Commissioned and funded by Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation.
This guide
Migraine
at work
guidance
for
managers
Whether you’re a line manager, This guide is designed to help you understand
what migraine is, why it matters to you and your
supervisor, team leader or
organisation, and how to help individuals with
managing a small business, migraine improve their experience and contribution
chances are you’ve worked at work.
with many people with migraine
Commissioned and funded by Novartis
(whether you know about it
Pharmaceuticals UK Ltd, the guide was
or not). independently produced by the Work Foundation,
following the publication of their breakthrough
research report ‘Society’s Headache’ in 2018. It has
Migraine is a common, debilitating but
been developed with the help of patient groups,
manageable condition. It has a significant, but
health experts and employers representing more
addressable, cost on people’s working lives and
than 1.3 million employees in the UK. We are very
business performance.
grateful for their input.
The impact of migraine in the UK
An estimated
23.3%
of adults aged
15-69 have
migraine.1
Migraine
is more
common
than
diabetes,
epilepsy
and asthma
combined.2
1
Work Foundation. (2018). Society’s Headache. Retrieved October 2019.
Migraine is
the 3rd
most common
disease in the
world.3
4
Ibid
cause of
with
disability
Migraine is the
2nd
highest
years lived
worldwide & the
highest among
women aged 15-49.4
Each year, an estimated
86m equivalent
workdays are lost
due to migraine-related
absenteeism and
presenteeism (being
present but not able to
work at full capacity).5
The indirect
costs of
migraine
are estimated
at just under
£8.8bn
per annum.6
Job code: MIG19-C025
Date of preparation: November 2019
Calculated using a weighted average of Global Burden of Disease (GBD) study 2016 data. 5
Ibid
2
Migraine Action. (2010). Migraine in the Workplace. 6
Ibid
3
Work Foundation. (2018). Society’s Headache. Retrieved October 2019.
Commissioned and funded by Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation.
A migraine friendly workplace
What is migraine?7
With the right information and
support, most people with
migraine can manage their
condition and work effectively.
A good working environment uses ‘high
performance working practices’8
to
encourage shared responsibility between
employers and workers and foster diversity.
People with migraine should not, therefore,
be singled out unnecessarily, but benefit
from a people-centred management style
that supports talent.9
To create a healthy workplace culture,
organisations need to:10
• promote good health and wellbeing,
encouraging workers to live a healthy
lifestyle
• support workers to take preventative action,
such as regular exercise
• ensure ongoing health management over
time, so that plans are kept under regular
review
For many people the
main feature is a severe
throbbing headache which
can last from four to 72
hours.
Symptoms may include
disturbed vision, sensitivity
to light, sound and smells,
feeling nauseous and
vomiting.
Symptoms vary from
person to person and
individuals may have
different symptoms in
different attacks.
Migraines may change in
length and frequency, with
most people symptom-free
between attacks.
Migraine is complex and
treatments can differ from
person to person. There
is currently no cure for
migraine.
Sickness absence policies should be
developed so that people with long term
health conditions, such as migraine, are not
put at a disadvantage.11
Failure to support workers with health
conditions can be costly, leading to problems
with retention – as well as poor morale and
reduced productivity amongst the workforce
at large.12
Employers also have a duty of care
and a legal responsibility to ensure workers
are treated equally and fairly.13
High Performance Working practices14
Increase autonomy and
control to help workers manage
their workload and triggers
Ensure demands are
manageable to reduce the
risk of stress acting as a trigger
Provide social support
to help workers manage their
condition
Offer flexible working to
enable workers to manage when
and where they work
7 10 13
NHS. (2019). Conditions: Migraine. Retrieved October 2019. Work Foundation. (2019). Migraine’s impact on employment in Europe. DWP. (2019). Guidance: Employing disabled people and
8
Institute for Employment Studies. (2004). High Performance Work Practices. Retrieved October 2019. people with health conditions. Retrieved October 2019.
Retrieved October 2019. 11
Migraine Trust. (2018). Migraine: Help at work. Retrieved October 2019. 14
Work Foundation. (2018). Society’s Headache. Job code: MIG19-C025
9
Work Foundation. (2018). Society’s Headache. Retrieved October 2019. 12
Migraine Trust. (2018). Migraine: Help at work. Retrieved October 2019. Retrieved October 2019. Date of preparation: November 2019
Commissioned and funded by Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation.
