· Features

Managing employees with long-term illnesses

More people are living and working with long-term health conditions. What does this mean for HR departments? GABRIELLA JÓZWIAK explores the business impact of ill-health.

More than one in four people in England currently live with a long-term health condition. These are defined as incurable problems controlled by medication or therapies. Changes to workplace policies, such as ending the default retirement age, mean people will live and work for longer, but not necessarily in good health. What can HR directors do to keep workplaces functioning?

The Department of Health predicts the ageing population and increased long-term conditions will cost the Government an extra £5 billion by 2018. And The Work Foundation researcher Karen Steadman says equal opportunity and disability legislation will keep workers with conditions in jobs.

She says HRDs should consider the impact of comorbidity – more than one long-term health condition – particularly combinations of physical and mental conditions. 

The Department of Health expects the number of people with three or more conditions to rise from 1.9 million in 2008 to 2.9 million by 2018. “Evidence shows when there’s a physical and mental health condition, productivity is really decreased,” adds Steadman. 

She advises HR professionals to make use of existing support services, such as the Government’s Access to Work scheme. The challenge is greater for small and medium sized businesses, warns Steadman, but she suggests that the forthcoming national Health and Work Service, which will offer free health support to employees and employers, could provide a lifeline.

Business in the Community’s (BITC) Workwell campaign director Louise Aston urges HRDs to focus on prevention. “It’s also down to personal employee responsibility, but it’s the employer’s role to support staff to do that,” she says.

As explored in our cover feature, wellbeing initiatives work best when they are positioned as strategic boardroom issues and aligned with business objectives. “The most successful strategies we’ve seen are where HR finds a boardroom champion outside HR, such as a CEO,” says Aston. “Companies doing really well also report publicly what they’re doing. What gets measured gets managed.”

Thankfully, for companies struggling with restrained budgets, it doesn’t have to cost the earth. Aston emphasises prevention is inexpensive and recommends free health promotion resources offered by charities, or events such as the national mental health campaign Time to Change.

HR magazine spoke to the forward-thinking HR directors who are tackling the big problems of the future, today. Here’s what you can learn from them about the ticking timebomb of long-term health conditions.

Mental Health

Mental ill health cost the UK economy £70 billion in 2013, according to the OECD. Consumer goods manufacturer Procter & Gamble (P&G) launched a healthy mind strand in its wellbeing scheme last year. HR director Niall de Lacy says the company recognised employees face increased pressures. 

De Lacy believes improving workplace mental health will give the company competitive edge. “It will be a more productive organisation that delivers great results,” he says. “There’s a commercial advantage as well as ibeing the right thing to do.”

P&G uses resources provided by BITC to shape training for line managers. De Lacy has also created a core group responsible for healthy minds that meets monthly and incorporates leaders from all departments. One positive result has been employees speaking out about personal experiences and acting as role models, which helps challenge the stigma around mental health. 

Accountancy and consultancy firm EY is tackling the issue using a strategy called Mental Health First Aid (MHFA). The approach aims to give employees skills and confidence to give crisis first aid for dealing with suicide and self-harm, increase awareness and reduce stigma. Having already set up an employee mental health network, last year senior manager of employee relations Paul Quinlan decided more action was needed.

“A fairly significant volume of our sickness absence was reported due to anxiety and depression,” he says. “We also had the odd call to HR saying: ‘One of my managers has just received a voicemail from a team member saying they’ve tried to commit suicide, what should they do?’”

As a result, Quinlan sent staff to MHFA training courses. So far, 100 workers have attended two-day courses and EY is currently working with MHFA to create a two-hour course in-house. It has also introduced mental health buddies and included a psychological care pathway as part of its occupational health service. It runs preventative events, webinars and drop-in clinics that address causes of mental health problems.  

Musculoskeletal disorders 

Musculoskeletal conditions include injury or damage of limbs or the back. According to Government statistics, they accounted for 41% of work-related illnesses in 2011/12. 

At BT, group safety adviser David Wallington leads action to avoid or treat musculoskeletal conditions among 60,000 employees. He says prevention is key, through educating staff and providing equipment that reduces risk. “For example, we’ve changed how we lift manhole covers,” says Wallington. “We used to use drain keys but now use a mixture of mechanical and hydraulic liftingaids to remove the risk of back injuries.” 

Wallington says the most common cause of musculoskeletal disorders among his workforce is moving awkwardly, particularly when getting out of vehicles. “A lot could be avoided if people took time to make sure they were properly warmed up by doing a little stretching,” he advises. 

