian FfW Coalition. She has been conducting research on MSDs in Latvia and has access to some useful data and research on the prevalence of MSDs in Latvia’s working age population. She and her colleagues have been doing some excellent research on workplace interventions as well as a project on the cost-effectiveness of self-management initiatives.

The challenge for Latvia is that state spending on healthcare has recently fallen below 3 per cent of GDP – a low figure compared with many other countries. This makes it more difficult to make persuasive arguments that investing in workforce health in the short-term will bring wider economic and social benefits in the medium-term. Despite this, the Fit for Work Coalition in Latvia is well-positioned and well-respected and we hope that the weight of evidence and good examples from both within and outside Latvia will help show that prevention – especially in the case of workforce health – is better than cure. For more details on our recommendations for the health and work officials in Latvia you might want to take a look at our evidence-based report.

>> Take a look at our Position Paper for the Latvian Presidency of the EU Council.

>> Daiga Behmane spoke at the Fit for Work 2013 Summit in October. You may check her presentation here.

>> Follow us on Twitter @FfWEurope  @StephenBevan

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Posted in Europe, Health Economics, Health Policy, Labour policy, Musculoskeletal Disorders, Policy | 1 Comment »
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Thank you for sitting, Europe! It costs €240 billion a year.

Wednesday, April 9th, 2014

The tentative and delicate green shoots of economic recovery are just about visible across some EU Member States. But a major driver of sustainable economic growth and recovery across the EU will be the speed with which these Member States can mobilise and deploy highly skilled, resilient and healthy workforces and rely on them to help deliver productivity growth and increased competitiveness. One challenge is that ageing workforces across the EU are also more likely to be constrained by a growing burden of chronic conditions which threatens work ability, productivity, social inclusion and labour market participation. Chief among these chronic conditions are musculoskeletal disorders (MSDs)… continue reading on the Hanover Blog

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Posted in Early Intervention, Europe, Health Policy, Musculoskeletal Disorders, Policy | Comments Off on Thank you for sitting, Europe! It costs €240 billion a year.
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Widening the gap of inequality. MSD – the forgotten non-communicable disease.

Thursday, February 6th, 2014

DG SANCO announced that it is going to host a summit in Brussels this April to debate innovative solutions to the growing burden of chronic diseases on the health care systems and the economy. Surprisingly enough, musculoskeletal disorders are not on their agenda. A door slammed in the face of 100 million European citizens suffering from musculoskeletal pain – one might say. To give you an idea of the dimensions of the problem, this figure is comparable with the aggregated population of Belgium, Germany and Austria. Actually, in excess of 40 million people are of working-age and have an MSD cause by their work. To make things worse, evidence-based studies conducted within Fit for Work Europe, through The Work Foundation, and elsewhere by organisations such as Eumusc.net and even the European Commission, show that the EU economy loses €240bn to MSD annually. MSD is also the leading cause of sickness absence in the EU, accounting for half of all absences from work lasting three days or longer and 60% of permanent job loss.

Yet the European institutions seem to have turned a blind eye to MSDs. Neither the European Commission, nor the World Health Organisation classifies MSDs as serious non-communicable diseases. Why is that? One can speculate that MSDs, unlike cancer, diabetes or cardiovascular diseases, are not considered to be a major cause of death. It is a fact, though, that MSDs can seriously contribute to the increase of mortality rates. People living with an MSD incur the risk of developing other conditions such as mental health problems – 30% of people with MSDs also have depression – obesity and cardiovascular diseases.

Allegedly, policy-makers have given little priority to MSDs because of insufficient cross-country data. One might argue that most people with MSDs are treated in outpatient settings and that most health information systems are rather designed to provide data about inpatient care.  It could also be claimed that MSD diagnoses are recorded differently in various member states, which makes it difficult to draw comparable conclusions. However, in recent years considerable progress has been made in capturing and processing comprehensive data related to MSDs. To name just a few sources, the Global Burden of Diseases and Eumusc.net have released hefty reports on the societal and economic impact of MSDs.

