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

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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?
Conclusions and recommendations • Access to clinical expertise needs to improve. The apparent lack of training among GPs on MSDs and variation in access to specialist consultants by some patients are affecting the ability of citizens of working age to get access to early interventions which may save their jobs. Similarly, the government should conduct some workforce planning in the medical profession to establish if it will have sufficient clinical staff (eg physiotherapists) to accommodate the projected growth in MSDs as the population, and the workforce, ages. In fact, we believe that medical training at all levels, from undergraduate to continuing professional development would benefit from inclusion of health and work issues, especially if the health of the working age population is set to deteriorate. • Recognise the value of vocational rehabilitation that supports clinical treatment of MSDs. Establish better system of referral to rehabilitation programmes, making sure that patients receive the most cost-effective, but also the most appropriate treatment for their health status. Recognise that prevention of long-term conditions is an investment in the future of health care and welfare systems. Fit For Work? 67
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Fit For Work? Rosemary Thomas Kseni
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Contents 1. Executive summary 5 2.
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1. Executive summary The ‘Fit for
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What can be done? Executive summary
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Executive summary We have found imp
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Increasing work intensity is a very
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2.2 MSDs: The European context Intr
Page 15 and 16: 2.4 A note on definition Introducti
Page 17 and 18: 2.5 Structure of the report Introdu
Page 19 and 20: Figure 3.1. Number of MSDs inpatien
Page 21 and 22: • Stamina and resilience; • Cog
Page 23 and 24: Work and MSDs in Bulgaria It is imp
Page 25 and 26: of RA and specific leukocyte antige
Page 27 and 28: injuries or back pain 15 ; Sieper,
Page 29 and 30: 2001). The study also found that fo
Page 31 and 32: • Local or whole-body exposure to
Page 33 and 34: workers of developing rheumatoid ar
Page 35 and 36: 3.4 The wider economic and social i
Page 37 and 38: Work and MSDs in Bulgaria Direct co
Page 39 and 40: presented in the Table 3.3 below. T
Page 41 and 42: 3.5 Summary Work and MSDs in Bulgar
Page 43 and 44: Job retention and return to work pr
Page 45 and 46: 4.2 The social security regime for
Page 47 and 48: Further indirect costs of disabilit
Page 49 and 50: 4.3 Conditionspecific interventions
Page 51 and 52: RA in Bulgaria who receive biologic
Page 53 and 54: Interventions Since it was first pr
Page 55 and 56: apart from norms of shift work. 43
Page 57 and 58: Box 2. Case Study - EPIQ Electronic
Page 59 and 60: the beliefs that both parties have
Page 61 and 62: 4.6 Summary 4.5.4 Improved employer
Page 63 and 64: 5.1 Recommendations for employers 5
Page 65: 5.3 Recommendations for GPs and spe
Page 69 and 70: Breen, A., Langworthy, J. and Bagus
Page 71 and 72: der Tempel, H. and van der Linden,
Page 73 and 74: Guzman, J., Esmail, R., Karjalainen
Page 75 and 76: References Nachemson, A., Waddell,
Page 77 and 78: Waddell, G. and Burton, A. K., (200
Page 79 and 80: Appendix 2: Sample ‘Fit’ Note S
Page 81 and 82: Sources: Eurostat Statistical Datab
Page 83 and 84: Sources: Parent-Thirion, Fernández
Page 85 and 86: Hourly labour costs 2007 Average ho
Page 87 and 88: % sickness absence due to health re
Page 89 and 90: Appendix 3: Benchmarking grid Refer
Page 91 and 92: The aim of the project is to stimul
Page 93 and 94: Appendix 4: Fit for Work Europe Wha
Page 96: We provide: Research Advisory Consu
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