Health and work

Frank, Andrew

DOI: 10.7861/clinmed.Let.21.4.10 Editor - I welcome, very much, the recent review of health and work by Walker-Bone and Hollick.1 They correctly point out that all physicians, and other healthcare professionals (HCPs), have a responsibility to provide support and advice to disadvantaged individuals (DIs) whose ability to work is impaired due to health or other disadvantage.2 Often the nature of the disadvantage relates not only to impaired physical or mental health issues but also to other factors (eg poverty or pre-existing disability).3,4 They helpfully discuss the difficulties that many doctors have in discussing work issues with DIs and perhaps a simpler introduction to this area can be found in Talking work5 I strongly support their views that: * DIs should be encouraged to return to work (RTW) if there are any aspects of their work that they can continue to perform * reasonable adjustments are an important component of facilitating a RTW * supportive employers can do much to prevent ill health at work (eg through wellbeing programmes etc).1 The inter-relationships between health and work are broader than this review suggests. [...]a new industry has developed, mostly funded by the private sector, using case management as a tool to facilitate good rehabilitation and RTW when applicable.7 Such teams liaise with OH when available. Clinicians should be aware of the scope of assistance available to their patients from the DWP in addition to the correct use of fit notes so ably described by Walker-Bone and Hollick.1 For DIs with more complex problems, they should consider liaison with: * appropriate rehabilitation service where available * occupational health department where available * DWP * the voluntary sector: * general advice (eg Scope, Leonard Cheshire Disability or Disability Rights UK) * particular support from those living with a particular health condition (eg Macmillan Cancer Support) and/or offering peer support.4,6,10 In summary, physicians are able to offer general advice to assist DIs prior to their seeking their first job, those with difficulties at work and those currently out of work.