In addition, Fit for Work Europe has been working for five years now to promote the prioritisation of MSDs amongst the most harmful non-communicable diseases and the implementation of healthcare and workplace interventions that support  job retention and return to work for people living with MSDs. With an evidence base of over 30 studies conducted in Europe, Fit for Work is currently testing practical solutions to MSDs in several members states (Spain, the UK, Latvia, Portugal, Lithuania). 

The first results of the Early Intervention pilot that ran in Spain clearly indicates that an earlier, more sustained recovery for working age citizens suffering from MSDs can highly contribute towards increased cost savings for the economy, easing the strain on the health care systems and increasing the labour market participation. As featured in the Parliament Magazine (p. 27), the Spanish pilot showed a 50% reduction in permanent work disability (people leaving work completely), a 39% decrease in temporary work disability (people having sick days from work as a result of their condition) and a 40% reduction in sanitary costs. In addition, it highly increased patient satisfaction, whilst the cost-benefit analysis revealed a two-year return of more than €10 for each €1 invested in the programme.

Fit for Work summons DG SANCO not to be oblivious to an innovative solution like Early Intervention, which could benefit not only the Europeans living with MSDs, but also people with other chronic conditions such as cancer, diabetes, cardiovascular and mental health disorders.

>>> Check independent expert opinions about MSDs and Early Intervention featured in a video from the Fit for Work 2013 Summit

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Posted in Early Intervention, Europe, Musculoskeletal Disorders, Policy | Comments Off on Widening the gap of inequality. MSD – the forgotten non-communicable disease.
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New study reveals intervention that could significantly reduce impact of one million EU workers needlessly off sick each day

Wednesday, October 16th, 2013

An extra one million employees could be at work each day if early interventions were more widely accessible for people with musculoskeletal disorders (MSDs) such as back pain. This is according to a new report from the Fit for Work Europe Coalition, written by The Work Foundation and published today (16 October) at a summit in the European Parliament, Brussels, endorsed by the Lithuanian Presidency of the EU Council.

With many EU member states on track to see 50% of their population diagnosed with an MSD by 2030, the report warns that early treatment for MSDs must be prioritised in order to tackle this growing problem. But it also shows how permanent work disability could fall by 50% if a tried and tested model were to be followed across different countries.

The leading cause of sickness absence across the EU, 44 million workers now have MSDs – including back pain and strains of the neck, shoulder and arms. This costs up to €240bn annually in lost productivity and sickness absence, representing up to 2% of GDP across the EU. The report calls on EU member states to coordinate action between government departments, employers and clinicians to tackle this problem and save billions while transforming the lives of those affected by such devastating conditions.

As our analysis shows, access to early healthcare interventions for workers with MSDs are not being prioritised,” said Professor Stephen Bevan, Founding President of the Coalition – a group representing physicians, patient organisations, economists and researchers promoting policies to improve workforce health. “Thousands are taking unnecessarily long periods away from work or even leaving work permanently when tried and tested tactics could be helping to speed up their recovery and return to work,” he added.

Using data from a two-year trial of a successful early intervention clinic for people with MSDs in Madrid, Spain, the Fit for Work Europe Coalition has developed estimates of the effect of repeating its results across 12 EU member states where comparable data exists.

By assessing and treating 13,000 workers with MSDs after five days of sickness, the Madrid clinic succeeded in reducing temporary work absence by 39% and permanent work disability by 50%. The report explores the implications of these findings on 12 EU member states and estimates how they would affect all 28 EU member states.

Professor Steve Bevan, who is also a director at The Work Foundation continued, “If these results were repeated across the whole of the EU, we estimate that up to one million workers would be available to work each day. This would be a considerable boost to productivity and significantly reduce sick pay bills at a time when member states are under pressure to make savings and increase economic growth. Even if the reduction in absence achieved were 25% rather than 39%, we estimate that in excess of 640,000 extra workers would be available for work each day.

