ageing well in work a public health england and gmphn...
TRANSCRIPT
Ageing Well in Work
– A Public Health England
and GMPHN Project
Sam Haskell
Healthy Adults Policy Implementation Manager
Public Health England (PHE)
27 January 2015 – Continuing to Work event (Inclusion)
http://www.kingsfund.org.uk/sites/files/kf/media/how-is-the-new-nhs-structured.pdf
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Four regions, fifteen Centres
Eight Knowledge and
Intelligence Hubs – London
– South West
– South East
– West Midlands
– East Midlands
– North West
– North East, Yorkshire and the
Humber
– East
Other local presence – ten microbiology laboratories
– field epidemiology teams
– Centre for Radiation Control
units
Public Health England
Regional focus
“It is the working man who is the happy
man. It is the idle man who is the
miserable man.” Benjamin Franklin, C.18
“Being in good employment is
protective of health. Conversely,
unemployment contributes to poor
health.” Marmot Review, 2010
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• Is work good for you health and well-being?, Waddell & Burton (2006)
• Vocational Rehabilitation – What Works for Whom and When, Waddell, Burton and Kendall (2008)
• Working for a Healthier Tomorrow, Dame Carol Black, (2008)
• Fair Society, Healthy Lives, Michael Marmot (2010)
• Various NICE Guidelines, including:
The Existing
Evidence Base
- Promoting Mental wellbeing at Work (PH22)
- Managing Long-Term Sickness and Incapacity for Work (PH19)
- Workplace Interventions to Promote Smoking Cessation (PH5)
- Promoting Physical Activity in the Workplace (PH13)
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• 1 in 6 pensioners (1.8 million or 16% of pensioners in
the UK) live in poverty, defined as 60% of median
income after housing costs
• Low income in retirement is often linked to earlier low
pay, or time out of employment – i.e. due to caring
responsibilities, disability or unemployment
• Basic state pension and other benefits assist with this
to some degree
• ALSO to enjoy the health benefits of a good job
Ageing Well in Work
- The Context
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Changing UK Demographics
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• Increasing number of people
aged over 65:
2010 4.5m people (1 in 6)
2030 10 m
2050 19 m (1 in 4)
• 1 in 5 workers do not expect
to retire until they are over 70
• 1 In 3 UK workers will be
aged over-50 by 2020
UK demographics 2008-30
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Less than 50% of people
disability-free at 65 years
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Long-Term Conditions
and Unemployment
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• 40% ‘employment penalty’
(adjusted for qualifications
& demographics)
• Impact on health
(cumulative) and
employment prospects
• Impact on families (e.g.
19% live in poverty versus
15% for whole population)
Other Potential Challenges?
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Key Interventions – Ageing
Funding – Access to Work Grant
Legislation – Equality Act
Guidance…
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Ageing Well in Work:
Testing Strategy Concepts
Jan Hopkins Ageing Well in Work Project Manager
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To emphasise the role and importance that work plays in
recovery and condition management
To explore ways of helping people to remain active in
work as they age (even if they have chosen to retire) so
they can secure the health benefits of remaining active
To optimise the number of healthy years an individual
has after retirement and reduce the numbers of
people who leave work because of health issues 50+
Understand role of employers and HCP in supporting
workers to remain healthy and active
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Aims Of Ageing Well in Work Programme
Holistic definition: work includes caring,
volunteering, self employment, fostering,
mentoring and wider civic engagement
4 Themes:
o Workplace Adaptations
o Retirement Choices
o Managing Chronic Conditions in the
Workplace
o Managing an Older Workforce
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Illustrative Strategy
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Strategic
Change
Work is an important determinant of health
Work can aid recovery and improve condition
management
Early intervention may improve the health &
wellbeing of the population, delay retirement and
encourage active citizenship
Operational
Change
Managing health conditions in the workplace
Addressing needs of an ageing workforce
Promote health and wellbeing of the whole workforce
e.g. via Workplace Wellbeing Charter
Specific
Interventions
FFWS NHS Health
Checks
Health
Trainers
Expert
Patients
Early Intervention:
Think Across The
Life Course
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Old age is like everything else. To
make a success of it, you’ve got to
start young
Theodore Roosevelt
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A Life Course Approach
18 Source: GM Strategy
Prevention Is Better Than Cure Keeping people healthy and in work is easier, more cost effective
and better for health and wellbeing than getting long term
unemployed back into employment…or allowing individuals to slide
into inactivity
Older people take on average longer to regain employment
Inactive retirement may have a -ve effect on health
The journey to inactivity begins with a period of sickness
Sickness absence (all causes) can tip into inactivity and those are off sick
for 4-12 weeks have a 10-40% risk of still being off work at one year…Work
adjustments usually made after sick leave.
