Society of Occupational Medicine President Dr Shriti Pattani on the Spring Budget
I caught up with Society of Occupational Medicine President Dr Shriti Pattani, at the Health and Wellbeing at Work Conference to get her take on the announcements in the Spring Budget.
LS: The Chancellor announced a focus on a healthy workforce as part of the Spring Budget on 15/03/23, which included
1) Highlighting the gap in the occupational health landscape that exists in the UK
2) Finding ways to support more businesses to access occupational health
3) Focussing on tailored employment support within mental health and MSK services in England
What do you think these announcements mean for occupational health and the challenges the country is facing?
SP: To start with, it is really positive that the government have acknowledged the gap in the healthcare landscape when it comes to occupational health. They have also drawn attention to the importance and potential of occupational health in addressing issues with labour force shortages due to long term ill health. The government taking steps in this direction shows that they understand incentives around health, work and economic growth can be aligned.
LS: I agree. It can feel challenging to get the occupational health agenda and the potential of occupational health across to employers, policy makers and the public. Hopefully this Budget will focus the conversation on what needs to be done. Are you concerned that this is all talk with not enough action to follow?
SP: The Budget does outline one specific route that will push towards widening access to occupational health- through a pilot business subsidy scheme. Other announcements may take some time to come into fruition, including two consultations. One consultation will look at incentivising take up of occupational health through the tax system and another will examine ways to boost UK occupational health coverage. Realistically, it could be years before we see positive change to the work and health landscape from those two consultations.
The Office of Budget Responsibility has estimated that only 10 000 more people will be in employment in five years’ time as a result of today’s announcements, compared to more than half a million people living with long term ill health saying they want to return to work. In the fourth quarter of 2022, 2.5 million people of working age were economically inactive due to long term ill health or disability. This suggests that real terms change from the policy announcements will be limited and not on the scale necessary to address the current challenges the UK is facing.
LS: The announcements do fall short of the focus on work and health in recent months which laid the groundwork for more government investment than we have seen with this Budget. The two consultations seem quite far from delivering any meaningful change at this point. What do you think about the announcement of embedded tailored employment support within mental health and musculoskeletal services in England?
SP: While more resource and more profile on work and health is a good thing and mental health and musculoskeletal services are certainly key areas, one risk is around making sure resources are being used appropriately. Occupational health needs to be at the centre of conversations around work and health. Without that occupational health expertise, it can be difficult to funnel resources to what is most effective for the worker and the employer.
LS: I agree it can be harder to have productive conversations around work and health in non- occupational health contexts. Most clinical staff from other specialities will have had minimal training in occupational health. The fit note is an example of this- data suggests it can be difficult to use the fit note to its full potential in general practice.
SP: With more resource coming into the work and health space there will be an increasing need to make sure SME and taxpayer money is being used appropriately. As a speciality we have a responsibility here to make sure what is being offered and implemented is evidence based. The corporate wellbeing sector is not always evidence based and can be challenging for SMEs to navigate. The focus of any investment must be on health and employment outcomes and driven by evidence-based interventions. New research on how to encourage SMEs to invest more in employee health and wellbeing was published alongside the Budget. Financial resource remains a barrier to implementation, but so is access to specialist support necessary to help SMEs navigate the market to find services that actually work for them.
LS: Do you think mention of occupational health in the budget will change stakeholder perception around work and health?
SP: Naming occupational health and setting out the challenge with getting workers across the economy the occupational health support they need is a great start. Occupational health was mentioned 21 times in the Budget report! But there is a lot more work to be done when it comes to public messaging for work and health. We need to work on messaging for the public, employers, and policy makers to make sure we use this Budget as a turning point to get all stakeholders on board with delivering more evidence-based changes, aiming for more tangible impact on health and employment outcomes.
Integrated care systems and integrated care boards (ICSs/ICBs) have a role to play in catalysing change by supporting joined up care between the Department of Work and Pensions and health services, with occupational health as a wrap around to this. The NHS England Growing OH programme is critical to driving ICS/ICB engagement but the team is facing significant cuts in staffing. Supporting healthcare staff to get the access to the occupational health services they need at a time of workforce crisis could also be jeopardised if we do not have a plan to bolster occupational health training, resources and access.