The analysis, led by Professor Juan Jover, shows that if the Madrid results were repeated across Spain, where 26m working days are lost to MSDs each year, over 46,000 Spanish workers would be available for work each day instead of on sick leave. As the table below indicates, the numbers for 11 other EU member states are equally striking. For example, in Germany, the 217 million working days lost each year to MSDs could be reduced by around 480,000 (39%) if the Madrid clinic results were replicated – or by over 300,000 (if a more conservative estimate of 25% were achieved).

Purification Tejeda, a patient suffering from extreme pain from carpal tunnel syndrome, described how she benefited from the support of an early intervention clinic: “I was so scared about the impact it would have on my personal working life. I was given the right diagnosis, treatment and care very quickly and this helped to take away my unbearable pain. Thanks to this clinic, I can go back to work again. Work is so important to me. It makes me feel useful and responsible. I feel alive again.”

The full findings of the research is being presented at a summit  hosted by the Fit for Work Europe Coalition taking place at the European Parliament today (16 October). It will be attended by the Lithuanian Minister for Health of the EU and international delegates from welfare and health government departments, businesses and healthcare organisations.


Table showing data from 12 member states (70% of the EU workforce)

As the way patients are referred to early intervention services varies considerably between countries, this data is based on a more cautious estimate scenario of 25% instead of the 39% improvement rate achieved in the Madrid clinic. Nonetheless, the number of lost working days avoided even in this conservative estimate would still be substantial and show the significant impact that wider access to early intervention could have across the EU.   


Country Days lost to MSDs each year Number available to work if Madrid results replicated Number available to work with just a 25% reduction
Germany 217m 479,973 307,675
UK 35m 62,045 39,773
Spain 26m 46,091 29,545
Poland 21.7m 38,538 24,704
France 13.4m 23,724 15,208
Austria 7.7m 13,650   8,750
Ireland 7m 12,409   7,955
Finland 5.15m  9,142   5,860
Romania 3.15m  5,594   3,586
Slovenia 2.47m  4,379   2,807
Greece 1.2m  2,472   1,584
Estonia 1.02m  1,815   1,164
TOTAL 340.79m  699,832 448,610

Notes to editors

  1. An infographic (attached) is being launched at the 5th Fit for work Europe Summit, Investing in Healthcare: Breaking down the silos in the European Parliament, Brussels on 16 October 2013. This will be available from 14.00hrs CET on 16 October 2013 or from The Work Foundation media team in advance.
  2. Professor Stephen Bevan, Founding President of Fit for Work Europe and a director at The Work Foundation along with Fit for Work Co-presidents, Antonyia Parvanova MEP, Dame Carol Black and Professor Paul Emery are available for interviews, comments and briefings.
  3. Fit for Work Europe is a multi-stakeholder Coalition, driving policy and practice change across the work and health agendas. We aim to deliver more investment in sustainable healthcare by promoting and implementing early intervention practices. Research shows this approach is the most effective way of ensuring people with MSDs (musculoskeletal disorders) can enter and remain in work across the EU and globally.
  4. Fit for Work Europe is a project led by The Work Foundation, supported by AbbVie and GE Healthcare. For more information, please visit, www.fitforworkeurope.eu
  5. The Work Foundation aims to be the leading independent, international authority on work and its future, influencing policy and practice for the benefit of society. The Work Foundation is part of Lancaster University – an alliance that enables both organisations to further enhance their impact.
  6. AbbVie is a global, research-based biopharmaceutical company formed in 2013 following separation from Abbott. The company’s mission is to use its expertise, dedicated people and unique approach to innovation to develop and market advanced therapies that address some of the world’s most complex and serious diseases. In 2013, AbbVie employs approximately 21,000 people worldwide and markets medicines in more than 170 countries. For further information on the company and its people, portfolio and commitments, please visit www.abbvie.co.uk.
  7. GE Healthcare provides transformational medical technologies and services to meet the demand for increased access, enhanced quality and more affordable healthcare around the world.  GE (traded as NYSE: GE) works on things that matter – great people and technologies taking on tough challenges. From medical imaging, software & IT, patient monitoring and diagnostics to drug discovery, biopharmaceutical manufacturing technologies and performance improvement solutions, GE Healthcare helps medical professionals deliver great healthcare to their patients. Please visit www3.gehealthcare.com.


