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

jan.hopkins@tameside.gov.uk

Sam.haskell@phe.gov.uk

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