The Department for Communities is right to focus on improving access to work for disabled people. Disability and Work: A Strategy for Northern Ireland aims to support an additional 50,000 disabled people into the workforce by March 2036. With Northern Ireland having the lowest disability employment rate in the UK, where disabled people are approaching half (41%) as likely to be employed as non-disabled people, this ambition matters.

However, an essential question remains: is the Strategy focused on the right problem?

Evidence from MS Society Northern Ireland suggests that while supporting people into work is important, it is not enough. For people with long-term, fluctuating conditions like MS, the biggest challenge is not getting a job but staying in one. With one of the highest prevalence rates of MS in the world, Northern Ireland must pay close attention to the experiences of this community if it is to keep skilled workers in employment.

Staying in work with MS

People with MS deserve access to secure, high-quality employment where they can thrive. Yet MS is a lifelong neurological condition with invisible and fluctuating symptoms, including fatigue, cognitive difficulties, pain, and mobility issues. Managing these alongside work requires flexible and informed employers, timely access to health and rehabilitation services, and a welfare system that recognises that it costs more to be disabled.

Our research with the MS community in Northern Ireland, which will be published soon, shows that most people with MS are already working. 76 per cent of respondents were in paid employment, while only 4% fell into the Department’s target group of those not working but actively seeking work. The real issue is retention. Too many skilled and experienced people with MS are leaving employment earlier than they need or want to because workplaces and systems fail to adapt. This is a risk the current Strategy does not sufficiently address.

Employer support: the difference between staying and leaving

Half of respondents to our survey told us that MS has a significant or severe impact on their ability to work. Research from Lancaster University reinforces this, showing that people with MS often leave the labour market due to workplace barriers rather than medical necessity.

Our qualitative evidence – gained by listening and learning from the experiences of people in NI with MS - reveals stark contrasts: stories of long, fulfilling careers sit alongside accounts of stolen careers and aspirations never realised. The difference is often employer support. Where managers understand MS, and offer flexibility, people stay in work. Where they do not, exit becomes likely, even when it is preventable.

In our survey, over half (56%) said their employer was supportive or very supportive, rising to almost 7 in 10 (66%) when asked about their line manager. Support included being asked what adjustments were needed (38%), referrals to Occupational Health (32%), and flexible working arrangements (28%).

However, this picture is far from universal. Almost 3 in 10 (28%) described their employer as unsupportive, and nearly a quarter (24%) said the same of their line manager. Alarmingly, over 4 in 10 (44%) had left a job due to MS-related factors. Among those who left:

• 50% said workplace culture was not supportive

• 64% said health deterioration made the job unmanageable

• 46% cited inadequate adjustments to working hours

• 41% cited inadequate adjustments to role or tasks

These are not inevitable outcomes. They reflect avoidable failures in support.

Health and employment are inseparable

Staying in work with MS depends not only on employer attitudes but also on access to timely and appropriate healthcare. MS is unpredictable and progressive. Delays in diagnosis, treatment, rehabilitation, or mental health support directly undermine a person’s ability to sustain employment.

Evidence from the Northern Ireland Neurological Charities Alliance (niNCA) shows that neurological services are fragmented, with long waiting times and poor coordination leading to preventable deterioration. When treatment or specialist support is delayed, symptoms worsen, increasing fatigue, pain, and cognitive difficulties, all of which make work harder to maintain.

Mental health support is equally critical. Burnout, anxiety, and depression are common consequences of prolonged workplace strain and are a well-established pathway out of work for people with MS. A Disability and Work Strategy that focuses only on entering or returning to work, while ignoring health and mental health support, risks setting people up to fail.

Financial support helps people stay in work

 Financial support is another essential, but often misunderstood, part of employment retention. Personal Independence Payment (PIP) is not an out-of-work benefit. For many people with MS, it is what makes work possible.

Life costs more when you are disabled. Extra heating, transport, equipment, treatments, and therapies quickly add up. Around 63% of people living with MS in Northern Ireland rely on PIP, including many who are in work. Our evidence shows that people with MS use PIP to manage these additional costs, stabilise their health, and remain economically active.

If the aim of the Disability and Work Strategy is to increase participation and reduce economic inactivity, it must recognise that financial support like PIP is a cornerstone of job retention, not a barrier to work.

Rebalancing the Strategy

The evidence is clear. People with MS want to work. Many already do. Many more could continue working for longer with the right support. Yet too many are being forced out of employment not by their condition, but by a lack of understanding, flexibility, access to healthcare, and financial security.

The Disability and Work Strategy must be rebalanced. Supporting people into work matters but preventing avoidable exit matters just as much. That means investing in employment support that works, ensuring reasonable adjustments are the norm, integrating health and employment support, and protecting the financial support that enables disabled people to stay well enough to work.

If Northern Ireland is serious about closing the disability employment gap, it must stop treating disabled people as a pipeline into work and start treating them as a workforce worth keeping.

Naomi McBurney is the Senior Policy, Public Affairs and Campaigns Manager at MS Society Northern Ireland. Naomi has been in post for a year and during that time has played a leading role in ensuring people with MS are heard on the issues that impact them most – health, welfare and employment. She is passionate about developing evidence-based policy solutions that are grounded in lived experience and looks forward to continuing that work in the year ahead.