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Within two years of qualifying as a teacher in the late 90s, Katharine Merchant had both hips replaced due to a rare condition known as Perthes disease. Determined not to let this harm her career, she continued to work at an Essex-based secondary school. But in 2014, further conditions including osteoarthritis meant she was suffering from increasingly unbearable pain.
“I reached a bit of a crisis point with work. I couldn’t see a way of moving forward,” the 44-year-old geography teacher says. “I was beginning to feel: ‘Can I carry on teaching?’ I looked at retirement.”
Instead, Merchant approached her employer and, with help from a UK government “access to work” scheme, the school soon introduced a plan to better support her in the workplace. For example, physical adaptations were integrated into her classroom, including an orthopaedic chair, footrests, handrests and shelves at a lower height. Mirrors were placed at the back of the classroom which meant she could see better around the room without having to move.
On top of this, “support from a logistical point of view was put in place and that was profound”, she says, adding that the headteacher arranged for staff meetings to be held near her classroom, for example.
The success of the strategy of Merchant, who still works at the same school in Basildon today, is testimony to the fact that even small, inexpensive changes can go a long way for staff with musculoskeletal conditions, the leading cause of disability in the UK.
An estimated 17.8m people in the UK live with a musculoskeletal condition — nearly a third of the total population, according to research by Versus Arthritis, the British charity. Within the working age population, one in eight have reported having musculoskeletal problems. In 2016 alone, this accounted for 30.8m lost working days.
of employees with four or more musculoskeletal conditions are depressed
Such conditions can strike anywhere. In addition to wear-and-tear damage to joints, and back and neck pain, sufferers can be affected by inflammatory conditions such as rheumatoid arthritis. The prevalence of musculoskeletal conditions in the workforce is only set to rise, as people work for longer. By 2030, some 40 per cent of the working age population will have a long-term condition, Versus Arthritis predicts.
For employers, listening to employees with difficulties and taking action not only improves employees’ quality of life, but can also reduce sickness absence and boost workplace productivity.
Today, many employers are drawing up programmes — proactively — to help manage the musculoskeletal health of their workforce regardless of whether they have a condition or not.
“What works is when employers actively engage in preventing [musculoskeletal conditions] from happening or helping those with existing issues get better rather than taking a reactive response,” says John Newton, director of health improvement at Public Health England, a UK government health agency.
According to Karen Walker-Bone, associate professor in occupational rheumatology at Southampton University, any employer strategy needs to be carefully tailored to the nature of the work employees are doing.
Risks to sedentary employees who work at their desks will differ from those engaged in manual labour, for example. For staff in the latter category, “task rotation” — allowing several people to share repetitive tasks — is vital, she says.
More generally, employers should “encourage employees to maintain their own musculoskeletal health” by educating them on beneficial stretches and movements.
At Versus Arthritis, a recent office move gave the charity an opportunity to create a workplace that encouraged desk-bound workers to walk around — for example, by having photocopiers in the centre of the space. It also installed a “wellness room”, similar to a yoga studio, where staff can go to stretch at any point.
of employees without musculoskeletal conditions are depressed
But Laura Boothman, Versus Arthritis’ senior policy manager, also urged employers to look at wielding human resources policies to support staff — and in particular, to embrace flexible working.
“It’s about trust and empowerment,” she said. “It really matters for people who struggle to travel and those who have fluctuating conditions who don’t know what they will feel like tomorrow.”
When new conditions do develop, some employers such as John Lewis Partnership have in-house physiotherapy services. Early intervention is vital, according to Nick Davison, head of health services at John Lewis Partnership. More than a third of referrals to the partnership’s occupational health service are related to musculoskeletal conditions, he says.
The partnership estimates that the equivalent of 58,000 working days were saved in 2017 using its fast track service rather than waiting for public services.
However, experts also warn that musculoskeletal conditions should not be viewed in isolation. There is often a mental health component to consider.
“Painful conditions are depressing and being depressed makes you more likely to get painful conditions,” says Walker-Bone. “I’m concerned that we are beginning to develop siloed approaches. But actually we should be doing these things together — the overlap is enormous.”
This is not always straightforward. Davison of John Lewis Partnership acknowledges that having formulated separate approaches for helping staff with musculoskeletal and mental health conditions “can make integration challenging”.
He adds: “Taking a holistic person-centric view definitely makes sense — focusing on the whole person rather than just a specific condition has a real benefit for the staff member. This is an area we’re looking to build upon.”
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