Volunteering improves cognitive functioning, healthy behaviours and life
satisfaction, delays early retirement and aids transition into out of work.
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Why Is Work So
Important?
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Work Is A Determinant Of
Health
It is very important that your workplace is
a healthy place… that you are in good
health to be in work. So work and health
are very connected and you really can’t
have one without the other. Work is a real
determinant of your health.
Dame Carole Black
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Good Work Is Good For Health And
Good Health Is Good For Business
Preventing people from falling out of work, helping
people to flourish at work and helping people get
into work are all essential
A third of new jobseekers allowance claimants reported that their
mental health deteriorated, while those who entered work reported
improved mental health .
Employees with a mental health condition, who remain in work
without the support they need, cost UK businesses around £15
billion a year. In the UK, stress-related disorders and mental strain
is responsible for the loss of 6.5 million working days each year
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Early exit from the workplace is a concern:
Health Matters?
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•1 in 7 of the over 50s provides informal care which increases
exit from the labour force due to caring responsibilities and
carer ill-health.
•Poor mental or physical health whatever its cause is
associated with early exit. Musculoskeletal conditions are the
primary cause of exit.
•Older workers who report depressive symptoms are at
increased risk of early transition out of work and might require
specific and additional attention.
Age
Management:
Managing an
older workforce
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Evolving Concept Of Age Management
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Typologies Of Age Management
• Decreasing Work Demands; Ergonomics, transition
to part-time pension, quit night shifts
• Enhancing Individual Resource/Resilience; Training,
work career guidance and health promotion
• Intergenerational Learning: management training
around age management, double staffing, reciprocal
learning e.g. seniors share craftmanship
• Life Course: age management applies equally to all
staff, supporting wellbeing of all staff and individual
based flexibility 26
The Value Of A Diverse And Healthy
Workforce
Foster intergenerational learning, they have corporate
memory and they have different customer facing
skillset.
For the employer; greater productivity, a boost in worker
morale, greater retention of staff, lower stress in the
workforce and therefore less absenteeism. There can
reputational +++ if protecting and promoting employee
health is formally recognised by means of awards.
Costs in terms of implementation.
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Age Management Everybody’s
Business
Age management needs to be addressed at the
individual (seek good employers), organisational (e.g.
age neutral recruitment) and societal levels (e.g
address ageism).
Plans need to be made with individuals early in their
career in their 40s and be reviewed regularly.
Successful implementation depends on buy in from
relevant stakeholders including; businesses,
management, trade unions and employees.
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Workplace Wellbeing Charter: Health
And Wellbeing For All
• A framework/tool to improve health and wellbeing of
all staff not just older workers.
• Workplace perfect setting since we spend most of our
waking day in that setting.
• Previously 30+ variations of the scheme across
England
• Launched in June 2014, these provide core content
for existing Charter schemes and a common baseline
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Managing Health
Conditions in the
Workplace
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Long Term Conditions
• 15 million people in the UK have a LTC incl 50% of
workforce
• 4.6 million people in England have a physical health
problem with a co-morbid mental health, with about
30% being long term conditions
• More prevalent in those over 60 (58%) than under 40
(14%).
• Class gradient: Poorest social class have 60% higher
prevalence than those in least deprived •
• People with LTCs account for 50% of GP contacts
Some individuals in deprived communities will have
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Mental Ill-health Is A Particular
Challenge
Many people with severe mental illness want to work
and estimates suggest 30-50% are capable of doing so,
though only 10-20% are part of the workforce
Even common mild mental health conditions can be an
impediment to sustainable employment.
Mental health service users face stigma and
discrimination and this can seriously affect recovery and
quality of life. Time to Change is a joint campaign to
encourage agencies and individuals to work together to
tackle discrimination.
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Work for Health and Recovery
• Remaining in work can be good for one’s MHWB, can
to some extent aid recovery & condition management
• Recovery is not recovery from illness but staying in
control of your life in spite of illness.
• Healthcare and associated professionals may not
fully appreciate that work is often a necessary
element of recovery.
• Airbus. 89% of referrals remained in work whilst
receiving care
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Interventions to resolve health and
work must take a holistic approach
• Work related stress are often associated with the way
work is designed and managed so workload, working
hours, lack of control and poor career development
are all influencers
• Stress reflects interaction with the wider context so
poverty, debt, educational attainment, need for re-
skilling and training as four examples may impact
individual resilience and response to stress
• Co-morbid mental and physical health problems
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Next Steps
• Apply the evidence base to deliver interventions
which will be tested in GM.
• Make recommendations and suggestions to influence
national policy.
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Thanks and Discussion
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