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COALITIONS ʹ CORE PRINCIPLES
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EUROPE
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 Media coverage in 25 countries in September 2009
º Launch of the Fit for Work Europe
 Media coverage in key EU press (Euractiv, Europolitics,
Initiative and Report in September 2009 Parliament Magazine and journals in 2010)
ʹ Speakers included representatives from
 Conference outcomes in 2009 fed into the setting of the
the European Commission, European
Parliament, Belgian Ministry of Labour,
Belgian Presidency priorities
President of EULAR. Event endorsed by  Conference outcomes in 2010 fed into the Belgian Ministerial
Swedish Presidency of the EU Conference on Chronic Conditions and Council Conclusions on
Chronic Conditions
º Launch of Fit for Work Europe Coalition
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in September 2010
 Engage closely with the WHO in the drafting of their guidelines
ʹ Cross party political support from the
on MSDs
European Parliament (5 MEP co-hosts
including Mrs Antonyia Parvanova MEP as  Take into account eHealth and the potential contribution of
President of the Coalition) other policy areas such as employment and disability in the
Coalition͛s work plan
ʹ Event endorsed by the Belgian Presidency
 Work closely with all key stakeholders involved to raise
of the EU
awareness on MSDs and to show case best practices at EU and
ʹ Speakers included representatives from National level
the European Parliament, Belgian Ministry
 Organise a roundtable with the Hungarian Presidency on
of Health and Social Affairs, WHO Europe
Mental Health and MSDs (under discussion)
and EULAR

^
AUSTRIA
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 Introduction of the Rheuma Job Coach Homepage to show
º Launch of the Fit for Work Austria
support towards patients suffering from MSDs and suffering from
Report in June 2009 job retention ( June 2009)
ʹ Showcasing the burden of MSDs on the
 Think tank put together including politicians to discuss future
working population
policy targets with regards to MSDs ʹ agreement on the need for
ʹ Underlining the need for collaboration an Austrian Fit Note (as opposed to a sick note) (June 2010)
between the Ministry of Health and
Social Affairs, the Chamber of  Fit for Work became the main subject of reform talks during
Commerce, relevant companies, payers, European Forum Alpbach (August 2010)
academia, healthcare professionals and  Presentation of Fit for Work Austria results given during the AGM
patients of the Austrian Society for Obesity (October 2010)
º Launch of Fit for Work National
Coalition in January 2010
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ʹ Lead by the Society of Rheumatologists
ʹ Members are representatives from
Ministry of Social Affairs, insurance
companies, health economics, payers,
patients and healthcare professionals
 Pilot project with the insurers for self employers together with
the Chamber of Commerce (December 2010 onwards)
 Introduction of the Fit Note concept to the Austrian Parliament
(Spring 2011)
 Together with Rheumatology societies and self-help groups,
continue the dialogue with politicians on early diagnosis, early
treatment and cost-savings for healthcare systems
ÿ
BELGIUM
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 åuestion put forward by national Fit for Work coalition members
º Launch of the Fit for Work Europe
to Mrs Onkelinx, Belgian Deputy Prime-Minister and Minister for
Report in September 2009 Health & Social Affairs in National Parliament
ʹ Launched in the European Parliament  Succeeded in getting the Royal Society of Rheumatologists to
ʹ Key local patient groups involved discuss work productivity
(ReumaNet and CLAIR) and validated and
approved by Prevent (Institute for
Occupational Safety and Health)
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ʹ Adviser to Minister Milquet as keynote
speaker
º Launch of Fit for Work National
Coalition
ʹ Members are representatives from
Prevent, ReumaNet, CLAIR and support
from the Belgian Presidency during Fit
for Work Europe Conference 2010
 Create an ͞Expert Document͟ on the reintegration of patients in
the working environment. Publication foreseen during the
Belgian Congress of Rheumatology
 Development of flow charts focusing on the most common
problems for occupational reintegration
 Training of Rheuma-Nurses on legal aspects of bringing patients
back to work
 Run a pilot project using the support of a disability case manager
to get MSD patients back to work
‰
CANADA
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 Kicked ʹ off the development of National Arthritis Framework
º Launch of the Fit for Work Canada
(ACAP)
Report forecasted for å1 2011  National Arthritis Newspaper Insert (Arthritis in the Workplace)
ʹ Report will complement the Alliance for featured the Fit for Work Canada report
the Canadian Arthritis Program (ACAP)
National Framework Activities
ʹ Together with the Public Health Agency
of Canada report on arthritis, the Fit for
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Work report will contribute towards the  Convince the government of the need to recognise arthritis as a
development of a national framework on national public health priority
arthritis
 Organise and launch a National Fit for Work Employer / Payer
º National Coalition and Steering Committee to promote the need for better recognition of MSDs
Committee in the workplace and early intervention strategies
ʹ National Coalition under ACAP. Member
organisations include Arthritis
Community Research & Evaluation Unit,
Arthritis Health Professions Association,
etc
ʹ Steering Committee including private
payers and employers