Migraine triggers and support measures
As well as common
triggers for migraine,
there are common
support measures
that can help people
with migraine.
However, as symptoms will
vary, it is important to speak
to individuals to understand
which could apply to them.
People with migraine may find
it helpful to keep a migraine
diary to help identify triggers
and support needs.
Common migraine triggers15
Common support measures16
Not enough
or changing
sleep
patterns
Irregular
meal
times
Keeping a
migraine
diary
Access
to a quiet
room
Being
dehydrated
Flexible
working
hours &
location
Artificial
light and
glare e.g.
screens
Loud
noise
Regular
food &
water
breaks
Seeking
occupational
health
expertise
Additives,
caffeine
and
alcohol
Time off
for medical
appointments
Lack of
exercise
Regular
one-to-one
meetings
Well
ventilated
environment
Stress
Migraine Trust. Common Triggers. Retrieved October 2019. Job code: MIG19-C025
16
Migraine Trust. (2018). Migraine: Help at work. Retrieved October 2019. Date of preparation: November 2019
15
Commissioned and funded by Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation.
Your role as a manager Good practice19
Being a manager brings
responsibilities to ensure good
health management, to meet
individual needs.
A management style based on trust is
essential for someone to feel comfortable
about discussing their condition and gaining
the support they need.17
An open, empowering
management style is also likely to increase
employee engagement and reduce stress.18
This means, taking a sensitive and proactive
approach to identifying the needs of
individuals in the workplace, encouraging
a shared responsibility for creating a work
environment that enables everyone to
perform at their best.
When a team member reveals that they
experience migraine, one of the best things
you can do is listen to them. Make time to
have a confidential discussion about how their
migraine impacts on them and the ways in
which you can support them to manage
their condition.
You can ask them if they want a colleague
or workplace representative present
at this meeting. You may also want
to seek specialist support from
an HR or occupational health
professional, or look at other
sources of advice and support
(see useful links section).
Below are some examples of good practice, where managers
discuss individual needs and put in place practical adjustments
based on those needs.
Since starting shift work
at a warehouse, Josh was
experiencing an increased
number of migraines which
resulted in him taking more
sick leave.
Following a conversation with
his boss, Steve, Josh started a
migraine diary. His diary showed
that working through breaks
was a trigger for his migraines.
Steve decided to ask the wider
team about potential changes
that may improve the working
environment for everyone.
As a result, all workers are
encouraged to take regular
breaks during their shifts and
the company now provides a
water cooler.
Team leader, Debra,
noticed changes in one
of her valued team members,
Layla. Following a discussion
with Layla, she discovered
this was due to migraine.
After looking into the condition,
Debra worked with Layla to
make changes to help manage
her symptoms.
When Layla has a severe
migraine, Debra encourages
her to return to work at a
gradual pace and to work
from home. To support this,
the team now use file-sharing
and have access to one
another’s calendars.
17
DWP with CIPD. (2018). Recruiting, managing and developing people with a disability or health condition. Retrieved October 2019.
Job code: MIG19-C025
18
CMI. (2016). The Quality of Working Life. Retrieved October 2019.
Date of preparation: November 2019
19
Examples informed by our interviews with patient groups, health experts and employers.
Commissioned and funded by Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation.
A Migraine Action Plan20
This template can support It should be drafted by the individual, with the help of a trusted colleague and health professional
where appropriate, and then discussed, revised and agreed with their manager. The plan should
conversations to understand and
be held confidentially and regularly reviewed.
take practical steps to address
migraines.
1. How might migraines impact on your 3. What can be done to help you minimise 5. Are there any warning signs that your
work? (e.g. find it difficult to concentrate, visual migraine attacks at work? (e.g. move manager/colleagues might notice before
problems, vomiting or nausea) working area to increase natural light, taking a you experience a migraine attack?
lunch break) (e.g. dizziness, fatigue, confusion)
2. Is there anything that triggers 4. What would you like work colleagues 6. If your manager/colleagues notice
migraine for you? (e.g. lack of sleep, to know about your condition? (e.g. warning signs – what should they do?
irregular eating times, loud noise) inform trusted colleagues, keep it confidential, (e.g. talk to me discreetly about it)
brief the team on migraine)
20
Based on: Mind. (2018). Wellness Action Plan and Employer Guidance. Retrieved October 2018. Job code: MIG19-C025
Date of preparation: November 2019
Commissioned and funded by Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation.