Media enquiries:

Ioana Piscociu +44 20 7976 3526  ipiscociu@theworkfoundation.com


Angelo Evangelou +44 207 976 3597  aevangelou@theworkfoundation.com

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Posted in Early Intervention, Europe, Health Economics, Health Policy, Labour policy, Policy | Comments Off on New study reveals intervention that could significantly reduce impact of one million EU workers needlessly off sick each day
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Good Health? Yes Minister – whatever your portfolio

Tuesday, October 15th, 2013

It may sound trite, but the old saying that ‘every minister should be a Health Minister’ has never been more true than today. It’s obvious, to me at least, that ministers overseeing planning and transport policy, for example, should be thinking about the opportunities they have to help citizens walk or cycle safely. Finance Ministers should consider whether some citizens’ wellbeing is disproportionately compromised by austerity measures and Employment Ministers should routinely think about ways of helping those with chronic ill health or disabilities have access to fulfilling working lives if they aspire to them.

All sounds very utopian, doesn’t it? Yet if we are to develop more strategic and joined-up approaches to preventative public health, this is exactly the kind of thinking that we need to encourage among policymakers across all developed Western economies. The fact that we are doing everything we can to minimise, control and reduce healthcare costs is a sign of the austere and narrowly-focused times we live in and perhaps we should think more about where we ‘invest’ for longer term benefit rather than just cutting to hit a short-term budget target. Currently, spending on preventative healthcare across all EU member states represents only 3% of the total, while over 70% is spent on managing the care of people with chronic conditions – an increasing number of whom will be of working-age. Unless we find ways of investing in proactive and joined-up health initiatives which are about town planning, employment and public health, we will find that the much-celebrated capacity of our health system to treat people once they become ill will run out of resources.

This week in Brussels, The Work Foundation, through our Fit for Work Europe Coalition, is hosting a major summit on this very theme. Called Investing in Healthcare: Breaking down the Silos, endorsed by the Lithuanian Presidency of the EU and featuring contributions from eminent speakers such as Vytenis Andriukaitis, Health Minister, Lithuania,  Dr Roberto Bertolini of the World Health Organisation Europe; Dame Carol Black, Co-President of the Fit for Work Europe Coalition; Gianni Pittella, Vice-President, European Parliament  and Dr. F. Jesús Alvarez Hidalgo, Principal Administrator, Unit Heath, Safety and Hygiene at Work, DG EMPL,  European Commission  this event will highlight examples from across the EU of innovative thinking which suggests that a ‘Health in all policies’ approach may still be possible and certainly desirable.

Our specific interest in this event is to showcase what can happen if the health needs of people of working-age are prioritised so that they can benefit from quicker diagnosis, earlier interventions which allow them to remain active in the labour market and support from employers which allows them to access and flourish in good quality and secure jobs. We will hear examples from Latvia, Sweden, Ireland, Spain and Germany. We’ll also be challenging policymakers both in Brussels and in national governments to act now to break down policy thinking in silos which prevent joined-up and forward-looking action which just might stand a chance of defusing the public health time bomb which we all know is ticking away.



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Posted in Musculoskeletal Disorders, Policy, The Work Foundation | Comments Off on Good Health? Yes Minister – whatever your portfolio
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Fit for Work Estonia call on government to better support workers with musculoskeletal disorders

Thursday, January 24th, 2013

Late last year, Fit for Work (FfW) Estonia took part in a debate to discuss how people with musculoskeletal disorders (MSDs) can be supported by policymakers to stay in and return to work to coincide with the publication of FfW Estonia.