CROATIA
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 Key messages from the Fit for Work report were presented at the
º Launch of the Fit for Work Croatia
Committee of Health and Social Care Conference in the Croatian
Report in October 2009 Parliament ʹ received support from the Parliament particularly
ʹ Recommendations for government to with regards to promotion, prevention, treatment and
improve collection and accuracy of data, rehabilitation of patients
raise awareness of MSDs among HCPs,  The National Insurance Institute allocated 4,7 million euro for
employers and employees, improve special fund for biologic therapy in rheumatic diseases
access to clinical expertise
 The Croatian Rheumatology Society introduced a new national
ʹ Recommends innovative job design to recommendation on RA management
assist rehabilitation
º Launch of the National Coalition in
October 2010
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ʹ Members include the Bone and Joint
Decade National Committee, Patient
Association and national Rheumatology
society
 Further discuss with key stakeholders (patient associations,
rheumatology society, national insurance institute) the benefits
of early diagnosis, treatment and impact on patients͛ quality of
life and ability to work
*
DENMARK
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 90 million US dollars of the 2010 budget agreement between the
º Launch of the Fit for Work Denmark
government and the regions has been earmarked for improving
Report in May 2009 MSDs/chronic diseases
ʹ The report focused mainly on the  Fit for Work objectives will become election themes in 2011
benefits and need of early intervention,
the physical symptoms incurred and the
benefits of work capacity vs work
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incapacity
 National implementation of patient course programmes for MSDs
º Launch of the National Coalition
securing early intervention
ʹ All relevant KOLs and decision makers in
the labour market and healthcare sector
have been informed of the Fit for Work
project and report launch. They have
also been informed in the promotion of
the conclusions and recommendations
of the report

Ñ
FINLAND
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 Government support for workability and functionality support
º Launch of the Fit for Work Finland
for MSDs as well as other chronic conditions through the
Report in September 2009 Minister of Labour
ʹ Recommendations include a national  A commitment from the vice-chairman of the Social Affairs and
service framework for the treatment of Health Committee in the Parliament and a MP from the the
MSDs and the acknowledgement of the leading government party to influence the upcoming
principle that job retention or return to government programme to include objectives in line with key
work are legitimate clinical outcomes
national recommendations
ʹ Clinical expertise needs to improve
 The chairman of the leading opposition party introduced
ʹ More reliable and valid data on patients
suffering from MSDs and their absence employment issues specific to chronically ill patients willing to
from work is needed stay or re-enter the labour force as one of the election themes
º Launch of the National Coalition in for 2011
September 2009
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ʹ Participants included the Finnish
Rheumatism Association, KOLs, MSD group  Urge the Ministry of Social Affairs and Health͛s Occupational
members of the Finnish Parliament, Wellbeing Committee to introduce Fit for Work findings and
Parliament Committee for Social Affairs recommendations to the Committee and to take into account
and Health, Finnish Institute of the benefits of early intervention and workability
Occupational Health, Ministry of Social
Affairs and Health

|
FRANCE
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 MSDs are raised as a national public health priority thanks
º Launch of the Fit for Work France Report in
to its existing MSD national plan implemented by the
November 2009 Ministry of Work (Health in Work Plan 2010 ʹ 2014)
ʹ Existing evidence that the proportion of the  Implementation of a national « seminar » managed by
French workforce with MSDs is likely to grow Chaire Sante Sciences Po dedicated to « Chronic Diseases
over the next few decades and Work »
ʹ Job retention or early return to work is good  « Sciences Po Seminar Handbook » (published report of
for the patient
working group recommendations) ʹ alludes to
ʹ Review the extent of collaborative working
recommendations from the Fit for Work France report
between government departments in order to
set up a national service framework for the
treatment of MSD patients #
 
