- Managing long-term health conditions in the Workplace.
- Long-term health conditions versus disability.
- Equality Act & Reasonable Adjustments – Top Tips.
- Possible Reasonable Adjustments.
- What happens if you do not make reasonable adjustments?
- Is long Covid a disability?
- Definition of Long Covid.
- Possible Support for employees experiencing long covid.
- Case studies – where it has gone wrong.
- 6 top tips for businesses for managing long-term health conditions
Long-term conditions are often referred to as chronic conditions within the UK, these conditions will require ongoing treatment and management. In some cases, for the person’s entire life, for example, asthma or diabetes.
Symptoms of long-term health conditions can vary, impacting the person’s quality of life and limiting the activities they can do. The person may require physical therapy or lifetime medication as a result of the condition. The condition may be slowly progressing, developing, and worsening over time, such as arthritis or heart disease.
In the UK, people with disabilities are protected under the Equality Act 2010. The Act outlines that a person has a disability when a physical or mental impairment has a substantial and long-term adverse impact on day-to-day activities. ‘Long-term’ means the conditions has lasted or are expected to last 12 months or more.
Long-term health conditions UK statistics
- 30% of the UK population live with one or more long-term health conditions.
- More than 4 million of these people also suffer from mental illness.
- The HSE reports there were 32.5 million estimated working days lost due to work-related ill health.
- People out of work due to long-term sickness increased by 363,000 since early 2020 (ONS)
Whilst they are two distinct concepts, long-term health conditions and disability intersect with each other at times, we have provided an outline of each below.
Long-term health conditions also known as chronic diseases are health issues that need continual management usually for a longer period of time, or life falling diagnosis. Managing long-term health conditions can be overwhelming, due to it impacting a person’s quality of life.
Disability is an overarching term for impairments, movement limitations, and participation constraints, according to the World Health Organisation (WHO). A disability may emerge from a mental, physical, or sensory impairment i.e., losing their vision. A disability impacts how a person interacts in society.
Considerations are needed for the barriers within a person’s environment preventing them from fully interacting in society, for example, if a person is in a wheelchair, they may only be disabled in environments lacking wheelchair accessibility.
Mental health may be defined as a disability when it significantly impacts a person’s daily life for at least 12 months, it is considered a disability under UK law. The Equality Act 2010 was developed to protect individuals suffering from mental health illness from discrimination and ensure equal opportunities.
- A long-term health condition is defined as a condition that cannot at present be cured but can be controlled by medication and therapies.
- A physical disability, or physical impairment, which may have a substantial and/or long-term adverse effect on a person’s ability to carry out normal day-to-day activities.
- This may include long-term conditions, which may have an impact on daily living, as well as physical challenges faced by some individuals.
- The key message here is about individuality, and not assuming that any condition affects everyone in the same way.
*Remember* you are not an expert in the condition, and you are not expected to be! This is why hiring external support is crucial for guidance for best steps going forward when managing long-term health conditions.
Think outside the box when it comes to reasonable adjustments showing the business has taken all measures and considerations possible to make adjustments helping to keep the employee working with the company.
Remove the bias when managing long term health conditions. Each case is unique to the individual, impacting them in various ways. Don’t think “well my aunt had this condition and didn’t have this symptom; she could work without adjustments.” Taking advice from professionals, on a case-by-case understanding is highly recommended.
Keeping up to date is crucial, as consistently gathering information on employment laws and reasonable adjustments helps to manage long-term health conditions as well as keep the business on the right side of laws.
People managers have significant impact on employee health at work, more than many will realise – keep this in the back of your mind when managing long-term health conditions.
- Phased return to work programme
- Alterations to start and finish times
- Altered hours, shorter days, days off in between workdays
- Alteration to workload (fewer tasks than normal)
- More time to complete tasks
- Need for more regular breaks
- Temporary changes to tasks
- Seek professional advice
Overlooking the importance of making reasonable adjustments in the workplace may have serious repercussions. Failure to comply with discrimination laws, employees may raise grievances against employers, and these may lead to tribunal claims. Tribunal claims may have a negative impact on the business’s reputation, impacting recruitment and retention of employees.
Discrimination claims are uncapped in relation to compensation for injury to feelings, meaning there may also be serious financial implications. Awards currently range from £1100 to £56,000. The financial implications only should put pressure on employers to take all necessary steps.
Failure to make reasonable adjustments may lead to negative employee relations, lowering staff morale and trust. This may result from employees feeling their needs are not being meet or addressed by the employer. Employers may see a drop in productivity and motivation.
Furthermore, the business’s reputation may be significantly impacted as corporate social responsibility (CSR) has a great sway on brand reputation. Poor CSR from being seen to discriminate against employees when managing long-term health conditions, may damage customer loyalty and future business leads.
A disability is “a physical or mental impairment that has a substantial and long-term negative effect on a person’s ability to do normal day-to-day activities.”