Over a hundred people took part in a lively debate which took place in Tallin. We were pleased to see a large number of high-level policymakers involved in the debate, such as Hanno Pevkur, the Minister of Social Affairs; Andres Tsahkna, the Head of Estonian Parliament Health Board and Peeter Ross, the Head of the Estonian Health Insurance Fund.

The debate explored recent findings which reveal that chronic diseases in Estonia cost the economy 27.2 million. Over two-thirds (68.7%) of this is due to reduced working hours and absences from work.

Despite this compelling evidence, policymakers in Estonia rarely recognise how work can contribute to improved health outcomes and economic returns. So it was welcome progress when Estonian MP, Andres Tsahkna, pledged his commitment to continue a relationship with the newly established FfW Estonia Coalition to improve work outcomes for people with MSDs.

The event featured FfW Europe Coalition member Professor Ingemar Petersson and captured the expertise of rheumatologists, rehabilitation doctors, clinicians, occupational health practitioners and e-health authority representatives. It also included powerful personal testimony from those with personal experience of MSDs demonstrating how the impact of such conditions can be reduced through the right kind of support.

The resounding conclusion was that chronic conditions are presenting a massive burden on the Estonian social and healthcare systems. Barriers preventing people with MSDs from working will only be broken down through early intervention and comprehensive national plans which improve the management of chronic diseases.

As the constructive debate drew to a close, Professor Petersson concluded, “If the FfW Estonian Coalition continues working along the lines we have seen today, within a couple of years the situation for Estonian patients will be much better.”

Posted in Europe, Policy | 1 Comment »
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Fit for Work Down Under

Monday, May 14th, 2012

The influence of Fit for Work research now extends far beyond Europe with our study of MSDs in Australia being published on 13th May at the annual conference of the Australian Rheumatology Association in Canberra. Despite having been hit less severely  by the economic crisis, the Australian labour market is still being affected and it is timely to take a look at the effect of  musculoskeletal conditions on the workforce.

Our research showed that:

– Almost 2.2 million (14.7 per cent) of working age Australians report a disability and almost a quarter of them experience
profound or severe core activity limitations. It is estimated that people with chronic conditions in Australia are 60 per cent less likely to participate in the labour market.

– Work-related injuries and diseases cost the Australian economy $57.5 billion in 2005-2006, representing 5.9 per cent of GDP. At least 43 per cent of all work-related injury/disease compensation claims resulted from cases of MSDs

– Up to 31.9 per cent of Disability Support Pension claims result from musculoskeletal and connective tissue disorders

– It is estimated that MSDs cost the Australian health care system almost $4.6 billion a year.

– Back pain, back problems and disc disorders are very common complaints in Australia, affecting nearly 2.8 million people, or 14 per cent of the Australian population.

– Rheumatoid Arthritis (RA) is the second most prevalent form of arthritis in Australia, affecting at least 2 per cent of the population and accounting for 4 per cent of the total expenditure on MSDs. Only 31 per cent of those with RA are in full-time employment, compared to 53 per cent of the general population in Australia

As with our research in many other countries, we found that earlier diagnosis and intervention could help more Australian workers with MSDs to remain in our return to work and that work participation and productivity – as well as quality of life – could be improved through more ‘joined-up’ effort between Government, healthcare professionals and employers. We are hopeful that  policy-makers and opinion-leaders across Australia will heed our messages and redouble their efforts to prioritise work as a clinical outcome for workers with MSDs.

Posted in Asia-Pacific, Health Policy, Labour policy, Policy | Comments Off on Fit for Work Down Under
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New FfW thought piece on the place of work in healthcare decision making

Friday, October 21st, 2011

FfW Europe Co-President, Stephen Bevan, and independent health economist, Leela Barham, discuss pros and cons of taking a wider societal perspective in healthcare decision-making, and possible reasons why work and labour market participation are rarely included in the remit of Health Technology Assessment.

