There is good empirical evidence that a biopsychosocial intervention, delivered in the workplace, is fundamental in tackling obstacles to work participation.
The biopsychosocial approach emphasises the influence of individual beliefs, attitudes and behaviours, and work environment factors, for example organisational policies, practices and workplace culture, on health and wellbeing.
Specifically, it has been shown that for many common disorders, vocational rehabilitation comprising healthcare alone has little impact on occupational outcomes; significant input from the workplace and appropriate workplace accommodations is required, according to Vocational rehabilitation: what works, for whom, and when?, (G Waddell, AK Burton, NAS Kendall, published 2008).
While there is an assumption that such principles will apply to all workers, there is a dearth of evidence on outcomes later in the life course.
Supporting the continued work participation of older workers is crucial in light of the increasing age of the working population. The expectations being factored into pension reviews and legislation mean that people will continue working to older ages, but recent evidence by the Health and Safety Executive suggests that ill-health has a major impact on the work ability of older workers.
Older workers tend to have longer recovery times from illness and an increased risk of prolonged absence, and are disproportionately excluded from work via premature retirement or transition to low-skilled and low-paid jobs, resulting in their decreased wellbeing and increased social disadvantage, according to What about older and debilitated workers? Wellbeing and working life: towards an evidence-based policy agenda (A Weyman, published 2009) and Keeping folk in work longer (P Noone, published 2012).
It has been recognised that line managers are probably best placed to provide the necessary workplace accommodations, according to Dame Carol Black’s Review of the health of Britain’s working-age population (2008), but not well equipped to interpret and apply biopsychosocial principles. Educating and enabling line managers to adopt this approach may be key in reducing the costs incurred by the employer, society and the individual associated with prolonged sickness absence and premature retirement.
Dr Serena McCluskey is senior research fellow at the Centre for Health and Social Care Research, University of Huddersfield