Chronic Disease in the Workplace

Over 12.8 million working adults in the UK suffer from chronic disease¹. That’s over 30% of the working population. Persistent ill health represents a significant economic burden for society due to the heightened pressure on the healthcare system, the increased sickness absence and the amount of productivity lost. Current research suggests that those with chronic health conditions are better served at work, yet the demands of modern employment can often contribute to the continued development of chronic diseases. As a result, employers need to be acutely aware of how to deal with employees who have them effectively and compassionately. 

What is Chronic Disease?

Chronic diseases are those long-term conditions or illnesses for which there is no cure. They are often managed by medication and treatment but can still limit a person’s daily activities. This type of ailment often develops slowly, and their onset period ranges from prior to birth to later in life. Once particular symptoms and diagnoses have been recognized and undertaken, chronic diseases are then permanent features of life, with rare exception.

Some key examples are as follows:

• Alzheimer’s Disease
• Arthritis
• Asthma
• Cancer
• Chronic Obstructive Pulmonary Disease (COPD)
• Crohn’s Disease
• Cystic Fibrosis
• Diabetes
• Dementia
• Epilepsy
• Fibromyalgia
• Heart Disease
• High Blood Pressure
• HIV/AIDS
• Kidney Disease
• Musculoskeletal Conditions
• Multiple Sclerosis (MS)
• Parkinson’s Disease
• Narcolepsy
• Stroke

With such a broad array of conditions, chronic disease is more common than you might otherwise think. As it is so widespread, it’s essential for employers to understand how best to tackle the issue in order to get the best out of their staff, as well as provide the assistance their employees need. Moreover, under the Equality Act of 2010, employers have a legal responsibility to ensure that workers who suffer from them receive adequate support in the form of ‘reasonable adjustments’ – more on which later².

The Extent of the Problem

An in-depth study from Nazarov, Manuwald, Leonardi et al (2019) looked at economies across Europe and the impact that chronic disease continues to have. It found that the scale and scope of the issue is far more impactful than might be otherwise thought.

The estimated costs to European economies totals some €115 billion or 0.8% of the Gross Domestic Product (GDP) per year, while some 70-80% of health budgets are spent on the treatment of chronic diseases³. They are the second most common cause of work incapacity, with twice as many absences as other illnesses and are the most common cause of disability pensions.

Meanwhile, recent figures for the UK show that the problem has only got worse over the past few years. The Institute for Public Policy Research estimated the cost to the UK economy to be £43 billion per year, around 2% of the country’s GDP⁴. That same paper concluded that chronic illness reduces the income of those living in the same household by as much as £1,800, or £2,200 per person effected.   

With such wide-ranging effects, it’s easy to see why businesses need to take chronic disease seriously. So, what can businesses do?

Managing Chronic Disease in the Workplace

Chronic disease requires a structured and layered approach in order to be dealt with effectively. In 2013, the European Network for Workplace Health Promotion signed a Declaration on Workplace Health Practices for Employees with Chronic Illness⁵. This declaration outlines 10 principles that are recommended for all politicians, employer organisations and unions at every level:

1. Focus on the prevention of chronic diseases at the workplace.
2. Detect chronic diseases at an early stage.
3. Shift the paradigm from reduced performance to retaining current and future working ability.
4. Focus on the abilities and resources of the individual and not only on limitations or restrictions.
5. Address discrimination against people with chronic diseases.
6. Raise the importance and priority of return-to-work on the policy agenda.
7. Increase the opportunities for employment of persons with chronic illness.
8. Ensure that work is rewarding: work must include a positive cost-benefit ratio.
9. Ensure close and systematic cooperation of all relevant players and stakeholders involved.
10. Fill the gaps in existing knowledge, extend and maintain evidence and experience-based interventions.

Reasonable Adjustments

As previously mentioned, under the Equality Act employers have the duty to make reasonable adjustments. What constitutes ‘reasonable’ will vary from organisation to organisation, but, put simply, it means those changes that employers can make that will not negatively impact the business, either in practical, financial or operational terms. Some key types of adjustment are as follows:

Flexible Hours

The potential for flexible working policies to help those dealing with chronic conditions to maintain a successful career is unparalleled. By allowing people to work from home, have part-time hours and flexible schedules, an individual with a chronic condition can manage their symptoms far more easily. Without this flexibility, those with persistent medical issues are often unable to find or keep employment, leading to financial hardship and a decrease in quality of life.

Flexible working policies are not only beneficial for employees with chronic conditions, but for employers as well. Such policies can reduce absenteeism, stress-related illness and staff turnover rate. With the right system in place, employers can provide a supportive work environment which will be beneficial to all parties involved.

Working Conditions

Workplace adjustments may need to be made in order to accommodate the physical, cognitive, and social demands of an employee. This can involve sharing tasks between colleagues, reducing the intensity or complexity of a job role, allowing for frequent rest times, or slowing down the pace of work. Depending on the condition of an individual’s chronic illness, it may also be necessary to provide a private area for medication, or modify equipment to reduce strain on the employee.