The Place of Work in Healthcare Decision Making

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New FfW Coalition briefing paper: Maximising Employment & Social Inclusion in the EU

Monday, October 17th, 2011

Steve Bevan, Founding President, Fit for Work Europe Coalition, publishes new briefing paper – ‘Fit for Work? Maximising Employment and Social Inclusion in the EU.’ The paper examines the case of workers with MSDs.

Fit for Work_ Maximising Employment and Social Inclusion in the EU

Posted in Europe, Health Policy, Labour policy, Policy | Comments Off on New FfW Coalition briefing paper: Maximising Employment & Social Inclusion in the EU
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Fit for Work Europe Annual Conference – don’t miss out!

Thursday, October 13th, 2011

FfW Conference 2011 Reminder

Posted in Europe, Health Economics, Health Policy, Labour policy, Musculoskeletal Disorders, Policy | Comments Off on Fit for Work Europe Annual Conference – don’t miss out!
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FfW Conference 2011 Agenda

Monday, September 19th, 2011

Fit for Work Europe – Annual Conference – 19 October 2011 Event Agenda

Posted in Europe, Health Economics, Health Policy, Labour policy, Musculoskeletal Disorders, Policy | Comments Off on FfW Conference 2011 Agenda
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Launch of Fit for Work Report in Poland

Monday, September 12th, 2011

On Thursday my colleague Ksenia Zheltoukhova and I were proud to launch the latest Fit for Work report at the Economic Forum in Krynica-Zdrój in southern Poland. We hope that the findings and recommendations of our research will increase awareness and provide a foundation for action at a national level. Now that Poland has assumed the Presidency of the European Union (EU), it has a unique opportunity to lead positive changes in the way the societal burden of chronic disease and work-related health conditions are managed. The Polish Presidency will also see the publication of a new EU Directive on Musculoskeletal Disorders (MSDs) at work, which provides another opportunity to put these issues under the spotlight.

So what is the impact of MSDs in Poland and what can be done to improve the situation?

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Lech Wałęsa Endorses Fit for Work Poland Report

Monday, September 12th, 2011

A huge highlight of our visit to Poland this week was the opportunity to meet former President of Poland Lech Wałęsa. The President very kindly wrote a Foreword to our report and has endorsed its findings. He said of our report:

‘Fit for Work is an initiative to improve the quality of life of active workers. I am glad to learn that in times of economic crisis there are people who are willing to promote new ideas, ready to and capable of fighting for a better future.’

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Building alliances in Ireland – The Work Foundation and Arthritis Ireland go ‘Fit for Work’

Monday, May 17th, 2010

We continue to take the ‘Fit for Work’ messages to National Governments wherever we can. Already, since the launch of the Irish report, we have briefed two prominent Irish Government Ministers. We have, among other things, called for a National Clinical Director for MSDs together with the formulation of a National Service Framework on MSDs in order to cement the clinical and labour market priority which Ireland should be given to MSDs in Ireland.

Last week I was a ‘witness’ – together with John Church, CEO of Arthritis Ireland – at a session of the Oireachtas Committee on Enterprise, Trade and Employment in the Irish Parliament – the rough equivalent of a Select Committee here in the UK. I presented the Irish ‘Fit for Work’ report and John and I were questioned for an hour by several Deputies and Senators, who were very interested in the implications of our research for Irish labour market policy.

Earlier in the day Jim Higgins MEP hosted a lunch session in conjunction with Arthritis Ireland for TDs and other opinion-leaders which also focused on the findings and implications of the Irish ‘Fit for Work’ report. Chaired by John Church, the audience heard presentations from Mr Higgins who focused on the growing awareness of the MSD issue in Brussels and Geraldine McCarthy, and eminent Rheumatologist. I also presented the main Fit for Work report findings and talked the audience through our main recommendations. A good debate followed which, among other things, covered the wider labour market status of people with disabilities, the potential for a UK-style ‘Fit Note’ in Ireland and the impact of Health Technology Assessment on access to drug therapies for Rheumatoid Arthritis.

