The Fit for Work service launched, on a phased basis, on 15 December 2014 to offer impartial advice to employers for dealing with long-term sickness absence.
The Department for Work and Pensions (DWP) has now published guidance for employers using the Fit for Work service.
In the period September 2010 and October 2013 the government reported that on average 960,000 employees were on sick leave for a month or more. It has also been reported that employers face an annual bill of around £9 billion for sick pay and associated costs and that the government spends £13 billion a year on health-related benefits.
Given this, a number of recommendations were made to reduce workplace sickness absence and the cost of ill health on individuals, employers and the taxpayer. One of the accepted recommendations was the introduction of a government-funded assessment by an occupational health professional of employees who are off sick for four weeks or more, with the aim being to provide expert advice and assistance to support the employee's return to work.
On 25 July 2014, the government announced that a new 'Health and Work Service' would be launched in late 2014, with the following expectations:
- an occupational health assessment when an employee reaches, or is expected to reach, more than 4 weeks' sickness absence
- a case manager to support each employee through the assessment process to ensure their level of need is correctly identified along with appropriate steps to get them back to work
- more general health and work advice for GPs, employers and employees via the telephone and a website
- a return to work plan that will be shared with the employer and GP
The renamed Fit for Work service was launched, on a phased basis, on 15 December 2014. The full service is anticipated to be available nationally by May 2015 and it is hoped that it will cut sick pay costs by up to £165 million a year. In the meantime a website and telephone advice line is available to enable all employees and employers to obtain free and impartial work-related health advice. The new service has been designed to help employers manage sickness absence and provide them, their employees and GPs with access to work-related health advice Once fully implemented it is estimated that GPs will refer 54% of patients to the Fit for Work service.
Fit for Work
The Fit for Work service will provide:
- free health and work advice, accessed via a website and telephone helpline to help with absence prevention. Advice can be sought about any work-related health matters affecting employees and the workplace, and this may include information on the type of adjustments which could help employees stay in or return to work, or more general work related health advice
- free referrals for an occupational health assessment for employees who have reached, or whose GP expects them to reach, four weeks of sickness absence
Occupational health assessment
Employees will normally be referred by their GP, but employers can also refer eligible employees after four weeks of absence. Employees will be eligible where:
- they are still employed by the employer (and are not self-employed)
- they live in England, Scotland or Wales
- have been absent for four or more weeks
- have a reasonable likelihood of making at least a phased return to work
- have not been referred for a Fit for Work assessment already within the last 12 months and have not received a Return to Work Plan
- have provided consent to be referred
Where a referral for an assessment is made, employees will be contacted within two working days and they will receive an assessment by an occupational health professional (who will become the case manager through to the end of the process). This will usually be done over the telephone but face to face assessments may be considered appropriate in some cases.
An assessment will involve the case worker taking a 'biopsychosocial' approach to look into all of the health, work or other issues affecting a return to work (including potential obstacles) and will involve formulating an agreed Return to Work Plan, which will reflect the assessment of the employee, and provide advice and recommendations agreed with the employee to enable them to return to work as soon as is appropriate.
Subject to the employee's consent, the case manager may deem it necessary to contact an appropriate individual within the employer's organisation (for example the employee's line manager or a member of the HR Department) to help form the Return to Work Plan. This will often be useful in order to:
- understand more about the nature of the employee's job or workplace conditions
- gain a better understanding of the specific workplace context
- to check understanding of any recommendations made
Once the caseworker has obtained the employee's consent, the employer (and the employee's GP) will receive a copy of the Return to Work Plan via email (or post if appropriate) which will provide the agreed advice and recommendations which the employer can take to get the employee back to work.
However, it is not mandatory for employers to implement the recommendations in the Return to Work Plan, but, all parties will be encouraged to do so.
The case manager will contact the employee at regular intervals after the assessment to check if the Return to Work Plan is on course. If necessary, and where the employee has not returned to work, a further assessment can be arranged by the case worker, which may result in the Return to Work Plan being revised.
Employees will be discharged from the service where they have returned to work (including any phased return), where Fit for Work can no longer provide further assistance or if a return to work has not been possible after three months.
The biggest difficulty envisaged with the new service is that employees will not give their consent. If this is the case a referral to Fit for Work will not be made, an assessment will not be conducted and a Return to Work Plan will not be shared.
An employee's consent must also be explicit, informed and freely given and needs to be obtained at each point in the process, including:
- before any referral to Fit for Work is made, whether by the GP or employer
- before any initial assessment takes place by the case worker
- before any Return to Work Plan (or version of) is shared with the GP and employer
- before Fit for Work contacts any appropriate person as part of the assessment process
Other difficulties envisaged include:
- case workers not fully understanding the employer's business, the employee's actual job role, or availability of other suitable roles
- recommendations not being reasonable or otherwise achievable because of the case worker's limited knowledge of the employer's business
- employees having too great a expectation, or the opposite, not taking any active involvement in the return to work process.
The actual uptake of this new service therefore remains to be seen.
Employers should consider updating their sickness absence policies and procedures to reflect the availability of the Fit for Work service. This may assist in obtaining an employee's explicit consent when referring to Fit for Work. It is also recommended that employers tell staff:
- about the advice that is available from the Fit for Work website or telephone line
- that they may be contacted by Fit for Work about an employee who has been referred by their GP
- if and when you wish to refer them to Fit for Work
- what they should do if they receive a Return to Work Plan and how they can support any recommendations made
When dealing with sickness absence that has lasted four weeks or more employers should also consider making a referral to Fit for Work themselves. Whilst Fit for Work is not mandatory, going forward it will be considered the default position and not using the service may be deemed to be a deliberate attempt to prolong sickness absence. Employers also need to remember their obligations as regards disability discrimination under the Equality Act when dealing with long term sickness absence.
Getting sick employees back to work more quickly is a key factor in protecting longer term health and wellbeing and is crucial to stop short-term sickness developing into longer-term benefit dependency.
Whilst the government's efforts to assist employers in this respect are to be applauded, it remains to be seen how effective the new service will be in practice.