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Chronic conditions

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Please find below Fit for Work's Contribution to the EU Chronic Conditions debate

FIT FOR WORK EUROPE - Supporting National Plans on Chronic Conditions and Musculoskeletal Disorders

Musculoskeletal Disorders (MSDs): a widespread burden to Europe's society and economy…

In Europe, 24.5 million people  (approx. 10% of the economically active population) are unemployed at a time when populations are starting to age and public spending cuts are growing.  The EU’s economic growth '2020 Strategy' focuses on boosting employment and social inclusion and sets an employment rate target of 75% by 2020 (currently the rate is 69%).   By 2060, the proportion of population aged 65 and over is projected to increase from 17.4% (2010) to  30%,  which means that there will be just one person of working age for every dependent person aged under 19 or over 65 years in the EU.

The quality and quantity of data on the definition, prevalence, impact and costs of MSDs vary considerably between countries. Nonetheless, we know enough to conclude that chronic musculoskeletal pain affects at least 100 million people in Europe and is yet undiagnosed in over 40% of cases.  MSDs account for half of all absences from work and for 60% of permanent work incapacity. Up to 50% of individuals with certain forms of arthritis retire within five years of the onset of the disease.  By the European Commission’s own calculation, MSDs result in more sickness absence than stress, and cost European countries up to €240 billion annually.  

They are the leading cause of disability and inactivity among Europe’s working-age population. In some EU countries MSDs account for 40% of the costs of workers’ compensation, and cause a reduction of up to 1.6% in the gross domestic product (GDP) of the country itself. The significant burden on European society is estimated at up to 2% of GDP.  The pension crisis faced by many Member States will compel many more citizens to work beyond their expected retirement age. As a result, already by 2013, the average workforce of 100 could include 48 employees with one or more long-term conditions, including chronic MSDs and we already know that in some Member States, for example, over 40% of men receiving hip replacements are of working age. 

Making Europe Fit for Work: A Call for Action at EU and National level to Address the Burden of MSDs

The Fit for Work Europe Coalition calls on EU and National Governments to make early intervention and work ability  priority areas for optimal care and management of Chronic Conditions, especially among citizens of working age. In order to help people with Chronic Conditions, the EU and its Member States should prioritise making the necessary changes to comprehensively and efficiently manage Chronic Conditions, including MSDs, through the establishment of National Plans which embrace early diagnosis, prevention and access to early, appropriate treatment, care and support that fosters continued labour market participation thus resulting in health, social and economic gains for Europe's economy.

FfW encourages the EU and National Governments to implement the following solutions:

- Early intervention in treatment and care of MSDs can lead to improved functionality and work ability and can serve as a case study for optimal care and management of a range of other Chronic Conditions, especially among citizens of a working age.

- Establishing European and National Directors for Health and Work can help to stimulate a more strategic integrated approach across the EU and national health, employment, social affairs and finance departments.

- Health Technology Assessments (HTAs) and health economic evaluation targets should be holistic and include clinical and societal impacts of regimens which support people with MSDs or other Chronic Conditions. Such evaluations can help result in health decisions that help patients to remain active and productive in the labour market, as opposed to decreased work ability and potential reliance on welfare payments.

- Work ability should be established as a clinical outcome of treatment and a meaningful dialogue about a patient’s workability status should occur regularly between people with MSDs and healthcare professionals.

- Better data generation and exchange is required at national and EU level on prevalence, incidence and costs of MSDs and other Chronic Conditions among the current and future EU workforce, as well as on successful solutions of improving productivity through early intervention practices and modified working conditions.

- Methods, tools and support networks to increase patient engagement and self management practices should be developed which support positive clinical and labour market outcomes.

- Cost-effective and timely physical and psychological therapies for people of working age with MSDs improves access and return to work as well as full and fulfilling labour market participation of people with MSDs.

- More collaboration between primary care physicians and specialists (e.g., physiotherapists and occupational therapists) is needed to ensure that healthcare professionals are supported in making decisions about work disability, job retention or return to work, including a revision of the medical statement so that work ability is part of clinical outcomes.

- Better enforcement of existing national legislation requiring reasonable workplace accommodations can help people to stay in work or reintegrate into the workforce.

- Labour market policies should be geared towards helping employees with Chronic Conditions and disabilities to remain in work or reintegrate into the workforce. This should include flexibility in welfare benefits which allows workers to earn income and claim financial support while they phase their return to work.