A Migraine Action Plan (continued) Useful links
7. What support could be put in place to
help you manage symptoms? (e.g. access
to a quiet room, flexible working hours)
8. What steps can you take if you start to
feel unwell at work? (e.g. take a break, ask
a colleague for support)
Staff signature Manager signature
Date Date to be reviewed
Acas (Advisory, Conciliation and Arbitration Service) provides free and impartial
information and advice to employers and employees.
Helpline: 0300 123 1100 www.acas.org.uk
CIPD is the professional body for HR and people development and provides resources for
people managers on all HR issues.
www.cipd.co.uk
CMI (Chartered Management Institute) offers practical solutions for individual
managers, employers and education providers.
www.managers.org.uk
Fit for Work is a government-funded initiative to support people in work with health
conditions. They offer free, expert and impartial work-related health advice.
Advice line: 0800 032 6235
www.fitforwork.org/blog/supporting-sufferers-of-migraine-at-work
GOV.UK offers guidance on employing disabled people and people with health conditions and
the Equality Act 2010.
www.gov.uk/government/publications/employing-disabled-people-and-
people-with-health-conditions/employing-disabled-people-and-people-with-
health-conditions
Migraine Trust is a charity providing information and support for people affected by migraine
in the UK, including an Employment Advocacy Toolkit.
www.migrainetrust.org/wp-content/uploads/2015/09/employment-advocacy-
toolkit-the-migraine-trust.pdf
NHS gives a medical overview of migraine, its symptoms, causes, diagnosis, treatment,
complications and prevention.
www.nhs.uk/conditions/Migraine
NHS Health at Work for Business represents occupational health teams working in the
NHS and supports the Government’s approach to health and work.
www.nhshealthatwork.co.uk/support-for-business.asp
WorkSMART is a job advice app for everyone at work. It is backed by the Trades Union
Congress, the umbrella body for Britain’s unions.
www.worksmart.org.uk
Job code: MIG19-C025
Date of preparation: November 2019

Migrane guidance visual

  • 1.
    Commissioned and fundedby Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation. This guide Migraine at work guidance for managers Whether you’re a line manager, This guide is designed to help you understand what migraine is, why it matters to you and your supervisor, team leader or organisation, and how to help individuals with managing a small business, migraine improve their experience and contribution chances are you’ve worked at work. with many people with migraine Commissioned and funded by Novartis (whether you know about it Pharmaceuticals UK Ltd, the guide was or not). independently produced by the Work Foundation, following the publication of their breakthrough research report ‘Society’s Headache’ in 2018. It has Migraine is a common, debilitating but been developed with the help of patient groups, manageable condition. It has a significant, but health experts and employers representing more addressable, cost on people’s working lives and than 1.3 million employees in the UK. We are very business performance. grateful for their input. The impact of migraine in the UK An estimated 23.3% of adults aged 15-69 have migraine.1 Migraine is more common than diabetes, epilepsy and asthma combined.2 1 Work Foundation. (2018). Society’s Headache. Retrieved October 2019. Migraine is the 3rd most common disease in the world.3 4 Ibid cause of with disability Migraine is the 2nd highest years lived worldwide & the highest among women aged 15-49.4 Each year, an estimated 86m equivalent workdays are lost due to migraine-related absenteeism and presenteeism (being present but not able to work at full capacity).5 The indirect costs of migraine are estimated at just under £8.8bn per annum.6 Job code: MIG19-C025 Date of preparation: November 2019 Calculated using a weighted average of Global Burden of Disease (GBD) study 2016 data. 5 Ibid 2 Migraine Action. (2010). Migraine in the Workplace. 6 Ibid 3 Work Foundation. (2018). Society’s Headache. Retrieved October 2019.
  • 2.
