Information for employers and workplace professionals

Over 20 million people (20,295,706), about a third of the UK population, live with a musculoskeletal (MSK) condition. This includes over 10 million people in the UK who have arthritis. Every year, around 350,000 people are newly diagnosed with osteoarthritis (OA), the most common form of arthritis; many more develop the condition but may not have a recorded diagnosis.

1 in 3 current UK employees have a long-term health condition.
1 in 10 current UK employees have an MSK condition

Our State of MSK Health details the data and impact of arthritis and MSK conditions.

While arthritis and MSK conditions can have a dramatic impact on people’s lives and work, with the right support many people with these conditions can work successfully.

Your employee is your most valuable asset. This information is designed to help you recruit and retain skilled staff by providing an inclusive and supportive workplace.

Employers have a duty of care to all staff. In order to support staff with a long-term health condition such as arthritis, understanding how it impacts on the individual is essential. Further guidance and links to information for employers on supporting staff can be found here.

What is arthritis and MSK conditions?

Musculoskeletal (MSK) health is about how muscles, joints and bones work together to enable people to carry out the activities they want to with ease, without discomfort or fatigue, and without fear of falls or fractures. Arthritis and other MSK conditions are important causes of poor MSK health.

The word arthritis is used to describe pain, swelling and stiffness in a joint or joints. Arthritis is not a single condition, there are numerous different types. Arthritis can make life difficult making it harder to get about, work or do everyday tasks.

The symptoms of arthritis can differ between individuals, with the impact often varying from day to day or week to week. Many types, such as osteoarthritis (OA) and rheumatoid arthritis (RA), are long-term conditions. Often people have more than one health condition in addition to arthritis or MSK conditions.

The most common type of arthritis is osteoarthritis (OA), where the body is unable to maintain and repair the joints leading to thinned and damaged cartilage. It can affect any joint in the body, the most likely joints to be affected are those that bear most of our weight, such as the knees and feet. Joints that we use a lot in everyday life, such as the joints of the hand, are also commonly affected.

Changes to the joint structure due to OA can sometimes cause or contribute to symptoms such as pain, swelling or difficulty in moving the joint normally. Injury or damage to a joint may lead to osteoarthritis in that joint later in life. Normal activity and exercise don’t cause osteoarthritis, but very hard, repetitive activity or physically demanding jobs can increase your risk. Osteoarthritis is less common in those below 45 years old.

Some types of arthritis are autoimmune conditions, such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis. Here the immune system attacks and inflames the joints and surrounding tissues causing swelling, pain, stiffness and joint damage. They can strike at any age including juvenile arthritis (JIA) in childhood. Arthritis is also a common symptom in other, mainly rare autoimmune conditions.

Rheumatoid arthritis affects around 400,000 adults aged 16 and over in the UK. It can affect anyone of any age and can be difficult to diagnose. It can get worse quickly, therefore early diagnosis and intensive treatment are important. The sooner it is diagnosed and treated, the more effective the treatment is likely to be. Diagnosis of rheumatoid arthritis is based on the individuals symptoms, a physical examination and the results of x-rays, scans and blood tests.

As well as painful, stiff or restricted joints, people with arthritis can develop:

fatigue.
limited mobility, decrease in dexterity, flexibility, grip and strength.
joint deformity.
stiffness.
pain.
impact ability to focus or concentrate.
decrease in physical stamina.

Symptoms can fluctuate, causing unpredictable and severe flares of symptoms lasting days or weeks at a time. Individuals may need additional adjustments and adapt their daily work routine during periods when their condition flares or is less stable.

Low mood, depression, anxiety and poor sleep are common for people with arthritis, all of which in turn can worsen symptoms and reduce people’s capacity to live well. In some autoimmune inflammatory conditions, in addition to attacking joints, the immune system can also attack other organs (such as the skin, kidneys, bowel or lungs) which can be life-threatening.

Treatment varies depending on arthritis type and the individual.

