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Gold, incentives and meh

New call for GP 'back to work' role

By Ian Cameron

Demands for GPs to do more to get patients back to work are set to increase after a review of evidence found working was 'convincingly' good for health.

The Government-commissioned review of 400 studies into common health problems concluded that 'the beneficial effects of work outweigh the risks, and are greater than the harmful effects of long-term unemployment.'

The findings prompted Professor Dame Carol Black, the Government's newly appointed work and health tsar, to call for GPs to 'embrace' the role work plays in health.

Dame Carol, who is also president of the Royal College of Physicians, said a new role of 'GP with a special interest in work' could be one way for practices to do more for unemployed patients.

PCTs could also employ networks of occupational health professionals to better assess patients' ability to work and recommend changes, she added.

Dame Carol conceded GPs may be reticent to take on more responsibilities. But she added: 'As the evidence base grows, so does the responsibility of a good doctor to say "being in appropriate good work improves physical and mental health and increases your longevity".'

The review should encourage more rigorous piloting of work advisers in GP practices, Dame Carol added.

Author Professor Gordon Waddell, professor of psychosocial and disability research at Cardiff University, said the

findings did not constitute hard scientific data, but were as

good an evidence base as was possible.

'There's a great deal of indirect evidence that fits together to what we regard as a very strong case,' he said.

'We think you would convict on that.'

But GPs were divided on whether they should play a role in helping patients get back

to work.

Dr Sam Everington, deputy chair of the BMA, said that although there was an 'absolutely clear link' between health and employment, and that GPs and practices did have a role to play, the Government must fully resource any such work.

But Dr George Moncrieff, a GP in Bicester, Oxfordshire, said GPs were precisely the wrong people to play such a role as it would undermine their role as patient advocate.

Independent occupational health nurses were better placed, he said.

Dr Moncrieff added: 'Without a shadow of a doubt being in work is good for people, but GPs have a responsibility for the patient, not society at large.'

Why is work good for health?

Unemployment associated with:

• poorer general and mental health

• long-standing illness

• psychological distress

• higher medical consultation and medication consumption rates

Employment associated with:

• income generation – essential for material wellbeing and 'full participation' in society

• meeting psychosocial needs

• improved self-esteem

• forming individual identity and social status

• better health outcomes

• improved general and mental health and reduced psychological distress

• reduced risk of long-term incapacity

• improved quality of life and wellbeing

• improved recovery and rehabilitation for sick and disabled

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