Long Covid has urgently put the spotlight on workers with long-term health problems.

Long Covid has urgently put the spotlight on workers with long-term health problems. The condition is defined as “not recovering [for] several weeks or months following the start of symptoms that were suggestive of Covid, whether you were tested or not” (Nabavi, 2020) and includes, among others, symptoms of fatigue, muscular pain and breathlessness.

While the virus’s effects are not yet fully appreciated and must not be underplayed, it is important to remember that enduring symptoms of ill-health (and associated ambiguity) are not exclusive to Covid. Fatigue is a symptom of chronic fatigue syndrome, depression and multiple sclerosis; breathlessness is a common feature of asthma, bronchitis and angina; and muscular pain is common in many musculoskeletal conditions, including arthritis and rheumatism. What the pandemic has highlighted, however, are shared health vulnerabilities and the importance of employer support.

This support should entail helping workers to self-manage ill-health symptoms and take preventative care to keep well, feel confident in their ability to work and be work engaged. Most long-term health problems are managed away from clinical care in people’s everyday lives – for example, taking medication, seeking social support and managing emotional consequences – and this includes at work. Support can enhance people’s confidence in managing health problems and not self-managing can be detrimental to an employee’s health and work. Conversations about supporting workers with long-term health problems need to happen now, be joined up and be aimed at empowering people via working practices.

But a question remains as to the sufficiency of workplace support and existing policy and procedural approaches. A recent Loughborough University study found work factors affected the behaviour of those with long-term health conditions (including mental health, musculoskeletal, neurological and respiratory), meaning some people did not manage their condition at work despite needing to. Workers with manager support, including flexibility, were more likely to manage their health. Workers experiencing difficulties in fitting managing their health around the job or anticipating stigma, less so.

The research found some workers felt clinical advice was not always needed, but it suggested employers do not provide support because they are ill-informed about this. It raised the question of why self-managing health at work is not viewed as essential, particularly as potentially more workers could now be affected by long-term health problems.

The research made clear that employers and especially managers have a critical role, but need guidance. A psychosocial model of workplace self-management support for long-term health conditions is needed to help managers prompt conversations with workers about self-managing long-term health problems. Long-term ill-health can lead to people’s premature work exit and are characterised by a person needing to self-manage them. The above model could help identify workers’ needs, target workplace support and help employers improve people’s health and work outcomes.

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