Osteoarthritis treatment focuses on symptom management including through self-management. Some people with hip and knee osteoarthritis will eventually require a joint replacement.
For people with many forms of inflammatory arthritis, urgent intensive treatment is needed to prevent irreversible joint damage, pain and disability.

As with all conditions, finding the right treatment that works for the individual can take time. Further information on the range of arthritis conditions is available on our website and is a helpful resource for those living with the condition, as well those who support them.

Understanding arthritis in the workplace survey

We surveyed people with arthritis on their experiences of working with arthritis or an MSK condition. The Understanding arthritis in the workplace survey highlights the need for better awareness and support from employers.

Find out more about the responses from the survey.

Support for staff, tips on improving workplace inclusion.

Arthritis and related musculoskeletal MSK conditions can affect any of us. Dealing with the symptoms, finding the right treatment and learning to live with the condition can take time.

Some staff who have developed an MSK condition, or where their condition has deteriorated, may need extra adjustments and flexibility during this period. Initially employees may need time off work and attend various appointments for tests and/or treatment. It may be difficult for employees to arrange appointments outside of their normal working hours, therefore offering flexibility and time off to attend these and any ensuing treatment can make a huge difference.

Being subject to additional pressure or scrutiny when you are dealing with a life changing condition can be stressful. Offering the opportunity to discuss how you can support your employee will reassure them and can reduce any stress or anxiety they may be experiencing.

Tips to support employees:

Create guidance on how to apply for adjustments and support for staff who develop or have a health condition or disability.
Ensure staff are aware of their rights to flexible working from the first day they start work.
Managers and support staff, such as H&S, HR, union reps, should be aware of the process and empowered to agree adjustments that will reduce barriers to work.
Promote opportunities for employees to discuss and identify adjustments or equipment that could improve their capacity to work.
Support your employee’s application to Access to Work scheme if it is relevant, exploring any reasonable adjustments you can agree and what AtW could provide.
If appropriate, offer access to an Occupational Health assessment.
To ensure your staff can work safely and well, implement the recommendations of any AtW or OH report. Communicate any decision and reasons if you cannot provide all that is recommended.
Review agreed adjustments on a regular basis.
Consider excluding some condition related sickness absences when calculating sick leave.
When planning events and meetings consider the needs of staff who have a disability or health condition.
Respect your employee’s right to privacy.
Consider becoming a Disability Confident employer.

Reasonable adjustments and Access to work scheme

Employers have a duty to make reasonable adjustments. Employers should take proactive steps to ensure that a disabled employee is not disadvantaged. That they have the same access to all that is involved in doing and keeping a job as a non-disabled person.

Risk

There is often an assumption that staff who have a health condition or disability will need a separate risk assessment. There is no duty for employers to carry out risk assessments on individual disabled staff, unless there is a need for specific adjustments. It is however, good practice to review your risk assessments to ensure it covers risks to all staff. Anyone who may need help in an emergency should have a Personal Emergency Evacuation Plan (PEEP) which is unique to them.

Arthritis and MSK conditions vary for each person in its impact and severity. You may not be aware of all staff who have a health condition, especially if it is not visible and they have not disclosed this to you. Staff do not need to disclose their condition, if they do not need adjustments and can continue to work safely.

Staff whose condition is impacting on their capacity to work safely and well, may need workplace adjustments, specialist equipment or changes to how they work. They may need a risk assessment. Employers have a duty to consider what reasonable adjustments they can provide to ensure staff living with a health condition or disability are able to remain in or return to work.

Reasonable adjustments will vary depending on the type and size of organisation. Many cost nothing or very little to implement.

Having a conversation with your employee to identify what barriers they face in work is the first step. Often, they will have a good understanding of how their role might be adapted to remove or reduce these barriers. Be creative and work with your employees to find a practical solution.

The guidance on reasonable adjustments states that you should consider’:

how effective the change will be in avoiding the disadvantage your employee would otherwise experience.
its practicality.
the cost.
your organisation’s resources and size.
the availability of financial support.