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º Launch of the National Coalition  Enhance MSDs debate on chronic diseases and work issues
within the Parliament and obtain commitments of key
stakeholders to support Fit for Work objectives

||
GERMANY
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 Agreed cooperation with the Commissioner for the
º Launch of the Fit for Work Germany Report
disabled in Rhineland Palatinate in order to put together a
in February 2010 national plan for improving working conditions for disabled
ʹ Take on board existing evidence regarding the people
proportion of the German workforce with
MSDs which is likely to grow over the next few
decades
ʹ Introduce the UK concept of the Fit Note
encourage GPs to indicate what the worker is
still capable of doing
ʹ Help make GPs more effective in handling
occupational health issues ʹ provide more #
 
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training To be determined
ʹ Access to clinical expertise needs to improve
º Launch of the National Coalition in June
2010
ʹ Working group consists of board members of
the German Society of Rheumatologists,
patient associations and the Federal
Association of Occupational Medicine

|
GREECE
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 Initiated discussions on work-related issues and MSDs / RA
º Launch of the Fit for Work Greece Report in
as well as the socio-economic impact of MSDs
November 2010  Obtained the support of the Foundation for Economic and
ʹ Secure MSDs as an EU and National Public Industrial Research as the local partner for Fit for Work in
Health Priority and develop national MSD / RA Greece
plans  Started the « Guide for Citizens with Rheumatic Diseases »
ʹ Establish work productivity as a clinical in cooperation with the Institute of Social and Preventive
outcome
Medicine, patient groups and Greek Rheuma association
ʹ Establish work productivity as a health
under the auspices of the Ministry of Health
economic evaluation target
ʹ Secure funding for early intervention and  Completed the « Let͛s Work Together » survey with the
treatment of MSDs Greek Patient Associations and EULAR PARE
º Launch of the National Coalition
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ʹ Established the Fit for Work Greek Committee
involving policy makers, physicians, patient  To be determined
groups and Greek Parliament members

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IRELAND
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 Appointment of Prof Oliver Fitzgerald as National Clinical
º Launch of the Fit for Work Ireland Report in
Lead for Rheumatology. He has also agreed upon funding
May 2009 for 24 MSDs trained physios to lead early intervention
ʹ Call for a National Director for MSDs clinics. This will have a positive impact on improving
ʹ Call for cross Governmental departmental patient flow in rheumatology
working group to review the recommendations  An audit of MSDs services has been completed under the
from the report and develop an action plan leadership of Prof Oliver Fitzgerald
º Launch of the National Coalition in February
2011
ʹ Organise a series of seminars during the launch
to gain commitment and sign up to the Work
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Charter as well as seek advocates for the Fit for
Work recommendations. The panel for each
seminar will consist of economists, physicians,
policy makers, patient organisations and
international experts
 Arthritis Patient Organisation has appointed a Work
Ambassador to develop employer / employee support
programme
 The Fit for Work steering group also plans to target
hospitals with a high level of absenteeism for the Fit for
Work programme and learn from other best practices
|^
LITHUANIA
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 Creation of a multi-functional working group to solve MSD-
º Launch of the Fit for Work Lithuania Report
related issues
in March 2010  Specific MSD-related questions posed by the Working
ʹ Invest in the health and wellbeing of the Group and directed towards the Healthcare and Social
Lithuanian population Affairs and Labour Ministries followed by a discussion in
ʹ Improve data collection and estimate the direct the Parliament
and indirect costs of MSDs to the Lithuanian
society
ʹ Review the extent of collaborative working
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between government departments on the
issues of job retention, early intervention, the  Joint meeting together with Healthcare and Social Affairs
economic burden to society and Labour Committees calling for a national programme,
º Launch of the National Coalition in March including budget allocation
2010
ʹ Participants include representatives from the
Rheumatology association, patient
organisations, Ministry of Health, Ministry of
Social Affairs and Labour, Parliament
Healthcare Committee and Parliament Social
Affairs and Labour Committee