    Commissioned and fundedby Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation. A migraine friendly workplace What is migraine?7 With the right information and support, most people with migraine can manage their condition and work effectively. A good working environment uses ‘high performance working practices’8 to encourage shared responsibility between employers and workers and foster diversity. People with migraine should not, therefore, be singled out unnecessarily, but benefit from a people-centred management style that supports talent.9 To create a healthy workplace culture, organisations need to:10 • promote good health and wellbeing, encouraging workers to live a healthy lifestyle • support workers to take preventative action, such as regular exercise • ensure ongoing health management over time, so that plans are kept under regular review For many people the main feature is a severe throbbing headache which can last from four to 72 hours. Symptoms may include disturbed vision, sensitivity to light, sound and smells, feeling nauseous and vomiting. Symptoms vary from person to person and individuals may have different symptoms in different attacks. Migraines may change in length and frequency, with most people symptom-free between attacks. Migraine is complex and treatments can differ from person to person. There is currently no cure for migraine. Sickness absence policies should be developed so that people with long term health conditions, such as migraine, are not put at a disadvantage.11 Failure to support workers with health conditions can be costly, leading to problems with retention – as well as poor morale and reduced productivity amongst the workforce at large.12 Employers also have a duty of care and a legal responsibility to ensure workers are treated equally and fairly.13 High Performance Working practices14 Increase autonomy and control to help workers manage their workload and triggers Ensure demands are manageable to reduce the risk of stress acting as a trigger Provide social support to help workers manage their condition Offer flexible working to enable workers to manage when and where they work 7 10 13 NHS. (2019). Conditions: Migraine. Retrieved October 2019. Work Foundation. (2019). Migraine’s impact on employment in Europe. DWP. (2019). Guidance: Employing disabled people and 8 Institute for Employment Studies. (2004). High Performance Work Practices. Retrieved October 2019. people with health conditions. Retrieved October 2019. Retrieved October 2019. 11 Migraine Trust. (2018). Migraine: Help at work. Retrieved October 2019. 14 Work Foundation. (2018). Society’s Headache. Job code: MIG19-C025 9 Work Foundation. (2018). Society’s Headache. Retrieved October 2019. 12 Migraine Trust. (2018). Migraine: Help at work. Retrieved October 2019. Retrieved October 2019. Date of preparation: November 2019
  • 3.
    Commissioned and fundedby Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation. Migraine triggers and support measures As well as common triggers for migraine, there are common support measures that can help people with migraine. However, as symptoms will vary, it is important to speak to individuals to understand which could apply to them. People with migraine may find it helpful to keep a migraine diary to help identify triggers and support needs. Common migraine triggers15 Common support measures16 Not enough or changing sleep patterns Irregular meal times Keeping a migraine diary Access to a quiet room Being dehydrated Flexible working hours & location Artificial light and glare e.g. screens Loud noise Regular food & water breaks Seeking occupational health expertise Additives, caffeine and alcohol Time off for medical appointments Lack of exercise Regular one-to-one meetings Well ventilated environment Stress Migraine Trust. Common Triggers. Retrieved October 2019. Job code: MIG19-C025 16 Migraine Trust. (2018). Migraine: Help at work. Retrieved October 2019. Date of preparation: November 2019 15
  • 4.
