Managing long-term worklessness in primary care: a focus group study

Cohen, Deborah; Marfell, Naomi; Webb, Katie; Robling, Michael; Aylward, Mansel

doi:10.1093/occmed/kqp169

Cited by 22 publications

(12 citation statements)

References 15 publications

(20 reference statements)

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“…Several studies have shown that certification rates are higher for patients presenting with psychological problems, and the condition seems to generate greater sympathy from GPs (6,9,17 -20). There is little evidence to support the therapeutic role of abstaining from work for those with mental health problems (21,22). However, patients have reported that stress and depression have a high impact on the ability to work, and thus…”

Section: Reasons For Psychological Related Sickness Certifi Cationmentioning

confidence: 99%

Assessing fitness for work: GPs judgment making

Foley

Thorley

Hout

2013

European Journal of General Practice

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Background:The complexity of a fi tness for work consultation is well documented. General practitioners (GPs) fi nd that such consultations often create confl ict and they feel ill-prepared for the task. Objectives: We aimed to examine the consultation process in the fi tness for work consultation and to report on the response of GPs to two hypothetical consultations of work related sickness absence, one of a psychological and one of a physical nature. Methods: Three areas of the consultation were examined; social/family circumstances, workplace history and information required assessing the severity of the condition. We used a randomized design using an online questionnaire completed by 62 GPs located in the Republic of Ireland. Analysis was conducted in NVivo 8 qualitative software using thematic and content analysis techniques. Results: GPs may be expected to collect and consider information relating to social, domestic, fi nancial, lifestyle and workplace factors, including workload, job satisfaction, job strain, work ethic, inter staff relationships and employee support mechanisms. The mode of presentation may trigger specifi c information seeking in the consultation. Conclusion:GPs may evaluate fi tness for work in a variety of ways depending on medical and non-medical factors. Further research should further examine the factors that may infl uence the GPs decision to prescribe sickness leave.

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Section: Reasons For Psychological Related Sickness Certifi Cationmentioning

confidence: 99%

Assessing fitness for work: GPs judgment making

Foley

Thorley

Hout

2013

European Journal of General Practice

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“…Personally addressing certain health‐related barriers was viewed by most Personal Advisers as a legitimate task to perform. However, understanding the impact of a claimants’ health condition and identifying suitable forms of work can be a challenging task, and healthcare professionals have struggled to achieve this (Cohen, Marfell, Webb, Robling, & Aylward, ). Importantly, there are many differences between the role of the Personal Adviser and a healthcare professional.…”

Section: Discussionmentioning

confidence: 99%

Experiences from the frontline: An exploration of personal advisers’ practice with claimants who have health-related needs within UK welfare-to-work provision

Ceolta-Smith

Salway

Tod

2018

Health Soc Care Community

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Recent UK welfare reforms have been less successful than expected by the Government in supporting unemployed people with long-term illness into work. Frontline workers remain a core element of the new welfare-to-work machinery, but operate within a changed organisational and policy landscape. These changes raise important questions regarding whether and how claimants' health-related barriers to work are considered. This paper examines the UK welfare-to-work frontline worker's role with claimants who have long-term illness. Fieldwork observations in three not-for-profit employment support services and semi-structured interviews with 29 participants (claimants, frontline workers, healthcare professionals and managers) were conducted between 2011 and 2012. Participant observation of the wider welfare-to-work arena was initiated in 2009 and continued until 2013. A qualitative methodology drawing on ethnographic principles was adopted. Thematic analysis of the data was carried out. The findings show that the frontline worker plays a key role in assessing and addressing claimants' health-related barriers to work. Two important health-related role dimensions were identified: a health promoter role which involved giving health promotional advice to claimants about their general health; and a health monitor role which involved observing and questioning claimants about their general health. Frontline workers' practice approaches were shaped by organisational and individual factors. Integration between the National Health Service and employment support services was limited, and the findings suggested improvements were required to ensure an adequate response to claimants' health-related needs to support their journey into work.

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“…However, workplace health appears to be an area of practice where GPs report a lack of knowledge, confidence and training in handling work issues with patients (Roope et al ., 2009; Money et al , 2010). Changes to the system involve challenges for the GP, particularly in the areas of long-term worklessness and rehabilitation (Cohen et al , 2012). Our results support previous evidence that suggests that GPs may avoid research in this complex area because of such issues.…”

Section: Discussionmentioning

confidence: 99%

Feasibility trial of GP and case-managed support for workplace sickness absence

Rannard

Gabbay

Sen

et al. 2013

Prim Health Care Res Dev

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The design was a feasibility-controlled trial in which participants were sickness absentees, or presentees in employment with work-related health problems. Individuals completed health status measures (SF-36; EQ-5D) and a Job Content Questionnaire at baseline and again at four-month follow-up. Findings In the intervention group, 29/60 participants completed both phases of the trial. GP practices referred two control patients, and, despite various attempts by the research team, GPs failed to engage with the trial. This finding is of concern, although not unique in primary care research. In earlier studies, GPs reported a lack of knowledge and confidence in dealing with workplace health issues. Despite this, we report interesting findings from the case-managed group, the majority of whom returned to work within a month. Age and length of sickness absence at recruitment were better predictors of return-to-work rates than the number of case-managed contacts. The traditional randomised controlled trial approach was unsuitable for this study. GPs showed low interest in workplace sickness absence, despite their pivotal role in the process. This study informed a larger Department for Work and Pensions study of case-managed support.

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Managing long-term worklessness in primary care: a focus group study

Cited by 22 publications

References 15 publications

Assessing fitness for work: GPs judgment making

Assessing fitness for work: GPs judgment making

Experiences from the frontline: An exploration of personal advisers’ practice with claimants who have health-related needs within UK welfare-to-work provision

Feasibility trial of GP and case-managed support for workplace sickness absence

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