|ÿ
NORWAY
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 Obtained strong support from the Norwegian Rheumatic
º Launch of the Fit for Work Norway Report in
Association. The Chair of the association is actively writing
September 2009 newspaper articles focusing on MSDs and health
ʹ The Norwegian Rheumatic Association is the economics outcomes
͞owner͟ of Fit for Work Norway and they have
relayed the health-economic outcome to
politicians and other relevant stakeholders
ʹ Since the launch of the report, the government
has implemented many tools to make
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employees fit for work again. The focus has
been to increase the income tax
º Launch of the National Coalition
 Launch of HO report related to older women suffering from
RA
 Collaboration with the Norwegian ͞Muscle and Skeletal
Decade͟

|‰
SPAIN
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 Government support obtained and demonstated through
º Launch of the Fit for Work Spain Report in
the announcement of a national strategy for MSDs
December 2009  Regional action plan on MSDs created in Catalunyia and
ʹ Establish work productivity as a health and currently being initiated in 4 other regions
economic target  Creation of a technical committee for the development and
ʹ Consider introducing policy changes and new implementation of the Plan, led by rheumatologists
legislation regarding the budget allocation for (members of the Fit for Work National Coalition)
early detection and early treatment of MSDs
ʹ Possible collaboration between the Ministry of
Health, the Ministry of Labour, trade unions
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and the national social security institute on
issues of early intervention and treatment of
MSDs and the economic burden to society
º Launch of the National Coalition in 2008
ʹ Members include rheumatologists, national
and local rheumatology societies, patient
associations, representatives from the Ministry
of Health, Ministry of Labour and the National
Social Security Institute
 The created technical committee to evolve into an
institutional committee for the development of the
national strategy on MSDs
 The national strategy will be submitted to the territorial
council for its approval and implementation at national and
regional level
 Continue to promote discussion and interaction between
all stakeholders who may be involved in the national
strategy
|
SWITZERLAND
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 Government awareness of the impact of MSDs on society
º Launch of the Fit for Work Switzerland
 Two symposia on MSDs and the Fit for Work initiative during the
Report in May 2010 Swiss Society of Rheumatology conference and the Swiss Society
ʹ To develop and encourage the early of Physical and Manual Medicine Rehabilitation Conference
intervention and early treatment of MSDs  Support from Parliamentary politicians and officers of Ministers
ʹ To coordinate the health insurances, involved in the 6th Review of Insurance Invalidity on Fit for Work
creating a new model and defining
responsibilities of each actor involved
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ʹ To ensure that MSDs are recognised as
part of the new Review of Insurances for
invalidity (along with chronic diseases)
º Launch of the National Coalition -
Swiss Fit for Work Association in May
2010
ʹ Members include the Swiss Society of
Work Medicine, Swiss Society of
Rheumatology, Swiss Society of physical
Medicine and Rehabilitation, Swiss
Ministry of Economy, Head of the
Institute for Disability Management
 Put forward a national Fit for Work champion to collect funds
and implement programmes proposed by the Fit for Work
association
 Implement an educational programme for rheumatologists and
GPs on early intervention and management of MSDs related to
work
 Organise a workshop together with health and social insurers to
develop a new model of standardisation for coordination
between insurances ʹ supported by Ministry of Health
 Establish a reference centre for people suffering from MSDs and
experiencing difficulties at work ʹ supported and funded by the
Canton of Vaud and the University of Hospital of Lausanne
|*
UNITED KINGDOM
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 NAO report in RA services referenced Fit for Work. NAO is a body
º Launch of the Fit for Work UK
that scrutinises whether UK Government effectively spends
Report in September 2007 taxpayer͛s money
ʹ Early intervention is essential  Change from old « sick note » to new « fit note » that focuses on
ʹ Clinicians should think beyond capacity
symptoms, consider wider societal  Fit for Work briefings used and referenced by senior
impact of condition and focus on parliamentarians when debating welfare legislation in the House of
capacity over incapacity
Commons
ʹ Assess the direct and indirect costs of
 Fit for Work pilots developed in certain areas by previous Labour
the condition
government
º Launch of the National Coalition in
2010

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ʹ Members include UK Government
Health and Work Director, The Work
Foundation, EULAR, advocacy groups
including NRAS, ARMA and NASS
 Continue working with Bill Morgan ʹ Secretary of State Andrew
Lansley͛s Special Advisor ʹ who is in favour of MSD national
strategy
 As part of the health reform, NICE will develop quality standards
that will inform clinical practice and commission decisions. Fit for
Work to work closely with UK Government Health and Work
Director to make the case for RA which if accepted by NICE, would
raise priority for RA
|Ñ