    Commissioned and fundedby Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation. Your role as a manager Good practice19 Being a manager brings responsibilities to ensure good health management, to meet individual needs. A management style based on trust is essential for someone to feel comfortable about discussing their condition and gaining the support they need.17 An open, empowering management style is also likely to increase employee engagement and reduce stress.18 This means, taking a sensitive and proactive approach to identifying the needs of individuals in the workplace, encouraging a shared responsibility for creating a work environment that enables everyone to perform at their best. When a team member reveals that they experience migraine, one of the best things you can do is listen to them. Make time to have a confidential discussion about how their migraine impacts on them and the ways in which you can support them to manage their condition. You can ask them if they want a colleague or workplace representative present at this meeting. You may also want to seek specialist support from an HR or occupational health professional, or look at other sources of advice and support (see useful links section). Below are some examples of good practice, where managers discuss individual needs and put in place practical adjustments based on those needs. Since starting shift work at a warehouse, Josh was experiencing an increased number of migraines which resulted in him taking more sick leave. Following a conversation with his boss, Steve, Josh started a migraine diary. His diary showed that working through breaks was a trigger for his migraines. Steve decided to ask the wider team about potential changes that may improve the working environment for everyone. As a result, all workers are encouraged to take regular breaks during their shifts and the company now provides a water cooler. Team leader, Debra, noticed changes in one of her valued team members, Layla. Following a discussion with Layla, she discovered this was due to migraine. After looking into the condition, Debra worked with Layla to make changes to help manage her symptoms. When Layla has a severe migraine, Debra encourages her to return to work at a gradual pace and to work from home. To support this, the team now use file-sharing and have access to one another’s calendars. 17 DWP with CIPD. (2018). Recruiting, managing and developing people with a disability or health condition. Retrieved October 2019. Job code: MIG19-C025 18 CMI. (2016). The Quality of Working Life. Retrieved October 2019. Date of preparation: November 2019 19 Examples informed by our interviews with patient groups, health experts and employers.
  • 5.
    Commissioned and fundedby Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation. A Migraine Action Plan20 This template can support It should be drafted by the individual, with the help of a trusted colleague and health professional where appropriate, and then discussed, revised and agreed with their manager. The plan should conversations to understand and be held confidentially and regularly reviewed. take practical steps to address migraines. 1. How might migraines impact on your 3. What can be done to help you minimise 5. Are there any warning signs that your work? (e.g. find it difficult to concentrate, visual migraine attacks at work? (e.g. move manager/colleagues might notice before problems, vomiting or nausea) working area to increase natural light, taking a you experience a migraine attack? lunch break) (e.g. dizziness, fatigue, confusion) 2. Is there anything that triggers 4. What would you like work colleagues 6. If your manager/colleagues notice migraine for you? (e.g. lack of sleep, to know about your condition? (e.g. warning signs – what should they do? irregular eating times, loud noise) inform trusted colleagues, keep it confidential, (e.g. talk to me discreetly about it) brief the team on migraine) 20 Based on: Mind. (2018). Wellness Action Plan and Employer Guidance. Retrieved October 2018. Job code: MIG19-C025 Date of preparation: November 2019
  • 6.
    Commissioned and fundedby Novartis Pharmaceuticals UK Ltd, this guide has been independently produced by the Work Foundation. A Migraine Action Plan (continued) Useful links 7. What support could be put in place to help you manage symptoms? (e.g. access to a quiet room, flexible working hours) 8. What steps can you take if you start to feel unwell at work? (e.g. take a break, ask a colleague for support) Staff signature Manager signature Date Date to be reviewed Acas (Advisory, Conciliation and Arbitration Service) provides free and impartial information and advice to employers and employees. Helpline: 0300 123 1100 www.acas.org.uk CIPD is the professional body for HR and people development and provides resources for people managers on all HR issues. www.cipd.co.uk CMI (Chartered Management Institute) offers practical solutions for individual managers, employers and education providers. www.managers.org.uk Fit for Work is a government-funded initiative to support people in work with health conditions. They offer free, expert and impartial work-related health advice. Advice line: 0800 032 6235 www.fitforwork.org/blog/supporting-sufferers-of-migraine-at-work GOV.UK offers guidance on employing disabled people and people with health conditions and the Equality Act 2010. www.gov.uk/government/publications/employing-disabled-people-and- people-with-health-conditions/employing-disabled-people-and-people-with- health-conditions Migraine Trust is a charity providing information and support for people affected by migraine in the UK, including an Employment Advocacy Toolkit. www.migrainetrust.org/wp-content/uploads/2015/09/employment-advocacy- toolkit-the-migraine-trust.pdf NHS gives a medical overview of migraine, its symptoms, causes, diagnosis, treatment, complications and prevention. www.nhs.uk/conditions/Migraine NHS Health at Work for Business represents occupational health teams working in the NHS and supports the Government’s approach to health and work. www.nhshealthatwork.co.uk/support-for-business.asp WorkSMART is a job advice app for everyone at work. It is backed by the Trades Union Congress, the umbrella body for Britain’s unions. www.worksmart.org.uk Job code: MIG19-C025 Date of preparation: November 2019