Impact Of Chronic Health Conditions/Disabilities

Question 1

What is the first challenge facing work, health and society?

Answer 1

To minimise ill health and mitigae its effects on function, enabling participation in work and extending working life.

Question 2

What are the annual economic costs of sickness-absence and worklessness associated with ill health?

Answer 2

Over 150 billion pounds - greater than the budget of the NHS.

Question 3

What risks are associated with high levels of sickness-absence and worklessness?

Answer 3

• diminished quality of life in Britain
• undermine efforts to reach full employment
• deny business the talent and contributions of a potential workforce
• condemn workless families to a cycle of poverty and dependency that will widen inequalities, perpetuate social injustice in the most deprived communities and obstruct efforts to eradicate child poverty.

Question 4

What is a newer definition of health?

Answer 4

To be able to do as much as possible for as long as possible in working and non working lives.

Question 5

Describe the extent of global disability.

Answer 5

• 15% of people experience physical or mental disability
• > 1 billion people
• 200 million of which are children

Question 6

Why are the number of people with disabilities increasing?

Answer 6

• population growth
• increase in chronic disease
• medical advances which extend and prolong life (ageing population)

Question 7

State the figures of disability and impairment for the UK.

Answer 7

• 11 million people affected
• 6% of children classed as having disability or impairment
• 16% of working age adults classed as having disability or impairment
• 45% of adults over state pension age classed as having disability or impairment

Question 8

What is the definition of a disabled person according to the Equality Act of 2010?

Answer 8

A disabled person is one with a physical or mental impairment that has a substantial or long term effect on his/her ability to carry out normal day to day activities (but not on their ability to do a job).

(Even if a condition is controlled by drugs or assisted by a aid e.g. hearing aid/counselling, it still counts as a disability. Exception is eyesight being controlled by spectacles)

Question 9

Define impairment.

Answer 9

Due to an injury, illness or congenital condition that causes or is likely to cause a loss or difference of physiological or phsychological function

Question 10

List some of the causes of disability in young people.

Answer 10

• prenatal
• premature
• birth injury e.g. cerebral palsy
• congenital e.g. Down’s syndrome
• accident
• infection e.g. meningitis, polio, septic arthritis
• violence
• disease
• developmental e.g. Spina bifida, club foot
• metabolic e.g. rickets

Question 11

List some of the barriers that children with a disability may face.

Answer 11

• physical disability
• locomotor disability
• cosmetic disability
• sensory e.g. blind or deaf
• cognitive impairment

Question 12

List some examples of purposeful activity.

Answer 12

• paid employment
• self employment
• voluntary work
• education
• carer
• homemaker
• child rearing
• full time or part time
• community activies e.g. clubs, church

Question 13

What factors can influence participation in work and school?

Answer 13

• personal
• external
• disease

Question 14

What is the biopsychosocial model of disability?

Answer 14

• disability
• attitudes and beliefs
• psychological distress
• social reinforcers

Question 15

List some of the promoting factors for promoting young disabled people in work participation.

Answer 15

• gender - male
• educational level predictive for employment
• parental educational level
• higher level of psychosocial functioning
• lower scores on depression scales

Question 16

List some hindering facts of young disabled people in work participation.

Answer 16

• lower educational factors
• gender - female
• inpatient treatment a negative predictor
• motor impairment
• wheelchair use
• functional limitations
• multiple health problems
• low mental health perception, dependent coping strategy impeding factors for employment

Question 17

State the qualifying conditions for disability regulations.

Answer 17

• physical impairment, includes sensory
• mental impairment, includes mental illness and learning difficulties
• substantial effect = > 12 months or terminal
• effect on day to day activities

Question 18

List some of the ways in which a disability may have an effect on an individuals day to day activities.

Answer 18

• mobility
• manual dexterity
• physical coordination
• continence
• ability to lift, carry or otherwise move everyday objects
• memory or inability to learn or concentrate
• pain, fatigue, severe disfigurement

Question 19

What is the doctors role in advising about disability to employers?

Answer 19

• identification of the health issue
• understanding the prognosis
• assessment of impact on functioning
• knowledge of the work undertaken
• assessing fitness for work
• are restrictions, adaptations, adjustments needed?

Question 20

What are some reasonable adjustments that could be made to help a disabled person to work?

Answer 20

• adjustment to premises, workstation e.g. voice activated software
• support e.g. supervision
• change in duties/redeployment
• modification of hours/place of work
• absence from work for treatment/rehabilitation
• may involved moving from higher to lower grade of job

Question 21

What is the role of health professional in deciding what reasonable adjustments may be suitable for a disabled person?

Answer 21

• state whether or not there is an impairment
• state effect on day to day activities
• state how long it will last
• recommend adjustments to enable worker to do the job
• should not definitively state that the person is disabled as that is a legal issue

Question 22

What is the role of the occupational health physician?

Answer 22

• assess fitness for work e.g. pilots, train drivers
• stop workers being damaged by their work
• control occupational hazards and risks
• adapt work to suit the ageing or disabled worker
• assess impact of health on ability to work
• to extend working lives
• assess eligibility for ill health retirement

Question 23

Why is good work important?

Answer 23

• good work prolongs life expectancy
• defines who you are, what you earn, life expectancy
• gives you a purpose
• promotes well being
• bad work damages health

Question 24

List some of the activities of daily living.

Answer 24

• personal care
• dressing
• walking, stairs, distances
• domestics tasks e.g. housework, gardening
• driving
• work tasks
• financial tasks

Question 25

What percentage of working age population for on ESA in Scotland?

Answer 25

2.5% (3.5% in Glasgow)

Question 26

What percentages of 55-59 year old males are on ESA in Scotland?

Answer 26

18% (30% in Glasgow)

Question 27

What percentage of ESA claims are due to mental health issues?

Answer 27

> 50%

Question 28

What is the Healthy Working Lives strategy in Scotland?

Answer 28

Individuals are empowered and enabled to do as much as possible, for as long as possible, or as long as they want, in both their working and non working lives.

Question 29

How can worklessness impact the next generation?

Answer 29

• more likely to suffer from low income and poverty
• lower parental incomes correlates with poor health in children
• child deaths from injury correlate with low employment status and worklessness
• behavioural and conduct orders are more likely when no parent is working
• children of workless households are more likely to be workless when older

Question 30

What factors contribute to the process of becoming workless?

Answer 30

• failure of educational and skill development sector
• lifestyle factors not addressed systemically
• lack of occupational health and safety
• NHS doesn’t bother about return to work
• NHS does not have maximisation of functional capacity as a treatment outcome measure

Question 31

What is the future of the NHS in terms of decreasing worklessness?

Answer 31

• fit note instead of a sick note
• maximising functional capacity to be considered as part of every treatment or care plan and every clinical interaction
• vocation advice should be offered routinely
• diagnosis, treatment and function
• not just about traditional work - think purposeful activities