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Work and Caring

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Why raise the issue of work?

There is a strong relationship between work and health. A systematic review carried out by Waddell & Burton (2006) found that: 

  • There is a strong link between unemployment and poorer physical and mental health and well-being 
  • Unemployment is associated with an increased use of medication, health services and higher hospital admission rates 
  • Returning to employment after being out of work can result in significant health improvement and increase individuals' levels of self-esteem 
  • For those with ongoing health conditions, remaining in work is shown to be beneficial to their health as it can help them recover from sickness and decrease the risk of long-term incapacity.

How to raise the issue of work or vocational rehabilitation

  • Vocational Rehabilitation is defined as “whatever helps someone with a health problem to stay at, return to or remain in work – it is an idea and approach not just interventions and services.”
  • Employability is defined as “is a combination of the processes and factors which enable people to progress towards employment, to stay in employment and move on in the workplace.
  • Staff should use their own judgement about when and where to raise the issue of employment during a consultation
  • The earlier the issue is raise E.g. when someone is off work sick or when someone has just been made redundant or has not previously worked the quicker help and support can be provided
  • Diagnosis and recurrent consultations and annual reviews for an LTC offer important opportunities for employment to be raised
  • Patients/Carers may already be making staff aware of their work status

Suggestions to start the conversation

  • Do you need any help or advice on returning to work or staying in work?
  • Do you need any help with finding work or getting into employment?
  • Do you have any worries/concerns about work or employment?


How to respond

  • Individual employment situations can be complex whether these involve absence from work, unemployment, employer demands and or other issues
  • It is important to remember you do not need to go in to deep and fix problems for patients
  • Where patients do have issues the role of staff is to:
    • Reassure that support is available
    • Explore the pathway using questions some simple questions to ascertain the best service to support the patient
    • Gain consent for referral
    • Refer to the service

Why raise the issue of caring?

  • At any point in time 1 in 8 people in Scotland are caring for someone. 3 out of 5 of us will care for someone at some point in our lives. The value of the care they provide is estimated to be around £10.3bn each year (Scottish Government 2015 ). Much of the upcoming policy and service provision is reliant on informal carers continuing to provide that role.
  • Many people don’t recognise themselves as a carer and therefore do not seek the information and support that may be available to them. While many carers find caring rewarding, the impact on their health and wellbeing can be severely affected if they are unsupported.
  • Preventing any ill effects from caring and the breakdown of the caring role is vital to ensure that those wishing to continue to care can do so well.
  • There is recognition that NHS staff are in a key position to identify carers and take the opportunity of this healthcare interaction to:
    • Acknowledge their role as a carer
    • Inform them of their rights and the support available
    • Include them in discussions about on-going care

From April 2017 The Carers (Scotland) Act will provide regulation on this for NHS and HSCP staff.

Click for Scottish Carers Bill

How to raise the issue of caring.

  • For many this initial conversation may not lead the person recognising their role or identify any support needs but will inform them that support is available. Where patients do have issues, the role of staff is to:
    • Reassure that support is available
    • Gain consent for referral
    • Refer to the service

The Carers Pathway provides an overview to what services are involved in supporting carers, what they provide and how to access. 

Click here for more information and resources.

Referral to Services
For information about local services please access Health and Wellbeing Directory.

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