This was the grand setting of the Attlee room in the House of Lords, in which Baroness Jolly hosted a roundtable event to gain expert views on improving approaches to supporting those with migraine.
The Work Foundation was commissioned to undertake research culminating in a report “Society’s headache: The socioeconomic impact of migraine”, which highlighted that migraine is one of the commonest causes of years lived with disability. Many do not realise how common it is – 23.35 of adults aged 15-69 experience the condition and the economic costs in the UK are estimated to exceed £8.8bn.
The event brought together experts – neurologists, specialist nurses, occupational physicians and specialists from patient charities with long experience and we also heard powerfully from a migraine sufferer in her early thirties of the lived experience of someone with catastrophic regular headache, visual disturbance, sickness and photophobia. She described the disruption of family life, impact on her work and the personal consequence of understanding that the condition may be inheritable and gave her the huge decision on whether to have children or not.
The Roundtable focused on the practical needs identified by the research, which may be grouped in to three main areas:
- The need to improve migraine diagnosis treatment and management with clearer care pathways and understanding of tiered care needs (self management, primary care and specialist care).
- The need to improve awareness by educating particularly about both the frequency of migraine but also its disabling nature and impacts
- The need to work with employers to better understand employees’ needs and to be able to support workers with migraine.
I was struck by the scarcity of specialist doctors, nurses and treatment centres able to provide good quality advice. Migraine can be a complex condition to treat and it is often dismissed as “simply a headache” – which means patients often spend years without the advice and treatment they need.
The event also reminded me how difficult fluctuating conditions – medical issues which have unpredictable effects and which occur without warning can be to manage for employees and employers. Clearly an issue like migraine may start suddenly while in the workplace and practical issues such as whether an employee can get home, or needs help in work may need consideration and the roundtable also highlighted the need to creatively consider adjustments – lighting, work organisation and technology may all play an important part.
Many of the current approaches to occupational health, including the operation of the Fit Note system and interactions with Primary Care, deal poorly with fluctuating conditions and don’t support the worker and employer in understanding needs which may fluctuate in real time. Our rapidly developing Empactis Health platform is capable of working flexibly in real time to help managers understand an employee’s health needs and adapt to enable timely support.
Migraine is one of many fluctuating conditions – many mental ill health conditions, other neurological conditions, musculo-skeletal or gastro-intestinal conditions have highly variable symptoms that can change function and capability and understanding more timely support and intervention is in my view key to successful management, benefiting employee, business and all involved.
