There are currently about 750,000 people of working age with cancer. This represents over a third of the 2 million people living with cancer – and with survival rates improving and people retiring later, the numbers are likely to increase.
Many cancer patients struggle to return to work, however. A recent Macmillan survey showed that 57% of cancer survivors who were in work when diagnosed had to give up their job or change roles as a result of their diagnosis. The total loss in productivity of cancer survivors unable to return to paid work in England was estimated, in 2008, to be £5.3bn.
When I was diagnosed with breast cancer in 2005, it was still assumed that, after cancer, those of us in remission would want to spend more time with the family or go round the world ticking off items on our bucket list.
Most of us want to return to work, however. Work contributes to financial independence, provides a sense of purpose, gives you identity and self-esteem, creates structure and order in our lives, is an important source of friendship and social interaction, and is a lifeline back to normality, wellbeing and recovery.
There is comprehensive legislation in place to support a successful return to work. Together the Equality Act 2010 and the Disability Discrimination Act 1995 provide protection from discrimination. Everyone with cancer is classed as disabled from the point of diagnosis for the rest of their life, and their employer or a prospective employer must not treat them less favourably for any reason relating to their cancer. All areas of employment are covered including recruitment, promotion, training, pay and benefits.
So, what is happening and why? Every case is different but there are some common issues employers and those with cancer need to be aware of, such as dealing with the side effects of treatment, which can be both physical (pain, fatigue, loss of bladder control, impotence) and psychological (depression, lack of confidence), and can begin long after treatment has finished.
Employers need to understand that recovery is a process and that it takes time. Legally, employers have a duty to make reasonable adjustments to support a return to work. There is no fixed definition of “reasonable”; this will depend on the circumstances, including practicality, cost, and the extent to which an adjustment will be effective in alleviating any disability. Adjustments might include:
• Offering light duties or alternative work on a temporary, reduced hours basis
• Allowing flexible working
• Allowing the individual to work from home for part of the week
• Allowing extra breaks to help cope with fatigue
• Allowing time off to attend medical appointments
Once back at work, there are a number of other helpful actions employers can take to support a successful return, in addition to implementing a standard, phased return to work plan which typically includes some or all of the actions described above. These include:
• Regular follow-ups to check all is working well
• Developing knowledge and understanding within the organisation about cancer and how best to support affected employees
• Coaching/third party/EAP support
• Giving an individual time to reflect with a knowledgeable but independent third party about their experience and to integrate it into their life – both at work and outside work – often gives individuals the sense of mastery and control that they may have been denied during treatment
• Buddying schemes
• Clear employment policies on support available to facilitate a return to work after cancer and other forms of chronic ill health
• Website links/access to appropriate charities, counsellors and health providers.
As things stand, some employers do offer some or many of these adjustments but many still offer only the bare minimum – a few very temporary, short term adjustments – and a few do nothing at all, ignoring the legislation.
Some cancer charities, such as Macmillan, and organisations, such as Working With Cancer, as well as trade unions, provide advice and guidance to those facing difficulties in returning to work after cancer – but the problem is that if an individual is already struggling with the after-effects of treatment, it’s tough fighting an employer at the same time. Recent changes in employment law have made this even more difficult.
The saving to employers of doing what is reasonable and right can’t be quantified but if it saves the time and cost of a managed exit as well as the cost of recruiting and training a new employee, and if it aids recovery as the evidence increasingly suggests, then it must be worth the effort.
Barbara Jacoby is an award winning blogger that has contributed her writings to multiple online publications that have touched readers worldwide.