3 Helping people with rheumatoid arthritis
to be able to work
17. Almost half of the adult population with
rheumatoid arthritis is of working age. Three quarters of people
with the disease are diagnosed when of working age, and one third
of people with the disease will have stopped working within two
years.[54] The wider
costs to the economy of sick leave and work-related disability
(lost employment) in respect of rheumatoid arthritis amount to
an estimated £1.8 billion annually.[55]
18. If people were diagnosed with the disease
earlier and had maintained treatment, their chances of continuing
in work could be much improved.[56]
The National Audit Office had identified in its economic modelling
that increasing from 10% to 20% the number of people treated within
three months of experiencing symptoms would increase NHS costs
by £11 million over five years but could result in productivity
gains of £31 million for the economy, due to reduced sick
leave and work-related disability.[57]
There is, however, no particular incentive on the NHS to fund
earlier treatment.[58]
19. Effective support to remain in or return
to work depends on dialogue between the Department of Health and
the Department for Work and Pensions and in particular the views
of medical assessors employed by the Department for Work and Pensions
to determine the impact of a medical condition on someone's ability
to work. The Committee was sceptical that in practice assessors
had the necessary expertise to recognise and understand rheumatoid
arthritis and the impact the disease can have on someone's working
life. The Department, however, said that the Department for Work
and Pensions was satisfied that assessors understood rarer conditions
such as rheumatoid arthritis and could make proper judgements
about people and their ability to work.[59]
20. Little progress had been made in improving
access to services to help people with musculoskeletal conditions
manage their return to work, despite the Government's commitments
in its response to Dame Carol Black's March 2008 Review of the
health of Britain's working age population, Working for a healthier
tomorrow.[60] The
Department recognised that Dame Carol Black's work envisaged more
coherent working between the Department of Health and the Department
for Work and Pensions, but acknowledged that progress had been
poor.[61]
21. The National Audit Office Report identified
a lack of coherence in the links between the NHS and organisations
commissioned by the Department for Work and Pensions to help people
get back to work. Just 56% of acute trusts were aware of Department
for Work and Pensions schemes to help people back into work, and
a third of these did not provide information about the schemes
to people with rheumatoid arthritis.[62]
Only 12% of GPs gave information about continuing in employment
to patients newly diagnosed with rheumatoid arthritis. People
with rheumatoid arthritis rated services to support them to remain
in work as the least effective services compared with other aspects
of their care, and just 20% of people with the disease considered
they received sufficient information about employment issues.[63]
54 Q 72; C&AG's Report, paras 1.7 and 1.2 Back
55
C&AG's Report, para 1.10 Back
56
Q 23 Back
57
C&AG's Report para 17 Back
58
Q 12 Back
59
Q 24 Back
60
Q 71; C&AG's Report, para 4.15 Back
61
Q 71 Back
62
C&AG's Report, para 4.19 Back
63
C&AG's Report, para 4.18 Back
| 