Office staff are given ergonomically sound desk furniture. Managers segregate rotas with fixed breaks to ensure workers keep moving. Wallington also instructs all employees to check workstations daily. “We expect people to do a dynamic risk assessment every time they do a job: a short 20 second check before you sit down,” he says. “Similarly, engineers in the field should ensure they’re taking appropriate steps before starting.”

When injuries do occur, BT provides staff with telephone-based and hands-on physiotherapy. Concerned employees can call a helpline to discuss their condition. If they need intensive treatment, BT offers a one-week rehabilitation programme. This has helped 93% of employees return to their role. “Early intervention is very important and cost-effective,” says Wallington.

Coronary heart disease 

An estimated 2.7 million people in the UK live with coronary heart disease, which causes heart attacks and angina. Hitek Electronic Materials has worked with the British Heart Foundation (BHF) to address the condition in its distribution centre. 

Three years ago, marketing executive Gemma Hickson set up a wellbeing scheme using free BHF resources. As a result, Hitek promotes good health by giving pedometers to employees so they can hold competitive walks. It provides free fruit and bottled water, and rewards employees who manage to give up smoking. Almost all 22 staff members have successfully quit.

Unfortunately, an employee recently suffered a heart attack. The event prompted Hickson to consider installing a defibrillator in the office. “The attack didn’t happen in the workplace, but the MD backed us – an attack can happen at any time,” she says. With the help of BHF and the local ambulance service, Hitek installed a machine compliant with local medical services.

Ambulance staff also provided free training. “We’re in an industrial estate so we’ve told other businesses to send employees to have defibrillator training too,” adds Hickson. “We can justify the cost – the defibrillator could save someone’s life.”

Chronic obstructive pulmonary disease (COPD) 

COPD includes lung diseases such as chronic bronchitis and emphysema. According to the Department of Health, respiratory illnesses cause 24.9 million days of certified incapacity annually in the UK – costing £1.7 million. 

The British Lung Foundation (BLF) works with companies to encourage early diagnosis. It provided lung screening to 261 employees at Legal & General’s Surrey office. The initiative was led by partnerships account coordinator Sue Winterburn, after her father died from a lung-related illness. She arranged for BLF respiratory specialists to visit the office and perform handheld spirometry tests. They advised employees with lower than expected lung function to see their GPs. 

As a result, 7% of staff received referrals, 93% said they had raised awareness of lung health and 80% have tried to eat more healthily. “It was a great feeling to see so many colleagues have the test and walk away with the knowledge that they had a great set of lungs,” says Winterburn. “Everyone said what a great thing for Legal & General to do on-site and that they wouldn’t have gone to the doctors specifically for this test.”


More than 150,000 people in England have strokes each year, which occur suddenly when the blood supply to part of the brain is cut-off. Strokes are the biggest cause of adult disability in the UK, but people can recover and return to work. The Stroke Association has several employees who have suffered a stroke.

HR director Valerie McGlinchey says employers should assess each situation individually as every stroke is different. One of her staff returned with some left-sided weakness. “They have to attend regular physiotherapy, which we accommodate,” she says. “Their mental processes for the most part are fine, but periodically they might lose their train of thought so the line manager occasionally checks their writing.”  

McGlinchey says managing an employee’s return to work is important, and advises HR professionals to discuss with the individual how to communicate with other staff. “In one case we worked with the employee to agree an email for their team, which described the condition and how that affected them,” she says. “It bridged the gap between them being off work for a long time and coping with being different when they returned. It helped answer the team’s questions.” She also advises employers stay in touch with employees periodically during recovery. 


More than one in three people will develop some form of cancer. Cancer charity Macmillan’s Working Through Cancer programme provides employers with advice to help staff affected by cancer, such as making work adjustments or supporting carers.

One service is an in-house training session. The Vineyard Group of privately-owned hotels introduced it last year for managers and HR staff. HRD Emma Jenkins says it helped HR feel more comfortable supporting colleagues. 

“The main thing we took away was it’s not a one-size fits all approach,” she says. “We can’t pull out one process – the starting point is: How can we help you?” 

Jenkins says she had not considered that with some cancer patients, HR should discuss end of life plans. “You might have to discuss them handing in their notice – that was shock,” she says.

Later in the year, Jenkins plans to raise awareness of self-checking among staff for symptoms of prostate and breast cancer by hosting a Macmillan World’s Biggest Coffee Morning fundraising event. 

“That’s a good time to talk,” she explains. “As a manager it can be quite stressful if you don’t know how to deal with something. You can get panicked and say or do the wrong thing. But your employees are your biggest asset and being able to talk about something like cancer is key.”