Examples of reasonable adjustments can be found on the Equality and Human Rights Commission EHRC website.

Some to consider are:

Flexibility and time off to attend appointments.
Flexible working – start and finish time, number of hours or days working, adjusting breaks between workdays.
Regular breaks.
Access to seating for staff who spend much of their time on their feet.
Review or adjustment of tasks, temporarily or permanent.
Additional time to carry out tasks.
Change of work location, hybrid, or home working.
Car parking space.
Access to Occupational Health.
Additional training and/or mentoring.
Ergonomic tools or equipment – some of these may be funded through Access to Work scheme if beyond the normal equipment you provide.

Access to Work

Access to Work (AtW) is a publicly funded employment support grant scheme that aims to support disabled people start or stay in work.

The AtW scheme can provide practical and financial support for people who have a disability, physical or mental health condition. AtW considers the support required beyond the reasonable adjustments that employers are expected to offer.

Examples of what AtW can provide:

Assessment of workplace needs.
Specialist equipment such as ergonomic workstation, software, tools, bespoke safety footwear.
Funding for a support worker, driver, job coach.
Funding for travel to and from work, as well as within work, for staff whose condition impacts on their capacity to use public transport or drive.
Menial health support.

AtW can help your employee to stay in work and for employers to recruit disabled candidates. The AtW scheme is also available for those who are self-employed.

The Channel Islands and the Isle of Man are not covered by Access to Work. There is a different service in Northern Ireland.

Access to Work can be used for flexible working arrangements, such as hybrid working. This can include:

support to work from more than one location.
support for working at home for all or part of the time.

Access to Work can support employers to:

hire disabled staff with the skills you need.
retain an employee who develops a disability or health condition (keeping their valuable skills and saving both time and money recruiting a replacement).
show that you value and will support your employees by having inclusive employment policies and practices.

The application to AtW is made by the employee, they will have to provide the AtW assessor with details of a contact within their place of work.

AtW can arrange for an independent assessment of the applicant’s workplace needs. This can be useful when there is limited understanding of what might make a difference to reduce barriers to work. Alternatively, if your employee is clear about what they need, they can detail this in their application, detailing the items they require and costs.

Depending on the number of staff you employ and the length of time they have been employed, you may have to contribute towards any items recommended.

Number of employees	Amount of threshold
0 to 49 employees	Nil
50 to 249 employees	£500
Over 250 employees	£1000

When cost sharing applies, Access to Work will refund up to 80% of the approved costs between a threshold and £10,000. As the employer, you will contribute 100% of costs up to the threshold level above and 20% of the costs between the threshold and £10,000.

New recruits to the workplace can apply to AtW as soon as they have a confirmed start date. This is recommended as there can be a considerable waiting time to process claims. AtW will fully fund claims that are made within the first six weeks of employment.

Note: All government departments are responsible for arranging workplace assessments and adjustments for their employees known as civil servants. Civil servants though can still apply for Mental Health Support Services (MHSS).

How to support staff who apply to Access to Work

Add information on the AtW scheme to your recruitment packs and job adverts.
In the job offer mention that you are happy to support staff with a disability or long-term condition who may need adjustments or to apply to AtW scheme.
Include information and guidance on AtW and reasonable adjustments within your staff handbook or hub.
Ensure managers and workplace support colleagues are aware of AtW and the process to support their staff and implement adjustments or equipment required.
Arrange purchase of items recommended by AtW as soon as possible after the application has been approved.
Work closely with your staff who have made the application and keep them updated on progress of purchases or adjustments.
Remember you are responsible for insuring and maintenance of equipment or software funded through AtW.
If a member of staff leaves your company, consider offering the items to them to take to their new workplace. AtW can fund the movement of items.

Your approach to supporting disabled staff and those who live with a health condition will reassure potential and current employees.

Versus Arthritis offer training to employers to improve understanding of arthritis within the workplace. For more information and costs contact workingwell@versusarthritis.org.

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