Services for people with rheumatoid arthritis - Public Accounts Committee Contents

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

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