Guidelines (Position Paper)

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Musculoskeletal disorders (MSDs) are the leading cause of temporary workdisability among Ireland’s working age population. The social costs of MSDs are enormous, often over-shadowing those of other chronic conditions. In Ireland, 14 million days are lost each year due to absence and ill health in the workforce, with half of those attributable to MSDs. This costs Ireland E750m each year and 7 million days in absenteeism.

Work is good for your health and it is important to people living with MSDs and their families, both financially and for their quality of life and well being. Such a significant issue is reducing the level of labour productivity in the Irish economy and is damaging the competitiveness and effectiveness of private and public sector organisations.

The Fit for Work initiative is based on a ground-breaking pan-European study, conducted across 25 countries, which examined the impact of MSDs on an individual’s ability to work, the cost to the economy and society as a whole. Fit for Work Ireland is a coalition of key stakeholders instrumental in the quest to improve employees’ ability to work with MSDs, reduce the impact of MSDs on workplace absenteeism and contribute positively to getting Ireland competitive again.

This will benefit the employer, the employee, the Irish economy as a whole and also address the wider causes of absenteeism.


The Fit for Work Coalition believes that a programme that concentrates on the health and well-being of the workforce will ultimately reduce workplace absenteeism and improve the lives of people living with MSDs. However there are a number of issues and areas to consider in moving this forward. The Fit for Work Coalition is calling for a cross departmental group involving, initially, the Department of Health and the Department of Social Protection, to engage the expertise and insights of the coalition members to make this a reality. The main areas to consider are;

1. Early and Effective Interventions

2. Risk Assessment and Prioritisation

3. Improving Organisational Behaviours and Performance

1. Early and Effective Interventions

A significant amount of staff ill-health stems from common musculoskeletal disorders that are receptive to early, effective intervention, enabling staff to return to work quickly and benefiting the individual, the employer and the state. A workstream of the Coalition should engage with the relevant health and social protection areas to develop early and effective intervention guidelines.

  • The key goal of the Workstream should be to develop and propose nationally agreed service standards for early intervention. The Coalition proposes that intervention is made as soon as possible This should be done with the consent of the employee and employer working in a collaborative manner.
  • Cost effective solutions need to be explored whereby every employer has access to an outsourced occupational health facility that ensures a “Case Manager” is assigned to each employee. Best practice suggests that this service, along the lines of a primary care centre, would service a number of companies collectively and may cover a population cluster of approximately 3,000 employees.
  • The Case Manager in the care centre would be the central link between employee, employer and local medical infrastructure especially the local GP. The GP should still continue to be the advocate for the patient.
  • The Coalition recognises that the primary initial point of contact with the employee is their own GP.Therefore, it is proposed that a complete review of sickness certification be carried out with the Irish College of General Practitioners (ICGP). The aim of such a review is to facilitate a more coordinated approach to support more informed and appropriate intervention decisions. The Coalition recognises that Data Protection laws are in place to protect the privacy of the employee.
  • The Workstream should explore and recommend ways and means of funding this service.
  • Collaboration between insurers and employers to ensure quick and timely access to physiotherapy and other appropriate services. This may be facilitated by insurers providing tailored health insurance packages and offering significant discounts to employers who demonstrate the adoption of a Fit for Work Programme.
  • The Coalition recognises that issues of employee terms and conditions and employers rights and duties within current absence management policies, must be recognised and respected throughout the process. Consideration should be given to avoiding placement of any additional costs on the employee.

2. Risk Assessment and Prioritisation

The Fit for Work Coalition recognises that good prevention measures in the workplace will help reduce the risk to staff health, both physical and mental.

It is also recognised that considerable work has already been done in this area such as through the Health and Safety Authority and the National Disability Authority.

3. Improving Organisational Behaviours and Performance

The Fit for Work Coalition recognises that the promotion of staff health and well-being should be embedded in the culture of all organisations and that its importance is consistently demonstrated through the way in which staff and managers behave.

  • The Coalition recommends that all leaders and managers are developed and equipped to recognise the link between staff health and well- being and organisational performance.
  • We do not seek to prescribe the specific training tools and modules required as we recognise that there is considerable work already undertaken by organisations such as the Health and Safety Authority and the Nutrition and Health Foundation and we advocate for the adoption by employers of such programmes.
  • We recommend that employers and employee representatives engage with the relevant primary and secondary care health providers to ensure that work is addressed as a clinical outcome of any early intervention programme. This requires the collaboration of such organisations as the Irish College of General Practitioners, the Royal College of Physicians in Ireland, the Irish Society for Rheumatology and the Health Service Executive.

The full appendix and reference is available in the PDF format of the Position Paper.

Download a PDF version here

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