There is a real sense of momentum in Ireland and clear evidence that many of the ‘Fit for Work’ messages are having an impact on the way policy-makers are thinking.

Posted in Health Policy, Labour policy, Musculoskeletal Disorders, Policy, Rheumatoid Arthritis, The Work Foundation | Comments Off on Building alliances in Ireland – The Work Foundation and Arthritis Ireland go ‘Fit for Work’
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Spain: Launch of Fit for Work Report

Monday, May 17th, 2010

The launch today of the Spanish Fit for Work report coincided with the announcement of the latest Spanish unemployment figures. They make grim reading, as predicted in our report, they passed the 20 per cent threshold which now means Spain has a level of joblessness exactly twice the EU average. What is worse, youth unemployment is close to 40 per cent, again the worst in Europe. On of the core Fit for Work messages has been that we need to avoid people with long-term or chronic health conditions becoming the first victims of a depressed labour, yet that is what seems to be happening both in Spain and elsewhere.

Posted in Europe, Policy | Comments Off on Spain: Launch of Fit for Work Report
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Spanish Launch – Salud y Trabajo!

Friday, May 14th, 2010

The launch today of the Spanish Fit for Work report coincided with the announcement of the latest Spanish unemployment figures. They make grim reading, as predicted in our report, they passed the 20 per cent threshold which now means Spain has a level of joblessness exactly twice the EU average. What is worse, youth unemployment is close to 40 per cent, again the worst in Europe. On of the core Fit for Work messages has been that we need to avoid people with long-term or chronic health conditions becoming the first victims of a depressed labour, yet that is what seems to be happening both in Spain and elsewhere. (more…)

Posted in Europe, Policy | Comments Off on Spanish Launch – Salud y Trabajo!
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Do HTA differences help or hinder accessibility?

Wednesday, November 18th, 2009

I attended a lunchtime Roundtable event yesterday organised by the European Policy Centre  here in Brussels. The speaker was Dr Martin Terberger, Head of Unit for Pharmaceuticals at DG Enterprise and Industry. While the focus of the discussion was the so-called ‘Pharma Package’ a set of EU proposals to deliver safe, innovative and accessible medicines, I was able to ask Dr Terberger a question about the impact which differences in Health Technology Assessment (HTA) helped or hindered accessibility, especially if one outcome was to support the labour market participation of people with long-term or chronic conditions (eg some MSDs).

He was careful to avoid using the term ‘harmonisation’ but felt that, on the science, there was more room for ‘convergence’ around the clinical evidence. He warned, however, that HTA must take care not to widen health inequalities by treating more economically ‘useful’ patients differently from, for example, elderly patients just because of differences in their productive capacity.

Posted in Europe, Health Policy, Musculoskeletal Disorders, Organisations, Policy, The Work Foundation | Comments Off on Do HTA differences help or hinder accessibility?
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Bringing Fit for Work to the House of Commons

Friday, October 16th, 2009

On Tuesday, Dame Carol Black and I participated in a Roundtable event in the House of Commons – the seat of the British Government.  This was a well attended, lively event and I was given the opportunity to make the following speech about the Fit for Work programme:

“For last 18 months The Work Foundation has been conducting research across 23 countries examining the impact of MSDs – including Inflammatory Diseases – on labour market participation. Rheumatoid Arthritis (RA) was one of the conditions we examined in detail because we know that levels of work disability and withdrawal from the labour market are high among people with RA – up to 40% within 5 years of diagnosis.

We’ve been looking at the direct and indirect costs of sickness absence from work and of permanent work incapacity attributable to RA. We have also looked at the interventions which Governments, clinicians and employers can take which can keep people with RA attached to the labour market and help them lead fulfilling working lives and make their contribution to a productive economy.

We launched our report in Brussels two weeks ago and we are trying to influence both National Governments and the European Commission to support steps which maximise the Labour Market participation of people with RA. We are doing some of this Advocacy work in collaboration with EULAR.