To minimize the potential harm of chronic diseases developing in the workplace, employers should avoid creating hazardous working conditions, and instead reduce job demands and work schedules wherever possible. It is important to regularly review an employee’s condition and the adequacy of any adjustments made, as the individual’s needs may well change over time.

Managers should be amenable to dialogue and encourage employees to communicate any issues they are having. This can help ensure that any adjustments remain appropriate and allow employees to take breaks when needed. Other common arrangements include providing an employee with reduced or condensed hours, remote work opportunities, or a change in role or location. When returning to work after taking medical leave, flexible arrangements should be made in order to ease the individual back into their role.

By making these workplace changes, employers can create a supportive environment for employees suffering from chronic illnesses and ensure their comfort and safety at work. This will not only benefit the employee in question, but also boost the morale and productivity of staff in general.

Colleagues

Both for good and for ill, the influence that colleagues have on any person’s working career is undeniable. To that end, having the person who suffers from chronic disease be supported and encouraged by the wider team is vital. This can take the form of sharing tasks, dividing the labour in such a way as to be advantageous to the person suffering, or even simply being open to discussion about it. A few small words can go a long way.

Mid-life Reviews

Mid-life career reviews can provide invaluable benefits to both employees and employers alike. They can help identify and explore potential health issues, make plans for future working life and allow individuals to start taking precautionary measures to protect themselves before their situation worsens.

The best employers now offer mid-life reviews with preventative measures, condition management, and occupational health services – these proactive steps not only enable workers to reskill if needed for changing roles, but also ensure the long-term success of their employees and businesses.

The UK government has just announced a new website to help people reassess their working options, dubbed the ‘Midlife MOT’. For further details, click here.

Access to Training/Reskilling

“A change can be as good as a rest”, or so goes the saying, and it couldn’t be more true for many workers. Giving the opportunity for an employee to enhance their repertoire and move in to an area that better accommodates their condition is not only a great way to augment their capabilities (and their value to the business), but also to ensure that they remain comfortable in their role.

Mental Conditions

Mental health problems are pervasive, from common ailments such as stress, depression and anxiety to rarer disorders such as bipolar and schizophrenia. Mental health should be considered as equal to physical health, and its effect on workers and the wider workplace can be no less detrimental. As such, it’s imperative for employers to foster an environment in which employees feel as though they are able to discuss their issues openly and without fear of stigma or professional reproach.

For more information on how to deal with mental health, please see our newsletter on the latest changes to Acas mental health guidelines here.

Return to Work

Returning to work after illness is a challenging endeavour for both employers and employees. To ensure a successful return, health care professionals should provide employees with a Fit Note that outlines any adjustments that may be necessary to support their transition back into the workplace.

Employers and the returning employee should meet to discuss any updates that occurred while the employee was away, review the doctor’s recommendations, and determine if any modifications need to be made in order to help facilitate a smoother integration back into work. This may include changing duties, transitioning to a new role for a period of time, or providing reasonable accommodations for those with disabilities.

Additionally, employers might consider subscribing to an Employee Assistance Programme (EAP) which provides assessment, counselling and referral services for employees and their families in times of need. A successful return from illness requires good people management skills, sensitivity towards individuals and effective communication between employer and employee.

Conclusion

Chronic disease can cause great difficulty over the course of someone’s life, but it need not be defining. With the above recommendations, you will be able to get the best out of an employee while still tending to their particular needs.

For further help or advice on your particular situation, why not get in touch with our expert team of professional advisors today on [email protected] or call 01455 444 222.

1. Croner Group. (1^st November 2022). The Management of Chronic Illnesses at Work. https://app.croneri.co.uk/feature-articles/management-chronic-illnesses-work

2. Wilcox, A. (TWM Solicitors). (6^th February 2019). Long Term Illness and the Equality Act. https://www.twmsolicitors.com/news-and-blogs/long-term-illness-and-the-equality-act-2010/

3. Nazarov, S.; Manuwald, U.; Leonardi, M.; Silvaggi.; Foucaud, J.; Lamore, K.; Guastafierro, E.; Scaratti, C.; Lindström, J.; Rothe, U. (May 2019). Chronic Disease and Employment: Which Interventions Support the Maintenance of Work and Return to Work among Workers with Chronic Illnesses? A Systematic Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6572561/

4. Institute for Public Policy Research. (26^th April 2023). Long-Term Sickness is Costing the UK Economy £43 Billion a Year.Retrieved from: https://www.bloomberg.com/news/articles/2023-04-26/long-term-sickness-is-costing-the-uk-economy-43-billion-a-year

5. European Network for Workplace Health Promotion (ENWHP). (23^rd October 2013). The Brussels Declaration of Workplace Health Practices for Employees with Chronic Illness. https://www.enwhp.org/resources/toolip/doc/2018/04/23/brussels_declaration.pdf