Beena Nadeem reports on how employers can support older workers who develop long-term health conditions.
Just last month the TUC warned of thousands of older workers being consigned to a future of poverty due to ill health. Its report shows one in eight older workers were forced to quit their jobs before state pension age, while half a million 60 to 65 year olds have left because of ill-health.
Those in low-paid jobs like cleaning or manual labour suffered the most with their health and are six times more likely to quit early. This compares to just one in 20 professionals who left because of long-term sickness.
The TUC’s General Secretary Frances O’Grady says employers should consider a package that gives older workers who need or choose to work later in life not only a ‘mid-career MOT’, but also better rights to work flexibly.
Workingwise spoke to public health expert Professor David Blane about the impact of the state pension age creeping to 66 by this October. Blane said that, as workers live longer, we’re likely to see increasing issues for those with existing medical conditions, and on top of this, Covid could be forcing those in ill-health to delay retirement.
Yet keeping older workers in work and in good health is not easy, says Icarus Health’s Consultant Occupational Physician, Charlie Vivian. “The most obvious thing would be to get occupational health as a major consideration for employers.” But he says there’s a clear problem. “When the NHS was set up, occupational health was not included. This means that access to occupational health support is non-existent for large numbers of the working population.”
This is felt especially acutely in ‘small and micro enterprises who often do not have access to occupational health in any form’. So what is the solution?
Vivian says it is hard with the kind of complex problems people are facing. There are, however, some interesting ways around the issue which employers are adopting, says Rachel Suff, senior policy adviser in employment relations at the Chartered Institute of Personnel and Development. “Employers can provide flexibility for people who are more likely to have ill health, caring responsibilities and other commitments if they want to improve staff retention.
“There should be a default approach to accepting requests for flexible working wherever possible. Employers should also offer access to other forms of support, including occupational health and an employee assistance programme.”
Diversity in any healthy workplace is important, says Ruth Wilkinson, head of health and safety at the Institution of Occupational Safety and Health. She says: “We need to see employers deliver proactive age management, including better-designed work and workplace adjustment; training, retraining and redeployment; flexible working; and phased retirement,” she says. This can be delivered through occupational health professionals who can support the management of an older workforce through diversity-sensitive risk assessment, risk control strategies and who can also help dispel myths and unhelpful stereotypes.
They also need to be more aware of some of the other issues facing older workers. Older people are often stuck in what Dr Gail Kinman, a professor of Occupational Health Psychology at Birkbeck University, terms ‘sandwich carer’ roles with the dual responsibility for caring for children and elderly parents. This, she says, has been especially taxing during Covid.
She says that many older people have felt that their managers didn’t understand the impact this dual caring responsibility has had on their lives. The worry is that they may drop out of the workforce due to this double caring burden when the evidence shows that older people are at greater risk of long-term unemployment.
A report by the Resolution Foundation this week shows that, during the period 1998 to 2020, after becoming unemployed, 62 per cent of those aged 50 and above have returned to work within six months, compared to 74 per cent among those aged 16 to 29 and 72 per cent among those aged 30 to 49. Meanwhile, the latest ONS figures show the age group with the highest redundancy rate in the last quarter were those aged 50 years and over, although those aged 25 to 34 have the highest rates for the year.
Dr Kinman adds that older workers have also been more likely to lose their support networks during lockdown and their confidence and key skills, increasing the risk of long-term unemployment.
She echoes the TUC’s call for career reviews and guidance and access to training opportunities and staff mid-life MOTs. She also suggests managers need more help and training to develop skills to support employee mental health and development. She encourages employers to be “aware of the age-related causes of mental health problems and offer inclusive support, such as tool kits that are available to help support staff on age-related issues, such as the menopause and caring and financial wellbeing.”
Genevieve Smyth, a professional advisor for Royal College of Occupational Therapists (RCOT), says that the government and the DWP is aware that only half of all employees have any occupational health provision, leaving the rest unsure of where to access advice.
“At one point the DWP had a large unit called the Work and Health Unit. “It looked at the crossover between health and work. Its purpose was to help drive discussions of how to include occupational health in the workplace,” says Smyth.
One of its biggest pilot projects was its now defunct Fit for Work service [closed in 2018] – England’s first attempt at creating a public occupational health service. “The idea would be that you would go to your GP and they could make a referral to a free occupational health service that had its own website and access to lots of behind the scenes, occupational health professionals.
“What was great was that employers could access it to ask advice. It was a brilliant idea, but what was found was that GPs hate filling out referral forms, and because you couldn’t self-refer into the service, it became very underused…. The pilot closed down soon after,” she says, “and with it being so expensive it’s unlikely it will ever run again.”
Instead, Smyth directs workers to the myriad of online resources in the first instance. “There’s a lot of resources online produced by NHS England, and next year up until 2024 we will see 10,000 new allied health professionals working in GP surgeries, so that’s mostly going to be occupational therapists and physiotherapists as well as dieticians and musculoskeletal first contact practioners,” says Smyth.
She says that allows the professionals involved to create a document for individuals – an Allied Health Professionals Health and Work report – which can be used to claim statutory sick pay from employers for long-term illness.
“Because obviously, when we think of a third of the workforce with long-term conditions and most of those long-term conditions are around mental health problems and/or musculoskeletal problems, then it’s important to have more tailored help,” says Smyth.
“I really encourage people to look at occupational therapy-led vocational clinics to provide return to work advice and support for people with musculoskeletal conditions and mental health problems, in primary care,” she adds. She also says practioners may be able to help an employee speak about their condition to their employer.
Steve Herbert, Head of Benefits Strategy Howden Employee Benefits & Wellbeings says older workers have fewer absences than younger ones, but the period of time they take off work tends to be longer. “The key factor should be making sure that employers offer employees Private Medical Insurance and Health Cashplans to help them bypass the long waiting lists on the NHS, while Group Income Protection (GIP) can protect incomes if the absence is likely to be a long one.
He adds: “One underused aspect of GIP is the availability of Early Intervention Services provided by the insurer to help shorten the length of absence. A useful tool – but only if the employer and employee are aware of it and make use of the facility.”
Occupational health help on returning-to-work and Covid created by SOM
Developing and evaluating workplace health interventions
NICE guidelines around long-term health sickness absence and capability to work (gives robust evidence-based guidelines if people feel they need more back-up)
CIPD’s report on new ways of working after Covid
Centre for Aging Better’s tool kit for flexible working (for over 50’s)
Employers have a duty of care to protect the health and wellbeing of home-workers and risks must be assessed.