Long-term health conditions are among the most pressing challenges facing organisations, economies, and healthcare systems today.

• 1 in 4 adults live with two or more health conditions [1].
• 37% of those experience comorbidity—multiple conditions that co-exist, interact and compound [2].
• In 2022, ill-health-related absence, economic inactivity, and lost tax/National Insurance contributions cost the UK economy between £240 and £330 billion [3].

People with long-term conditions bring skills, knowledge and experience that organisations can not afford to lose. Yet too often they face barriers that prevent them from working at their best.

Take Wayne, a project manager with a chronic pain condition. With small adjustments—the option to work from home on flare-up days, access to micro-breaks and training in pacing strategies —Wayne is able to take early action to prevent worsening his condition, but leads a team that consistently meets their targets; he also mentors junior colleagues. Without these adjustments, the organisation would have lost a highly skilled leader.

For the individual, the costs are far more than financial. Long-term conditions or disabilities that prevent people from working often lead to social exclusion, mental health deterioration, and behaviours such as increased alcohol use [4,5]. Crucially, long-term absence has been linked to a higher risk of suicide [6]. For employers, it means losing valued people whose expertise cannot easily be replaced.
Given this, the importance of effectively managing long-term conditions—both for individuals and for the wider system—has never been greater.

What is Self-Management—and Why It Matters

Self-management refers to the actions individuals take to understand and manage their health and maintain their quality of life. This can include:

• Monitoring and responding to symptoms
• Taking medications or following treatment plans
• Making lifestyle or workplace adjustments
• Seeking out information, resources, or support

When people can self-manage effectively this can lead to:

• Improved physical health and quality of life
• Reduced anxiety and depression
• More confidence in making health decisions
• Less reliance on healthcare services [7,8]

For many people, workplace adjustments are central to this success. Long-term health issues don't necessarily prevent people from working they just may require changes in work routines, environments, or expectations.

Why Self-Management Is Hard

Managing health while working is complex—especially when individuals are navigating fluctuating or multiple conditions. People may be:

• Coordinating complex medication schedules
• Attending frequent healthcare appointments
• Managing unpredictable fatigue, pain or symptoms

Structural challenges, such as a lack of access to self-management education or tools, inconsistent support from healthcare professionals or a workplace that isn't equipped to accommodate ongoing health needs, further complicate matters.

Many individuals don't have the knowledge or confidence to initiate conversations at work about their health. Without support, the result is often disengagement, presenteeism, or unnecessary long-term absence.

Why a Co-ManagedApproach Works Better

Self-management is vital—but it works best when the responsibility is shared. A co-managed approach recognises the shared roles between:

• The individual
• Healthcare professionals
• Occupational health specialists
• Employers, line managers, and colleagues

Co-management involves creating an environment that supports individuals in applying their health strategies at work and in daily life. This could include: reasonable adjustments, flexible hours or workload adaptations, regular, supportive conversations between employees and managers as well as clear confidential channels for disclosing and discussing health needs.

This shared responsibility model aims to help people thrive through removing the emotional and practical barriers faced by people with long-term conditions – helping employees to stay well in work and helping employers retain valued talent.

Why This Matters for Employers

Inclusive workplaces don't just "accommodate" people with long-term health conditions—they actively enable them to thrive. That means:

• Retaining experienced, committed staff
• Reducing recruitment and training costs
• Improving morale and team cohesion
• Building a reputation as a fair, forward-thinking employer

The benefits of an inclusive environments are clear – but less is known about how employers can create these environments, and what knowledge, skills and tools are needed by people with long term health conditions and disabilities, and others in the organisation who play a vital role.

What we Know so Far and Future Research

Our recent research has focused on understanding what tools and information are currently available to people with long-term conditions and their employers and how to explore needs. The real question is whether workplace systems and cultures are designed to help them do so sustainably and well.

• Read our rapid evidence review
• Find out more about our research partnership with Loughborough University

We have been working with a consortium led by Loughborough University to develop a practical online hub to support both self- and co-management of health in the workplace.

If your organisation would like to take part in the Co-Manage trial, improve how you support staff with long-term health conditions, and be part of leading research into inclusive work design, get in touch with us, we would love to hear from you!

References

[1] Stafford, M., Steventon, A., Thorlby, R., Fisher, R., Turton, C., & Deeny, S. (2018). Briefing: Understanding the health care needs of people with multiple health conditions. London: Health Foundation.https://www.health.org.uk/sites/default/files/upload/publications/ 018/Understandin%20the%20health%20care%20needs%20of%20people%20 th%20multiple%20health%20conditions.pdf

[2] Li, J., Green, M., Kearns, B., Holding, E., Smith, C., Haywood, A., Cooper, C., Strong, M., & Relton, C. (2016). Patterns of multimorbidity and their association with health outcomes within Yorkshire, England: baseline results from the Yorkshire Health Study. BMC public health, 16, 649. https://doi.org/10.1186/s12889-016 3335-z

[3] Department for Work and Pension (2025, March). The cost of working age ill-health and disability that prevents work. Official Statistics.
https://www.gov.uk/government/statistics/the-cost-of-working-age-ill-health -and-disability-that-prevents-work/the-cost-of-working-age-ill-health-and- disability-that-prevents-work?utm_source=chatgpt.com

[4] Marmot M, Bell R. Fair society, healthy lives. Public Health. 2012;126(SUPPL.1).

[5] McKee-Ryan FM, Song Z, Wanberg CR, Kinicki AJ. Psychological and physical well- being during unemployment: A meta-analytic study. Journal of Applied Psychology. 2005;90(1).

[6] Milner A, Page A, LaMontagne AD. Long-Term Unemployment and Suicide: A Systematic Review and Meta-Analysis. PLoS One. 2013;8(1).

[7] Turner, A., Anderson, J. K., Wallace, L. M., & Bourne, C. (2015). An evaluation of a self-management program for patients with long-term conditions. Patient education and counseling, 98(2), 213–219. https://doi.org/10.1016/j.pec.2014.08.022

[8] Taylor, S. J., Taylor, S., Pinnock, H., Epiphaniou, E., Pearce, G., Parke, H. L., ... & Sheikh, A. (2014). A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions (PRISMS Practical systematic Review of Self-Management Support for long-term conditions). Health and Social Care Delivery Research, 2(53), 1-580.

Author: Hannah Karrlein

Citation: Karrlein, H. (2025) Supporting Self-Management: Why Workplaces Need a Co-Managed Approach to Long-Term Health. Affinity Health at Work.