Working through cancer - Business Works

Working through cancer

Ciarán Devane, CEO

The number of people who are living with cancer is growing as the number of cases rise and people are living with cancer for longer. These people are sometimes known as ‘survivors’; as at some point in their lives they have had a cancer diagnosis. There are two million people living with or after cancer in the UK right now and 774,000 of these people are of working age. These are people with plenty of life ahead of them, but who will have varied and sometimes complex needs that managers need to be aware of.

There are 90,000 people of working age diagnosed with cancer each year and many, will come back to work after their treatment for cancer. In fact, Macmillan’s research shows that people with cancer often have a strong attachment to the labour market. In this sense, people with cancer are no different to anyone else; they need to work to earn a living and want to work because to do so is ‘normal’.

In several respects, however, people with cancer are different. They are likely to take more sick leave than people who have not had a cancer diagnosis and are less likely to be able to work in their preferred job. Many talk of the deterioration of their working life. Working through cancer can be an uphill struggle, no matter how motivated the employee.

« it is unusual for someone to receive advice »

Sadly, it is unusual for someone with cancer to receive advice about whether and how to return or remain in work. It is also unusual for someone with cancer to access occupational health or other rehabilitation services to support their return to work. Macmillan also found that the employers of someone with cancer don’t feel confident of how best to support their employee and their team. While this remains the case, a cancer diagnosis will continue to diminish the employment prospects of people who are otherwise keen to get on with their working lives.

Informed decision making

informed decisions

Cancer and its treatment can have significant, long-term, effects. These can include fatigue, breathlessness, bone pain and depression. Such potentially ‘work-limiting’ effects of cancer do not dictate whether or not someone should return to work – people are more than the sum of their symptoms – but these effects must be understood and managed so that people can work, should they choose to do so.

It is vital that people with cancer are able to make informed decisions about their working lives. They need to know about benefits or other forms of financial assistance that might allow them to take a career break. They also need to know what the impact of treatment might be on their working life. Not only that, but a successful return to work is more likely the earlier on it is considered.

Cancer patients may look to their clinicians, Jobcentre staff or their employers for this information, but more often than not, that information does not get through; it may not even exist. Health professionals can see their role as limited to issues concerning the health of their patient. Yet if we expect employers to take responsibility for the health of their employees, surely we should expect the health service to reciprocate that support?

Rehabilitation and return to work support

Many of the after effects of cancer can be dealt with through the expertise of rehabilitation professionals, but few cancer patients ever get such support. Hospital-based rehabilitation services are focussed on a quick discharge and those provided through Jobcentre Plus are mostly aimed at those with lower-back pain, stress or a more permanent disability. Cancer patients suffering with chronic fatigue in the workplace are not seeing the benefits of the fragmented services that currently exist.

« crucial early referral »

Some kind of support may be available through occupational health services, but often these are only available to those in large organisations. It may not even be clear to employers how occupational health could help someone with cancer, reducing the likelihood of that crucial early referral.

Dame Carol Black, the Government’s Health and Work Tsar, has called for a ‘Fit for Work’ service which would provide case-managed vocational rehabilitation through teams of occupational therapists, physiotherapists and psychologists. Sickness absence would trigger a referral into this service early on. Employees would then be assessed and offered support for their health conditions, all aimed at an easy return to the workplace. So far, the government has only committed to piloting this service and it remains to be seen whether it will work for people with cancer.

The role of employers

With or without specialist rehabilitative support, employers play a pivotal role in supporting return to work. We know that a good relationship between employer and employee is a strong predictor of return to work rates for people with cancer.

For example, Paul was a cancer survivor who came to Macmillan for help. He’d been diagnosed with prostate cancer and a year later was made redundant because his manager just assumed “there was no prospect” of him returning to work. In fact, Paul could have been supported in coming back to work and wouldn’t now have to rely on benefits as he looks for another job.

« line managers do not feel supported »

But its not all the managers fault. Unfortunately line managers tell us that they do not feel supported in their turn to deliver the information, advice and adaptation necessary to ease the return to work for staff with cancer. This is particularly true for Small- and Medium-sized Enterprises trying to balance the needs of their business with those of their employee. Information and guidance could help them enormously.

The simplest and easiest way an employer can support staff-members with cancer is to plan the return to work carefully, in dialogue with the employee themselves. Flexible working arrangements or a phased return to work could help to prevent unnecessary sickness absence and help to build the confidence of the returning employee.

Unfortunately, we know that most cancer patients are never offered flexible working arrangements on their return to work. Cancer patients have a right to these, or any other workplace adaptation, as ‘reasonable adjustments’ under the Disability Discrimination Act (DDA). Sadly, despite high awareness of the DDA itself, only 1 in 5 employers is aware that cancer is considered a disability. Cancer patients are losing out on the support to which they are entitled.

What next?

what next

Thankfully there has been a marked shift in the way health in the workplace is discussed. Rather than condemn people with health conditions as incapable, we are encouraged to consider their abilities. Employment and ill health do not have to be mutually exclusive. The 774,000 people of working age living with cancer in this country know that we need to be more flexible in our thinking about working life. After all, all employees are individuals who exist outside of office hours.

There is some action that could be taken immediately to dramatically improve the experience of those returning to work after a cancer diagnosis. Information about work needs to be built into what is known as the cancer ‘care pathway’ so that cancer patients undergoing treatment can make informed decisions about their working lives. Rehabilitation services need to be available to all who need them, no matter where or if they work. Information about health and workplace adaptation should be passed onto employers along with a timely reminder about their duties under the DDA.

None of this will happen of course until we stop dividing up the lives of real people into neat boxes labelled ‘health’ or ‘employment’. Not only do health and welfare need to work together more effectively, but employers and employees do too. After all, the physical health of its employees is the competitive health of their business. As we all know, the longer someone is absent from work, the less likely it is that they will ever return, their abilities lost to the labour market. People with cancer are willing and ready to work – are we ready to help them?

Macmillan Cancer Support provides specialist health care, information and financial support to people affected by cancer. As well as helping with the medical needs of people affected by cancer, Macmillan also looks at the social, emotional and practical impact cancer can have and campaigns for better cancer care.

Macmillan Cancer Support's goal is to reach and improve the lives of everyone living with cancer in the UK by 2010.
Macmillan Cancer Support

For information and advice about working through cancer, please visit:
Macmillan Cancer Support
T: 0808 808 2020

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