An e-learning tool helps occupational health professionals support cancer patients, reports Katharine McDonald, a policy analyst at Macmillan Cancer Support.
As the incidence of cancer increases, and survival rates improve, the likelihood of occupational health professionals coming into contact with employees with cancer is ever increasing – there are now more than 700,000 people of working age living with cancer in the UK (Maddams et al, 2008). A survey of OH physicians in 2008 by cancer support charity Macmillan found that almost half felt that their training had not equipped them to support employees with cancer (Amiz, 2008). To address this, Macmillan has developed a work and cancer e-learning module specifically for OH professionals.
Impact of cancer on work
Going back to work can be an important milestone for someone with cancer. But the effects of cancer and treatment can significantly affect working life and, without advice and support, some people struggle to return to work. More than four in 10 people who are working when diagnosed with cancer have to make changes to their working lives, with almost half changing jobs or leaving work altogether (YouGov, 2010).
Sample vignette from the module
You assess Mrs Michaels, a 53-year-old care assistant for elderly clients in a residential home. Her manager is seeking advice on the likelihood of Mrs Michaels’ return to work, timescales and any adaptations in the workplace that may help with return.
Mrs Michaels was diagnosed with breast cancer after a routine mammography two months earlier. She has undergone lumpectomy and sentinel lymph node biopsy and said that her surgeon is “happy” with the operation and that her nodes were “negative”.
Mrs Michaels also explains that a bone scan and liver ultrasound were reported as “clear” and that she is now undergoing a course of chemotherapy. Her mood is pessimistic and she believes that she is unlikely to recover and return to work. During your chat, she asks about ill-health retirement (IHR).
Question: Do you decide that Mrs Michaels’ self-appraisal of her long-term work ability is reasonable and discuss further the possibility of her seeking ill-health retirement?
People with other chronic conditions are more successful in securing workplace adjustments than cancer survivors (Macmillan, 2008). Adjustments such as a phased return to work, flexible hours or occasionally working from home are simple but effective ways to support a successful return to work. The Equality Act 2010 requires employers to make reasonable adjustments for employees with cancer.
Support from employers is also key to a successful return to work, but few employers are confident about how best to support an employee with cancer. With 98% of public sector and 30% of private sector organisations having access to OH services, OH professionals are in an ideal position to support employees and employers to manage cancer in the workplace.
The new work and cancer learning module is called “The occupational implications of cancer survivorship: advising cancer survivors and their employers”. It was developed with funding from the National Cancer Survivorship Initiative (NCSI). NCSI is a partnership between Macmillan, the Department of Health and NHS Improvement to test new approaches to cancer aftercare, including supporting people to return to work where appropriate.
The two-hour module is designed to refresh existing knowledge and provide new information on the occupational impact of a cancer diagnosis on working-age adults. The content has been developed by occupational health physicians Dr Philip Wynn and Dr Jo Dent.
The module has been designed to help occupational health professionals to:
- advise and support employees with cancer to understand how their illness may affect their working life and how to manage this;
- address employees’ health and work fears so that they feel confident and capable of managing their illness, especially at work;
- improve employees’ confidence so that they can successfully negotiate changes to their working life;
- pre-empt work-related difficulties for an employee and advise on workplace adaptations to overcome them; and
- recognise and address undue pessimism in employees or employers as to how a cancer diagnosis might affect work and the workplace.
Macmillan is working towards having the module accredited by the Faculty of Occupational Medicine, and is investigating the necessary measures to have it accredited for occupational health nurses. The module was presented at the Society of Occupational Medicine conference in April on combating cancer.
The bigger picture
Macmillan research found that nearly half of OH physicians felt that line managers referred employees with cancer too late for OH advice to be most effective (Amiz, 2008). Almost half of employees who were in work when diagnosed say that their employer did not discuss sick-pay entitlement, flexible working arrangements, or workplace adjustments with them when they informed them of their diagnosis (YouGov, 2010).
Macmillan is campaigning to raise employer awareness of legal obligations and best practice; the charity provides a range of resources to help employers better support their employees. It has also developed information resources and tools for patients, carers and health professionals. To view all the available resources, go to the Macmillan website.
Maddams J et al. “Cancer prevalence in the United Kingdom: estimates for 2008”. British Journal of Cancer. 2009. 101: 541-547; and Cancer prevalence in the UK, 2008.
Macmillan Cancer Support. “Health and Well-being Survey 2008”.
Amiz Z. “Cancer survivorship and return to work: UK occupational physician experience”. 2008.
YouGov online survey of 1,740 UK adults living with cancer. Fieldwork took place between 26 July and 9 August 2010.
XpertHR finds out whether or not an employee with cancer is protected under the Disability Disrimination Act 1995 if the disease begins to affect their ability to carry out day-to-day activities.