Less common, or less well-known or understood, health conditions such as auto-immune diseases, ME, epilepsy and MS can often go under the radar from a workplace health support perspective. But they are still important for employers and, especially with the NHS under such pressure from Covid-19, something occupational health should be addressing, argues Christine Husbands.
When we think about long-term health conditions, illnesses such as cancer, cardiac and stroke may spring to mind. While it is true these conditions do make up a large proportion of the chronic conditions affecting employees, there is also a vast range of other chronic conditions with significant long-term effects that often go unrecognised by employers.
Yet these other, less well-known conditions, when added together, affect a significant number of working-age people.
About the author
Christine Husbands is managing director of RedArc Nurses
For example: auto-immune diseases collectively affect around four million people living in the UK. Some 400,000 people live with rheumatoid arthritis, a similar number with type 1 diabetes, 100,000 with multiple sclerosis, two million with hypothyroidism, and so on.
Lack of publicity can mean a lack of support
These conditions are what we might term “the poor relation” when it comes to publicity and hence they are less well known than the headline-hitting diseases that often have more resources, such as large national charities providing research and support, national screening programmes and the lion’s share of NHS resources.
Employer awareness of the existence, let alone the implications and side-effects, of these conditions, is therefore generally much lower and hence they often go unrecognised and unsupported.
As well as diseases, acute or chronic illness can be difficult to live with, such as sleep apnoea, hearing or vision loss, menopause, autism, and many more.
The NHS, of course, is the first port of call for any medical conditions, but chronic conditions can be time-consuming to diagnose or even end up being misdiagnosed. Moreover, even after a formal diagnosis, the pressures the NHS is under, especially now because of Covid-19, can mean services are difficult to access on a regular and reliable basis. Some examples of the common less well-known condition and their implications from a workplace health perspective are:
1) Epilepsy. According to the Epilepsy Society, around 87 people are diagnosed every day and over 500,000 people are living with epilepsy in the UK. Epilepsy is a neurological condition which can cause up to 40 different types of seizures of varying severity.
Everyday life can be significantly impacted depending on how well seizures are controlled. Some common implications of epilepsy are:
- Inability to drive or operate machinery.
- Inability to carry out a normal job.
- Medication can cause tiredness, make it difficult to concentrate which may affect performance at work and social interaction with others.
2) Myalgic Encephalopathy (ME), also known as Chronic Fatigue Syndrome (CFS). The National Institute for Health and Care Excellence (NICE) estimates that the prevalence for ME/CFS in the UK is between 0.2% and 0.4%.
Sufferers experience extreme tiredness and other physical symptoms that make it very difficult to carry out everyday activities, people often have to make some major lifestyle changes. Particular implications can include:
- As there is no specific diagnosis, a diagnosis is based on ruling other things out. Patients can go through many years of self-doubt before a formal diagnosis is arrived at and this can take up to 5 years, many people give up.
- It is generally misunderstood or not recognised by family, friends and employers which adds to the self-doubt of the individual.
- This condition is also often not understood within the health care profession.
- Access to therapies and services are often not available within the NHS until there is a formally diagnosed condition.
- The impact on physical health and emotional wellbeing can be devastating especially when there is no formal diagnosis.
- Work can be significantly affected, with most people needing to have flexibility or reduced hours and some people needing to give up altogether, adding financial worries to the mix.
3) Multiple Sclerosis (MS). The MS Society estimates that there are approximately 130,000 people in the UK with MS with 7,000 newly diagnosed every year. MS is a condition that affects the brain and spinal cord, the coating that protects the nerves is damaged and causes a range of symptoms such as blurred vision and problems with mobility and emotions.
- The symptoms of MS can vary from person to person and can affect people in very different ways. Sometimes the symptoms can be managed well and in others it can significantly impact their quality of life.
- Depending on the type of MS, symptoms may come and go or get steadily worse.
- As symptoms can vary and others may be hidden – such as fatigue – this can cause issues such as not being believed or understood. This can be problematic in the workplace with colleagues and employers alike and there have been examples of hurtful comments whilst parking in disabled bays.
Holistic support needs
How, therefore, can employers help? When employees have such conditions, there are many practical areas where employers can support employees directly, with arrangements such as flexible working or specialist workplace adjustments.
In addition, externally provided practical support such as arranging a second medical opinion (particularly valuable when a diagnosis is doubted), private consultations and diagnostics as well as private treatment, complementary therapies and much more. Expert guidance is vital to ensure that appropriate services are provided.
Whilst treatment may be available on the NHS, doctors and nurses may rarely have the time to offer complementary support, such as support for patients’ emotional needs.
The importance of good emotional wellbeing is fundamental to successful management of many chronic conditions, so a lack of emotional support can be very detrimental to the physical symptoms and ability to carry out everyday tasks.
Holistic support, addressing both physical and emotional aspects together, is most effective for the management of long-term chronic conditions, enabling the employee to carry out their role most effectively and live as normal a life as possible.
Availability of support
Employee benefits often include a range of health services such as support for mental health via an employee assistance programme (EAP), and other needs are catered for in the form of access to private GPs and private medical insurance.
Group insurance products such as critical illness, income protection and life insurance often include support services, some of which cater for any health condition.
Therefore, it is important that employers ensure support services cater for a wide range of health conditions not just the most common ones, otherwise a large proportion of employees will remain unsupported.
“Research first could help four million with autoimmune conditions in the UK”, October 2018, JDRF, https://jdrf.org.uk/news/research-first-could-help-four-million-with-autoimmune-conditions-in-the-uk/#:~:text=The%20group%20estimates%20four%20million,over%20400%2C000%20with%20rheumatoid%20arthritis
Epilepsy facts and terminology, Epilepsy UK, https://www.epilepsy.org.uk/press/facts#:~:text=Every%20day%2C%2087%20people%20are,have%20a%20diagnosis%20of%20epilepsy
National Institute for Health and Care Excellence, Clinical Guideline CG53, Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management
August 2007, https://www.nice.org.uk/guidance/cg53/chapter/Introduction
MS in the UK, MS Society, https://www.mssociety.org.uk/what-we-do/our-work/our-evidence/ms-in-the-uk