Work conversations in healthcare: How, where, when and by whom?

Helping people remain healthy at work has substantial economic, personal and societal benefits. Despite this, around 1 million working-age people aged over 50 have left the labour market involuntarily, usually because of their health. As part of a strategy to improve employment outcomes for working-age people with health conditions and/or disabilities, the Joint Work & Health Unit (WHU) funded Public Health England’s (PHE) ‘work as a health outcome’ programme. This was designed to promote healthcare professionals’ (HCP) understanding of the health benefits of good work and encourage them to have supportive conversations about work and health.

The aims were to identify current interventions that encourage conversations about work in a health setting; establish where and between whom supportive conversations take place; identify key behaviours that support or hinder the initiation and delivery of supportive conversations in healthcare; and identify the most desirable outcomes from a supportive conversation and their measurement.

Despite the launch of numerous, potentially relevant initiatives over the last decade, few were directed specifically at stimulating conversations about work during routine clinical encounters. Promotion and implementation of these initiatives has been limited and, as a result, healthcare awareness, engagement, and adoption has remained low.  

This project has identified many barriers, most underpinned by the lack of a consistent, agreed description or measure of ‘supportive’ conversations, and lack of articulation of the purpose or formal embedding of such conversations within practice. There was no evidence to establish the outcome or efficacy of any particular content or approach to conversations about work in healthcare, nor how these may be measured. It was found that most HCPs accept that work is generally good for health and wellbeing, but these fundamental limitations meant most do not engage their patients in conversations about work. However there are reasons for optimism: the evidence points to some short and long-term initiatives that will better equip HCPs to have supportive conversations about work, and to further advance the ‘work as a health outcome’ agenda within routine healthcare. These are conceptualised as ‘cultural awareness’, ‘conversation starters’ and ‘practice integration’. 

Funder: Public Health England

Team: Dr Serena Bartys, Dr Amanda Edmondson, Professor Kim Burton (University of Huddersfield), Christine Parker, Rachel Martin (University of Salford)