FfW Bulgarian report (English language) - Fit for Work Europe

5.4
Recommendations
for government
Conclusions and recommendations
66
• Encourage self-management. Try to ensure that the patient can adopt strategies to
manage aspects of their own condition, especially if they are staying in or returning to
work. A feeling of empowerment and control will help their mood and ensure that they
can keep on top of important aspects of their incapacity while at work. Collaborate with
patient support groups, which may often provide advice on job retention or return to
work. Consider using specialist psychological support to help patients deal with their
symptoms.
Encourage the focus on the capacity rather than the incapacity of disabled people. Review the
labour codes to ensure that they do not discourage employers from hiring disabled people.
Equally, the welfare system may discourage partially disabled individuals from retaining active
employment status and incentives should be introduced to ensure that those who are able and
willing to work could return to the labour market.
• Consider replacing the current system of sickness certificates with a UK-style ‘Fit Note’
(sample presented in Appendix 2) which encourages GPs to indicate what a worker is
still capable of performing. Focusing on the capacity of the employee would help other
health care professionals and employers to plan return to work interventions and to
make appropriate adjustments to job demands and/or working time.
• Consider a more standardised, joined up approach to recording data about the
prevalence of MSDs, economic costs and societal burden so that data is comparable
across government departments. Prioritise reducing the costs of MSDs for individuals
and their families, employers and the labour market. The government should consider
a national plan for people with MSDs – driven forward by a National Clinical Director
for MSDs – which monitors the improvement in diagnosis and access to appropriate
therapy and vocational rehabilitation in Bulgaria, reducing the societal and economic
burden of MSDs.
• Acknowledge the psychological effects of physical illness that if remain untackled can
perpetuate MSDs. Increase access to psychological support for people with MSDs to
enable them to manage the psychological impact of their condition. Occupational health
services that raise awareness of the impact of workplace factors on employee health
need to be equipped with appropriate legislation to pursue the necessary changes in
organisations.
• Expand the definitions of MSDs in the current classification of occupational diseases
beyond their current narrow focus, formally acknowledging that many MSDs and other
chronic conditions (such as rheumatic diseases) are not caused by work, but may
inhibit participation at work.
Fit For Work?