Fit for Work Europe - A Call to Action

Why a Call to Action?

Ensuring a sustainable and dynamic knowledge-based economy as well as quality of life feature high on
the EU policy agenda: the EU explicitly recognises that Health = Wealth. The European Union cannot
confront the current economic downturn without an integrated strategy, including efficient and
sustainable health systems, access to appropriate treatment and concrete health benefits for society as
a whole. A healthy population, which is Fit for Work, clearly contributes to the advancement of this
agenda.

Policymakers, employers, health professionals, and patients must act collectively to ensure
continued active participation in work and society and a high quality of (working) life. These are
the preconditions for both physical and mental health, fulfilment, prosperity and social cohesion.

However, of the EU’s 170 million people of working age, almost one in six (16 %) suffers from (chronic) health
problems or disability affecting their ability to participate fully in the labour market. A large proportion of
these people are directly affected by musculoskeletal disorders (MSDs). Apart from the significant social
and economic consequences, both for patients as well as their families and carers, MSDs undermine the
productivity of European workers. MSDs also draw heavily on the (financial) resources and service
capacity of national health systems and social security regimes, if not wisely managed. Prioritisation
needs to be given to people with MSDs in employment, as it is widely recognised that it is easier for
individuals to remain in work with a long-term condition rather than attempt to rejoin the workforce once
employment has been lost.

Therefore, concrete actions – e.g. prioritizing MSDs in national health plans - should be put in
place to ensure timely diagnosis, appropriate intervention and effective management of MSDs.
Only coordinated action between all stakeholders - Governments, Employers, Patients/Workers,
Health Professionals and Payers - will result in effective interventions allowing those living with
MSD to stay active, contribute to economies and society and maintain quality of life.

The Work Foundation’s Fit for Work project is supported by an research grant from Abbott, with the logistical support of 1
Weber Shandwick. Fit for Work reports are produced independently by the Work Foundation, with full editorial control
resting with the Work Foundation alone.
CALL TO ACTION:

1 EU and national level policymakers must ensure that health and work agendas are aligned to
promote health, positive health outcomes, and labour market retention and active inclusion. This will
be achieved by:

o Recognising that early diagnosis, appropriate intervention and effective rehabilitation of

MSDs are core to the effective management and prevention of MSDs, which ultimately
reduces the burden on health and disability budgets, and improves the quality of life of
the individual
o Developing new and adapting current national and EU-level legislation addressing
MSDs in a broad sense (both at work and beyond the scope of work), e.g. by means of
an EU Council Recommendation on MSDs, which promotes national prioritizing and
action plans in this area, and which sets work productivity as a measure for Health
Technology Assessment (HTA) or other economic measures, as well as a clinical
objective. The current efforts to develop an EU MSD Directive as well as the explicit
EU Institutions and national governments

mention of MSDs in the 2009 work plan of the EU Health Programme serve as a useful
point of reference
o Ensuring that social welfare systems support people with partial work disability to work
part-time or to make a gradual and supported return to work without financial penalty
(e.g. through the payment of partial benefits during periods of rehabilitation).
o Effective prioritization of MSDs accompanied with suitable resources to manage MSDs
appropriately
o Putting in place EU guidelines on early diagnosis, appropriate intervention and
effective rehabilitation
o Stimulating and facilitating good practice exchanges between member states, enhance
data collection and dissemination, and promote programs that help to mitigate the
impact of MSDs
o Considering the added value of early diagnosis, appropriate intervention and effective
rehabilitation in managing and preventing MSDs when developing public health and
social affairs policies at EU and national levels
o Recognising that labour participation results in improvements to citizens’ well-being,
their participation in and contribution to the economy and society as a whole

The Work Foundation’s Fit for Work project is supported by an research grant from Abbott, with the logistical support of 2
Weber Shandwick. Fit for Work reports are produced independently by the Work Foundation, with full editorial control
resting with the Work Foundation alone.
2 A healthy workforce is indispensable for a healthy business and business potential. The productivity
of European businesses is undermined by MSDs. Workers with MSDs who are supported at work
are more productive and represent a return on investment for businesses. Therefore the business
community should contribute to the development and implementation of policies and practice that
effectively protect and promote the health and wellbeing of their workforces, by means of:

o Developing workplace policies that promote early diagnosis, appropriate intervention

and effective transitional work arrangements, reasonable accommodations and
rehabilitation in relation to MSDs, which can prevent condition progression and can
measurably improve employees’ performance

o Create an open, supportive workplace environment for patients/workers to discuss their

physical and mental health conditions

o Supporting high quality work environments, e.g. by means of flexible, innovative and
ergonomic work design, thinking beyond health and safety risks to actively promote the
health and well-being of their workers

o Ensuring timely access to occupational health advice: vocational rehabilitation,

carefully organised and tailored to the individual, can make a real difference in
ensuring individuals returning to work, and to maintain productivity, morale and
sustained performance – which will in turn contribute to a healthy business

o Focusing on their employees’ capacity resilience and workability, contributing to the

health of their workforce as well as their social, psychological and economic well-being.
A wholesale change in attitude and approach should be taken, i.e. from incapacity to
capacity
Employers

o Integrating a health and well-being component in managerial awareness-raising and

training to ensure managers can manage the employment, deployment, retention and
rehabilitation of workers with MSDs and related health problems through creative job
design and work adjustments.