A key issue (one of many) is that current employment legislation in EU does not recognise MSDs which are not caused by work. Manual handling (CLBP) and Display screen equipment (WRULDs) are in scope – but the duty of care to support those with pre-existing conditions – such as RA – where poor working conditions can make these conditions worse, is currently out of scope.

Good Work is good for health: this includes control over tasks, control over pace & time; manageable physical work demands & an ergonomically suitable working environment; flexibility of working time.

We must reverse the focus of policy & practice from Incapacity to Capacity – the UK ‘fit note’ idea is intended to reinforce this message.

People with MSDs – including RA – can also experience periods of depression or anxiety which can complicate the process of returning to work. Policy-makers, clinicians & employers need to build this into the way they manage job retention & return to work (RTW).

Up to 30% of people with RA avoid disclosing their condition to their employer or colleagues – part of the self-stigma experienced by many.

Early Interventions can be critical, for example:

  • Accurate & early diagnosis
  • Early access to treatments and therapies – especially if early symptoms can be arrested and remission achieved
  • NAO data shows that early treatment brings economic & productivity benefits
  • TWF shows that early intervention can prolong careers and delay premature withdrawal from the labour market and that there is an economic ‘premium’ to early intervention.

There is considerable political focus on incapacity in the UK at the moment, especially as we are seeking to reduce public expenditure. However, as long as the debate has a punitive tone and is dominated by speeches and newspaper articles which focus on getting the feckless & ‘workshy’ off benefits and back into work, we are going to struggle to address the far more serious issue of how we avoid people with long-term and chronic health conditions becoming detached from the labour market until way after this recession is over.

During the Fit for Work study I’ve met hundreds of people with RA and other inflammatory conditions. None have been feckless or ‘workshy’. Most have been energetic, passionate, proud, determined, analytical, resourceful and dignified. I have been privileged & humbled to work with them & I am all too aware of the talent that goes to waste if people like this are lost to the world of work.”

Posted in Early Intervention, Health Policy, Musculoskeletal Disorders, Organisations, Policy, Rheumatoid Arthritis, The Work Foundation | 1 Comment »
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Is the next UK Government Fit for Work?

Friday, October 9th, 2009

Here in the UK the three main Political Parties have just completed their annual conferences – all anticipating a General Election next year and all seeking to highlight ‘eye-catching’ policy announcements. Yesterday afternoon David Cameron – leader of the Conservative Party – set out his vision for the next few years assuming he becomes our next Prime Minister.

During his speech he told the story of a man who has been signed off sick from work. He would like to work but instead he has just been put on Incapacity Benefit and forced to stay home. Could it be that this issue is becoming ‘mainstream’ at last?

Certainly, and for the last few weeks, the issue of long-term sickness and work incapacity has been high on the political agenda – though this has not always been the most enlightened of debates, as my article in the Times on Wednesday suggested.


With the launch of the European Fit for Work report last week in Brussels, The Work Foundation is placing itself at the centre of the debate on work incapacity. We are calling for an enlightened and proactive approach to the management of long-term and chronic conditions among the working age population.

Yesterday, The Work Foundation briefed HM Treasury Minister Stephen Timms on our work in this area. Even after completing our research, there is still plenty of work to do to take our core messages and our call to action to opinion-leaders and decision-makers!

Please show you support by downloading and reading our call to action and pledge to get Europe Fit for Work!

Posted in Health Policy, Musculoskeletal Disorders, Policy, The Work Foundation | Comments Off on Is the next UK Government Fit for Work?
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Show Your Support

Wednesday, October 7th, 2009


Read or download our call to action and pledge to get Europe Fit for Work!

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Posted in Early Intervention, Europe, Health Policy, Labour policy, Musculoskeletal Disorders, Policy, Rehabilitation, Rheumatoid Arthritis, The Work Foundation | Comments Off on Show Your Support
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