RIWC_PARA_A156 the need for, and the delivery of, a consistent disability management programme within the united kingdom
The Making of a Profession
Helping people to stay in, remain at and return to
Effective workplace rehabilitation is a product of the
actions of the employer and health services.
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What is Disability Management?
• A proactive process that minimizes the impact of an impairment
(resulting from injury, illness or chronic condition) on the individual’s
capacity to participate competitively in the work environment
• A process that enhances the likelihood that impairments will not result
in workplace disability.
What is known already?
Well lots actually!
• Any improvement in work-related support
for those who develop health conditions
will need to be underpinned by a
fundamental change in
• the widespread perception around fitness
for work; namely, that it is inappropriate
to be at work unless 100% fit and that
being at work normally impedes recovery.
Dame Carol Black Working for a healthier tomorrow 2008
What is known already?
Keeping people in work or getting them back to
work more quickly if they do go off sick is now
known to be a key factor in protecting their long
term health and well being.
Fitness for work 2013 Lord David Freud.
Governments response to Dame Carol Black and David Frost report Health at Work 2011
“Vocational Rehabilitation – What works for whom and when”
Waddell, Burton and Kendall 2008
What is Vocational Rehabilitation?
• whatever helps someone with a health problem to stay at, return to and remain in work.
• it is an idea and an approach as much as an intervention or a service.
Effective vocational rehabilitation requires
• work-focused healthcare and workplaces that are accommodating.
• strong scientific evidence.
• a good business case.
• evidence of its cost benefits.
Most people with common health problems can be helped to return to work by following a few basic
principles of healthcare and workplace management.
Where are we now?
Only 34% of adults with mental ill
health or learning disabilities are in
employment in England (NOMIS
There still needs to be a shift in
behaviour at community, professional
and individual level.
Public sector expenditure continues
to increase on ill health and
unemployment within the deficit
We continue to spend money on
activities that don’t keep people in
employment or get them back to work.
Some professionals still assume that not
working is better for people than going to
What do we know already?
What medical staff say about return to work,
what family and friends say and the response
of their employer will together determine
whether someone returns to work or not.
When considering people with the same condition,
similar employers, same race, age and gender –
some will return to work – others will not.
The longer people wait for treatment the less
likely it is for them to return to work.
What people say early in a period of illness
about their return to work will influence if they
return – regardless of the interventions they
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Work as part of
Not just an
Occupational Health issue
Training of medical
staff – workplace
rehabilitation is treatment
Working with a chronic
condition becomes the Prevention– focus on
new norm keeping people in Not working should
work be the exception
Medical and social care
staff – talk about work and
actively support people to
Early treatment –
move from an acute
Aspirations for our
Good Work –
Not every solution is
Cultural Issues to Overcome
Some practitioners say that they are unsure
work is good for recovery….
Many employers want to know how people
can be made 100% fit for work.
“we should concentrate on getting you
better before you think about work”
Work is good for health – being out of work
is bad for health. (Waddell and Burton
Being in employment has a positive impact
on recovery. Chronic conditions, poor
health and recovery from surgery do not
stop people working. (DWP Mental Health
and Employment 2008)
People have different rates of recovery,
employers and employees need to agree
when they can return to work and what
they will do (Boorman 2008)
• Variety of 24 modules to choose from
• Modules can be tailored around the needs of the course participants
• Assignments to re-enforce contents of modules
• Exam – currently based on 300 MCQs
• Credited course which is recognised worldwide
• Offers professional qualification
• Delivered by tutors with experience of working in the field
• Establish national standards of working
• Provide personal development opportunities
• Members of the multi-disciplinary team have a common understanding of
VR/DM and requirements of RTW
• Professional boundaries blurred to the advantage of the client
• Consistency of training
• Similar levels of expertise in the team achieved
• Team morale high
Developing Links for further development
• Is VR the domain of health professionals only?
• What about the unqualified workers being used by organisations
delivering return to work?
• How can we look to up skill them?
• Should we consider a CDMP as part of career path for non-health
• Could it be part of an “apprenticeship scheme”?
• Entry Level to Masters Degree?