The Work Foundation’s Fit for Work project is supported by an research grant from Abbott, with the logistical support of 3
Weber Shandwick. Fit for Work reports are produced independently by the Work Foundation, with full editorial control
resting with the Work Foundation alone.
3 People living with MSDs have a responsibility to play an active part in the self-management of their
condition. Advocating for the right to early diagnosis, appropriate intervention and effective
rehabilitation is a crucial element in this responsibility, by:

o Engaging in open and informed dialogue with physicians and health practitioners with
the aim to better manage their condition

o Being well informed of their condition and the various ways to better manage and
address the accompanying constraints that may hinder workability and/or quality of life

o Taking control of their own care and ensure early diagnosis (timely consultation of
health professionals), asking for appropriate treatment and ensuring effective
rehabilitation
Patients / Workers

o Actively engaging with public authorities for recognition and inclusion of MSDs into
European and national public health and social policy development

o Actively informing their employer at an early stage of their disease to ensure a focus
on their capacity and workability: work with managers and colleagues to find ways to
overcome the constraints of their condition

The Work Foundation’s Fit for Work project is supported by an research grant from Abbott, with the logistical support of 4
Weber Shandwick. Fit for Work reports are produced independently by the Work Foundation, with full editorial control
resting with the Work Foundation alone.
4 Patients with MSDs are both citizens as well as workers. Therefore, healthcare professionals should
consider the bio-psychosocial model, and incorporate work productivity fulfilling labour market
participation as a clinical outcome, by:

o Realising that poor management of MSDs severely impact patients’ ability to work and
quality of life, resulting in a loss of productivity

o Looking beyond simply treating the signs and symptoms of MSDs, to more holistic
indicators such as mental health, work participation and job design, when considering
interventions. Return to work and maintaining work productivity should be an explicit
clinical target

o Acknowledging that job retention, or the earliest possible return to work, is good for
the physical and mental health of the patient and focus on patients’ capacity and
workability rather than their incapacity
Health professionals

o Acknowledging and advocating the benefits of early diagnosis, appropriate intervention

and effective rehabilitation in managing MSDs

o Coordinating and disseminating knowledge about MSDs management and counsel

public health authorities when developing health, social and coverage policies, as well
as specific strategies to address these conditions

o Working with managers on job design innovation and encourage patients’ self
management of their condition and working environment

The Work Foundation’s Fit for Work project is supported by an research grant from Abbott, with the logistical support of 5
Weber Shandwick. Fit for Work reports are produced independently by the Work Foundation, with full editorial control
resting with the Work Foundation alone.
5 Prevention of MSDs is more important than allowing a disease to progress to necessitate a cure. The
earlier the diagnosis and the more appropriate the intervention for these chronic conditions the more
savings can be made in terms of health budgets. Therefore, ‘payers’ in national healthcare settings
should consider:

o Prioritising MSDs in their health management and services resourcing allocation,

acknowledging the impact of these conditions on the wider national economy and the
potential return on investment both for health providers as well as governments in
improved services and access to those services

o Factoring in the clinical and socio-economic benefits of early diagnosis, appropriate

intervention and effective rehabilitation in evaluating cost-effectiveness of MSD
treatment regimens

o Independent from the underlying social insurance system, taking an integrated

approach to include all consequences in payers’ judgement for propagation of
treatment regimens, including, pension funds, unemployment funds, fiscal funds, etc.

o Recognizing that early diagnosis and early intervention is an investment in patients’

positive health, well being, productivity and role in civil society

o Initiation of new concepts for financing early treatment programs with other
beneficiaries (e.g., the pension fund because of delay of early retirement)

o Taking more explicitly into account the social, economic and work impact of MSDs
when evaluating interventions and therapies, and recognise work productivity as an
explicit HTA target, where HTA or such evaluations exist
Payers

o Understanding and accepting that the concept of early diagnosis and appropriate early
intervention is equivalent to the concept of prevention

All stakeholders involved should play their part in better management of MSDs, to improve health
outcomes, quality of life and the economy as a whole.

Let’s make Europe Fit for Work!

The Work Foundation’s Fit for Work project is supported by an research grant from Abbott, with the logistical support of 6
Weber Shandwick. Fit for Work reports are produced independently by the Work Foundation, with full editorial control
resting with the Work Foundation alone.