Some 600,000 people with arthritis are missing out on the opportunity to work, according to the charity Arthritis Research UK. BBC presenter Julian Worricker, who has psoriatic arthritis, spoke to people trying to juggle staying in work with a painful and debilitating condition.
Britain is a nation of "put up and shut up" when it comes to workplace health.
That's according to leading charity Arthritis Research UK. This isn't just based on anecdotal evidence - before Christmas the charity questioned more than 2,000 people about their attitudes and experience regarding health and the workplace.
One theme arose time and time again - people's willingness to suffer in silence.
The survey's key findings were:
- 20% worried they wouldn't be fit enough to work the following year
- 39% didn't feel confident discussing their health with their employer
- 33% thought that colleagues wouldn't understand the impact of their arthritis
- Nearly a fifth, 17%, have lied about why they took sick leave
I have arthritis. Not rheumatoid, but another inflammatory form of the disease - psoriatic arthritis. It's linked to the common skin complaint, psoriasis.
I'm lucky in that I've rarely had serious flare-ups. I'm now taking a drug that dramatically improves my symptoms, and at work I can think of only a handful of occasions when I've been hampered, discomforted or forced to make adjustments for any nagging pain I may have been experiencing.
But for thousands of other people in the UK it's a very different story.
What is arthritis?
- Arthritis is a condition that causes pain and inflammation in a joint. It affects around 10 million people in the UK
- The most common types of arthritis are rheumatoid arthritis and osteoarthritis, although there are around 200 different musculoskeletal conditions
- Osteoarthritis is the most common form of arthritis, most commonly developing in adults in their 40s or older. It initially affects the smooth cartilage lining of the joint, making movement more difficult than usual leading to pain and stiffness
- Rheumatoid arthritis can affect people of any age (although often starts when a person is between 40 and 50) and occurs when the body's immune system targets affected joints, leading to pain and swelling
Source: Arthritis Research UK
Sarah Dillingham is a case in point. She was diagnosed with rheumatoid arthritis in her 20s when she was working in a high-pressure corporate environment.
During bad flare-ups she had to cope with extreme fatigue and intense pain. Everyday tasks, even holding a pen, were difficult.
Commuting, or as Sarah put it "being bashed about on the tube", really took it out of her.
Over 10 years she struggled to control her symptoms.
"My world became all about my job because in order to go in and deliver I could only do that if I got up early to deal with the pain. I didn't have any social life. Your world does shrink in quite an unhealthy way," she says.
She experienced the best and the worst from the people she worked alongside.
She tells me: "A fantastic colleague used to help by writing on the white board for me during presentations when I couldn't lift my arms up."
But one boss made it very clear that Sarah's health issues were not something to be considered important, forcing her to try and act as if there was no problem at all.
Christine Lewis's story taps into some of the same narrative.
She was a nurse when she was diagnosed with rheumatoid arthritis, but daily work tasks became too much for her and she switched her career to banking.
Initially her new employers were very receptive to her needs, but as time went on they became less supportive.
"They employed someone to come and assess me. She assessed my working environment and made various recommendations."
They suggested minor changes to her desk and workstation, Christine told me.
"They said that things don't happen very quickly in business. A year later, still nothing," she says.
Sarah's and Christine's stories diverge at this point. Sarah is now her own boss, works mainly from home, and can manage her travel so that it rarely coincides with the London rush hour.
As an employer, partly as a result of what she went through as an employee, she's a believer in what she calls "sensible flexibility".
She says: "I absolutely understand the importance of hiring people who will give 100%.
"At the same time pretty much everyone has something in their life, whether that's a long-term medical condition, or young children or having to care for someone.
"It can be as simple as being able to hold meetings over Skype, or an ergonomic mouse which is very cheap."
Christine, by contrast, took medical retirement at the age of 48.
She feels she still had a number of good working years ahead of her but, without the necessary adjustments being made in the office to help her manage, she felt she had no choice but to give up her job.
"Employers are missing out on the wealth of experience that people have," she says.
"Being that bit older, I've got a house. I've had children, I've been a housewife and all that actually is quite a lot of experience that employers should tap into."
The Department for Work and Pensions told us that funding is available through the government's Access to Work scheme to pay for equipment or support that a disabled person might need in the workplace.
Stories like those of Sarah and Christine might well influence the government's thinking in the coming months.
- The BBC's business and economics unit is looking at how businesses work with people with disabilities and how disabled people have made business work for them
- A range of stories will feature across online, TV and radio this week
- On Twitter and Facebook you can follow the hashtag #DisabilityWorks and at the end of the week you can download the Ouch podcast
It says it wants to halve what's known as the disability gap - that's the difference between employment rates of disabled and non-disabled people - and it's been consulting on how best to do that.
The Labour MP, Frank Field, chairs the parliamentary work and pensions committee. A lot of evidence about work and disability has come before him in recent months.
"Nobody doubts the will of the government wishing to do this. What's worrying is whether they've really thought about how hard this objective is to achieve," he says.
One suggestion is to encourage employers using incentives. "One should have, in this coming Budget, a reduction in national insurance contributions to those employers who say I'm taking [disabled] people onto my payroll," he says.
During our conversation Mr Field highlighted one statistic that put into perspective what the government wants to do: according to the Learning and Work Institute, halving that disability gap will take - at current rates - 200 years.
Arthritis and work
- According to the Equality Act 2010 (which doesn't apply in Northern Ireland) you are disabled if your arthritis has, or is expected to have, a serious negative affect on your daily activities for at least 12 months
- Your rights are also covered under the Equality Act. You must be treated fairly and without discrimination if your employer knows, or could be expected to know, you're disabled
- An employer must make reasonable adjustments to enable you to work if you are disabled. This could include providing equipment or support or altering working arrangements
- An employer must not ask questions about health or disability unless they need to know you can carry out a vital function of the job with reasonable adjustments in place. But you have a duty to tell an employer about a health condition if it might present a health and safety risk to yourself or other colleagues
Source: Arthritis Care
Julian Worricker presents a mini-series about arthritis on You & Yours, from Wednesday 22 February to Friday 24 February at 12.15GMT on BBC Radio 4.