Caroline Masundire reflects on our learning and experience of innovations in health and work and what we can do to minimise impacts Covid-19 will have on employees with health conditions
Covid-19 aside, May was quite a momentous month for me. For the past two years I have been leading Rocket Science’s role in managing the Government’s Work and Health Unit’s Challenge Fund and in May, I completed our overall programme and learning reports.
The Fund, launched in the summer of 2018 was designed to test innovative approaches to help people with Musculo-skeletal and/or mental health conditions stay in work, avoid long term sickness and unemployment. It was part of the Government’s ten-year strategy to get a million more disabled people into work.
We worked closely with 19 Initiatives, ranging from providing rapid access to occupational health support in clinical and community settings, through to direct support and advice in workplaces to capture their learning, understand their impact and identify what worked and what did not. During this time we were also working with other organisations on health and employment issues, including evaluating Fair Start Scotland. All of this experience combined illustrated the difficult challenges both individuals and employers face when managing health conditions at work.
The Challenge Fund was launched at a time of near full employment, we can argue about the quality of employment, but nonetheless the policy and funding focus had shifted to supporting people in work to stay in work and progress or to help those furthest away from the labour market move towards work.
During the Fund, the disability gap was closing (by 5.6 percentage points from July -September 2013) reducing by 1.6 percentage points just in 2019. Evidence was developing about the role of work in giving people the motivation to better manage their health condition and slow down its progression keep them in work for longer and improve their health. There was increasing recognition of the role of good work and conditions in helping to manage workplace wellbeing, reduce staff turnover and help reduce the skills gap. Mental health was widely talked about and supported and funds such as Access to Work provided a lifeline to help people to stay in work.
The arrival of Covid-19 will seriously impact on the progress we have made on health and work.
As services shift to get Britain back to work and the need to prioritise those that can get back to work quickly, the focus and resources supporting those furthest from the labour market are at risk. Our fortnightly Covid, Coffee and Catchup sessions with people in employment services is highlighting how precarious the situation is and the risk that resources will inevitably have to be redeployed to focus on those who are ready for work. There is also the risk that any announcements for the Chancellor in his emergency budget on support programmes will focus on helping people who can easily get back to work more quickly.
We are yet to understand the impact of Covid-19 on the employment rates of people with health conditions, but it is fair to assume that furloughing will have had an impact with the potential for redundancy and likelihood of unemployment for some. Older people are more likely to suffer from health conditions and the latest data on Universal Credit claims showed that around a fifth of people claiming were over 50.
Some people will also have been at a greater risk of contracting Covid-19 because of their work, statistics from the ONS in May 2020, highlighted that 15% of key workers who had a health condition were at moderate risk of contracting the virus. This begs the question on how sustainable is ‘key work’ for people with a health condition, especially if there is a second wave.
These are uncertain times and we are still finding our way on the road to recovery, but we cannot afford to lose sight of the progress we were making and the learning we were developing on how to keep people with health conditions in work.
At the heart of any approach must be how we:
• support employers to protect employees with health conditions already in work
• help those who have been made redundant or need to change careers because of their health condition
• assist those in need to access other services and support so they don’t fall into crisis.
Three things we can do!
1. Our learning from working with employers is that they are more likely to engage if they need help with a particular issue. As local authorities and other agencies are supporting employers to provide them with grants and business support, it is an ideal opportunity to work with them to identify employees who are at risk of losing their job and because of their condition will find it more difficult to find an alternative role. This includes reviewing workplace adjustments so they can be adapted to new rules of working, negotiating working hours if people need to reduce or increase working hours and offering help to the employee so that they can stay in work.
We found that businesses including SMEs do want to engage, they just need help to understand what they can do to help and a positive experience leads to greater opportunities to support them with staff and workplace practice.
2. We know that for employees who are working insecure, temporary or low paid work, reductions in their income can be make or break for them. The rise in Universal Credit claims illustrates that people are using this safety net, but we know that people will need help navigating the complexities of this as well as help with income maximisation.
Our learning has showed that the kinds of support offered to people to help them get into work such as benefits, housing and debt advice is equally important to help people in work avoid crisis. This can be effective in helping them sustain their employment as well as support their mental health.
3. Finally we need to help people to think broadly about their skillsets and the types of alternative work they can do, especially if they have been out of the jobs market for some time. We know that focusing on an asset-based approach can help people to think more broadly about what they can bring to a role, open their eyes to opportunities they would normally dismiss and support them with job search.
Building people’s skills in job search is really important as is giving them coaching and support to work through the role, the workplace adjustments they might need to have in place and to be confident in having these discussions with their employer.
We can go someway to minimise the impact of Covid-19 for those more vulnerable workers, but we must ensure longer term, that this does not become a reason to stop the progress we were making on healthy work.
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