Factors associated with work status in chronic fatigue syndrome (2019) S A M Stevelink, N T Fear, M Hotopf, T Chalder

[Invisible Woman]

I think the Chair of the roundtable is the person behind the introduction of these

I suspected that was the case but wasn't entirely sure of my memory & so didn't want to cast any aspersions, just in case.

Thw whole thing is a farce anyway from the employees point of view. One of my employers OT tried to make a big thing about me not having handed in (well, posted) any fit notes for a few years. Basically, trying to argue that I couldn't be that sick as my GP was no longer issuing them & conveniently disregarding the lengthy report written by my consultant. I had to point out that after a certain point in the proceedings I was no longer required to send any more in. Something she knew full well.

Anything you say, anything you don't say, anything you do,anything you don't do......all.used against you when it suits. Welcome to the world of behavioural "medicine".

Does anyone remember the kerfuffke when people objected to women getting lower car insurance premiums than men - I think it's because statistically the accident repairs for women tend to lower or something. Instead of reducing the premiums for everyone they raised them.for women.

Perhaps I'm just a cynic but it ocx to me that Wessely being the mental health champion is straight out of the insurers' playbook. When he bangs on about the unfortunate stigma (largely perpetuated by him & his mates), It's not that he's going to reduce the stigma. No, no. He & his pals are going to help ensure more people are stignatized by sucking them in via IAPT, MUS and the like. People won't realize what's happening until it affects them and then they're just in denial.....

It is a thing of beauty really, in it's way. Or would be if it didn't affect actual people.

 

[Simbindi]

I suspected that was the case but wasn't entirely sure of my memory & so didn't want to cast any aspersions, just in case.

See for example:

Earlier this month Dame Carol Black – Government advisor, doctor, Principal of Newham College at the University of Cambridge and past President of the Royal College of Physicians- put health firmly on the agenda at the British Safety Council’s annual conference.

Here, she speaks to SHP’s Lauren Applebey about her opinion on why the controversial Work Capability Assessment scheme is failing, the struggles GPs face in writing a proper fit note, getting people back to work after ill health, and how she feels companies should be dealing with mental health at work.

https://www.shponline.co.uk/leadership-and-innovation/interview-with-dame-carol-black/

 

[Invisible Woman]

Yes, that fluff is all very well isn't is it?

What about when people are in the early stages of an illness that takes a long time to diagnose or for which there are no biomarkers and those too ill to work?

It's not necessarily about the supportive management and work environment, though of course that helps. It's about the cumulative effort involved in basic daily living, commuting and travelling to work. On top of which you have the added stress of being sick and major uncertainty. Plus of course the extra burden and cost of lots of medical appointments.

Reducing the burden of illness in individuals, employers & society should be just as much about cushioning and supporting those who simply cannot remain in work at that time. If there was better support perhaps those who do have to go off on long term sick leave might return, or return sooner, to the workplace.

It seems to me that once again there's focus on a single solution instead of focussing on the individual, their circumstances and what they might need. So typically, those who are capable of making a return to work probably would have anyway. Whereas those too sick to are pushed through a dehumanizing punitive system that makes them sicker.

Perhaps instead of asking people who have to think of long term sickness, return to work and the barriers that exist in fairly abstract terms they could actually ask the people who know from experience - the ones who have been through it.

 

[Simbindi]

This is quite a useful link:

https://www.gov.uk/government/publi...the-most-out-of-the-fit-note-guidance-for-gps

Assessing your patient’s fitness for work
Your assessment about whether your patient is fit for work is about their fitness for work in general and is not job-specific. The following factors may be useful when making this assessment:

• any functional limitations of your patient’s health condition. For example:
  • stamina e.g. better in the morning or the afternoon
  • mobility e.g. walking, bending, stooping
  • agility e.g. dexterity, posture, co-ordination
  • insight or stability e.g. mental state, mood
  • treatment e.g. side-effects, duration of
  • intellectual e.g. cognitive abilities
  • sensory e.g. hearing, vision, touch
• the duration of their health condition and any likely fluctuation
• the impact of any ongoing clinical management [bolding mine]
• whether doing any work – not necessarily their current job – will make their health condition worse

I think this is very relevant to the problems with the 2007 NICE CFS/ME guidelines, regarding the purported outcomes of GET and CBT.