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Helping patients back to work

Occupational physician Dr Nerys Williams outlines the assistance available

1 Work is generally good for patients' health

A recently published review of the links between work and health showed that for most people work is good for health and wellbeing, and that being out of work is bad for both physical and mental health. The importance of work in helping to improve and maintain health must not be underestimated. Maintenance of employment or a return to work is one of the indicators of success in clinical management.

2 Prevention is better than cure GPs can play a crucial role in ensuring patients do not lose their jobs as a result of ill-health – for example, by ensuring good communication with employers and occupational health professionals, and by helping to identify ways work can be modified to enable a person to return from sick leave.

3 Specialist advice and assistance for people with complex health or disability-related barriers to work Most people with disabilities are able to make effective use of mainstream employment and training opportunities but some need more help. Jobcentre Plus disability employment advisors (DEAs) can provide specific advice on finding work or help if their condition worsens and they are in danger of losing their job.

4 Help from DEAs DEAs can facilitate access to a range of assistance including work psychologists for specific assessment and support schemes such as Access to Work, which provides a range of practical help to individuals and employers, and Workstep and Work Preparation programmes, which are aimed at supporting disabled people to find and retain work.

5 Patient expectations Studies have shown most patients who claim incapacity benefit expect to return to work but may need help in managing health conditions. Pathways to Work, a DWP scheme running in parts of the UK, gives patients claiming incapacity benefit access to condition management programmes. These are run in co-operation with local NHS primary care trusts and delivered by a range of health professionals such as nurses, physiotherapists and occupational therapists.

If patients successfully enter employment they can qualify for a weekly payment of £40 per week for 12 months if their salary is below £15,000 per year. Pathways to Work will be rolled out nationally in 2008 – to find out whether Pathways is currently available in your area go to

6 Help for people on health-related benefits Patients who claim a disability or health-related benefit may be eligible for help from a scheme called the New Deal for Disabled People (NDDP). Participation in NDDP is voluntary and aims to help disabled people to find and keep work and also encourages employers to match their vacancies to the skills and potential of individuals. To find out more about New Deal in your local area go to

7 Permitted work This encourages people claiming an incapacity benefit to carry out some form of paid work to ease their way back into employment, without losing their entitlement to benefit. For most people the rules allow work of less than 16 hours per week and, on average, earnings of up to £86 per week for up to 52 weeks with the aim of returning to work of more than 16 hours per week within that time. There are more flexible arrangements for people who need support in work and for people whose health condition is severe enough to mean they are not required to attend for the personal capability assessment. Alternatively, anyone on incapacity benefit can work and earn no more than £20 per week for an unlimited time.

8 Financial help to attend interviews for people with health problems If a patient meets the definition of disability under the Disability Discrimination Act 1995 then they may be eligible for financial assistance towards the cost of specific job or training-related interviews when other sources are not available.

9 Voluntary work Patients with health conditions preventing them from working and earning a salary may undertake voluntary work. They must not be paid but are allowed to receive reasonable expenses. Such voluntary work can assist in helping a person develop skills and take steps towards returning to work.

10 Disabilities and studying Individuals over the age of 19 who are claiming incapacity benefit and severe disablement allowance can remain on benefit provided the course does not compromise their incapacity status. Judgements are based on factors such as hours of study and the length and nature of the course.

Nerys Williams is a consultant occupational physician and principal occupational physician for the Department of Work and Pensions. She is a former GP

Competing interests None declared

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