Work, Health and Wellbeing

Received: October 5, 2012 Accepted: October 9, 2012 Available online: November 30, 2012 Correspondence to: Dame Carol BLACK Health Improvement & Protection Directorate, Department of Health 704 Wellington House, 133-155 Waterloo Road, London SE1 8UG, UK E-mail: [email protected] During the past decade we have become more aware of important relationships between health and work. There is a persuasive body of evidence. This was brought together in an important review by Waddell and Burton [1] Is work good for your health and well-being? which examined the evidence on that question. The review formed part of the evidence base for the UK Government’s Health, Work and Well-Being Strategy [2] published in October 2005. There are economic, social and moral arguments that, in general, good work is the most effective way to improve the wellbeing of individuals, their families and their communities. Moreover, there is strong evidence that prolonged loss of work, whatever the cause, can harm physical and mental health. For all these reasons supporting people into work is a key element of the UK Government’s aims for both public health and welfare reform. Similar responses are being made in many other countries across the world. I was appointed to the new post of National Director for Health and Work to initiate a national debate in taking forward the strategy and to secure widespread recognition of the benefits of work to health and well-being. My report, Working for a healthier tomorrow [3], made recommendations designed to protect and improve the health and well-being of working age people and to enable them to remain in or return to work with minimal delay when illness, injury or disability threatens their capability to work. Not only is working life important in maintaining the health and wellbeing of individuals and their families and it is also evident that a healthy workforce brings financial and productivity benefits to employing organisations. Conversely when employees are sick and absent from work, or remain at work but do not perform well a phenomenon called presenteeism the performance of the organisation falls. Employers from a range of organisations small, medium and large, public and private, including healthcare organisations such as those of the British National Health Service [4] can show that close attention to workplace well-being improves productivity, staff retention and engagement, and morale. A critical question is how do we move from analysis of the relations between ill health and work to a programme of interventions to deliver the strategy? The success of the strategy depends on preventive, therapeutic and rehabilitative interventions alongside those that strengthen motivation and confidence. An important step in the UK has been introduction of the Statement of Fitness for Work [5] (the Fit note) which has now replaced the previous Medical Statement or ‘sick note’ made by the patient’s doctor. It has encouraged important changes in understanding and behaviour. Most sickness absence and inactivity follows common health conditions which, with the right support, are compatible with work although sometimes it means a different kind of work. The statement enables the doctor to give advice that an employee’s condition does not necessarily stop them from returning to work but that return may be possible if the employer and employee together could find suitable adjustments. The Fit note also brings new opportunities and enhanced responsibilities to business. It signals, in a formal way, the growing recognition that for most people of working age the right work is good for health and well-being. It is well known that the longer a patient is on sickness absence from work the likelihood of yet more prolonged absence and of permanent worklessness increase rapidly. In some instances, of course, this is a natural consequence of the severity of illness or disability, but in many cases it is a result of inade-