“Post-COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis.” World Health Organisation
With each individual experiencing different symptoms, severity of symptoms and duration of symptoms of long Covid, it is hard to say whether it will always amount to a disability. In October 2021, the ONS estimated that there was 1.2 million experiencing long COVID in the UK, in January 2023 this is now estimated to be 2 million.
The Trade Union Congress (TUC) had recently called for it to be recognised as a ‘deemed disability’ to overcome this issue – in other words, for it to automatically be accepted as a disability, bypassing the complexities of the statutory definition above.
However, if this was to be implemented, it will likely lead to arguments as to where the boundary between normal Covid and long Covid lies.
Due to the uncertainty as to whether long Covid will be a disability in each person’s circumstances, it will be lower risk for you to act on the basis that employees with it have a disability while more information is pending. This means focusing on the reasonable – adjustments you can make.
Even if long Covid is not a disability, you should be careful that policies do not disadvantage those with the condition or indirectly discriminate against other protected characteristics.
For example, long Covid has so far been found to affect older people, ethnic minorities, and women more severely. A SAGE independent report found that the general population usually experiences mild symptoms of COVID-19 and 5-10% will develop long COVD.
Symptoms of Long Covid
- Feeling unwell
- Cognitive symptoms-Brain fog, confusion, memory loss
- Persistent Cough
- Gastric problems
- Neurological symptoms- ringing in the ears, loss of feeling in hands/feet.
Managing long term health conditions brings the need for support systems in the business, taking consideration by a case-by-case bases.
• Time off for appointments
• No lone working
• Clear objectives and regular communication
• Working from home or Hybrid working model
• Equipment adjustments
- What else is the employee asking for?
- What have the experts recommended?
L Buchan V West Lothian Board (2021)
An Edinburgh hospital worker was dismissed by health board following a long sickness absence, as of injuries sustained from being hit by a van door at work. Ms. Buchan won her unfair dismissal and disability discrimination case against NHS Lothian and awarded £11,571.51 by the tribunal. The compensation was for injury to feelings, as Ms Buchan claim of disability harassment was not upheld by the tribunal.
The accident had left her out of work for 2 years, previous to the accident Ms Buchan had been experiencing lower back pain and numbness in her fingers. Occupational health had done an assessment, but the pain did not affect Ms Buchan ability to attend work, prior to the accident she had no sickness absence.
The accident occurred in April 2019; Ms Buchan was opening one of the backdoors of the van she used for work. The wheelchair ramp extended unexpectantly, causing the other door to open causing Ms Buchan to be hit, falling to the ground.
Despite being injured Ms Buchan did not take any time off work but communicated to her line manager that her existing pain had worsen, particularly the pain and numbness in her left arm. Due to the persistent pain, she was signed off work even though she was trying to “push through” and continue to work.
Ms Buchan had raised issues regarding her pay, how her line manager handles the long-term absence and how her application for injury allowance was in the first instance unsuccessful. Fast forward to September 2020, during a meeting, dismissal had been mentioned causing Buchan to become upset and suggesting a role where she can work from home, as she had been signed off to do so.
A year later, NHS Lothian had come to the decision to terminate Ms Buchan employment on the grounds of capability due to her being unable to meet the expected standards of attendance for her current or other roles. When this decision was made, Ms Buchan had been on sick leave for 2 years due to a workplace injury.
NHS Lothian failed to make reasonable adjustments for Ms Buchan i.e., providing a work from home role. Leading to Ms Buchan being awarded £ 11,571.51. Learning from NHS Lothian is to train line managers on managing long-term health conditions, ensuring this doesn’t occur again.
- Treat each case individually: people experience with long-term health conditions is unique and should be managed in the same way. Creating plans specific to the person is highly recommended, whether this is working from home or flexible working times. Encourage open communication between the employee and line managers.
- Proactively manage absence: employee handbooks should have an absence management policy, helping line managers to refer back to. Arrangements should be made in order to cover the person’s workload if absence for a long period of time. Consider the return-to-work process, will this be a phased return.
- Educate line managers: training line managers on how to handle long-term health conditions, this involves signs of struggle in an employee, identifying the employers’ legal obligations and the support incentives available for the employee.
- Take advice at every step of the way to keep you right: you are not expected to be an expert, consult with health professionals, lawyers and HR consultants regularly to help manage the situation properly. HR consultants will help line managers understand the risks involves by taking particular steps.
- Be mindful of uncapped claims: Employers have a duty of care, understand the laws as to not leave the company liable costing them possibly 10s of thousand pounds.
- Be patient and trust the process: managing long-term health conditions is a long process, don’t make any quick/emotional decisions. Continue to make adjustments where possible and within reason, utilising all avenues available to the business i.e., external HR consultants.
When managing long-term health conditions investing in outsourced HR services is recommended. Our team of HR consultants can guide you through the process for managing long-term health conditions with the best practices.