Fit for Work 


The occupational health scheme Fit for Work completed its roll out across England and Wales in September 2015. Employers and GPs can now refer employees who have been, or are likely to be, off work sick for four weeks or more to the new service for a voluntary occupational health assessment to help them return to work. 


The new service was set up following a recommendation in the 2011 coalition government-commissioned review, Health at Work — an independent review of sickness absence. This found that while much sickness absence ended in a swift return to work, a significant number of absences lasted longer than they needed to, with over 300,000 people falling out of work and on to health-related state benefits each year. 


The review recommended that the government fund a new independent service to provide an in-depth assessment of an individual’s “physical and/or mental function” and provide advice about how people on sickness absence could be supported to return to work. 


Under Fit for Work, employees can be referred for a consultation with an occupational health professional who will examine the issues that might be preventing a return to work, including work-related and wider personal issues, as well as health matters. They then work with the employee to agree a return-to-work plan. The plan provides evidence of sickness for pay purposes, replacing the need for a GP fit note, and if the employee gives consent, Fit for Work professionals can also work directly with employers to help achieve a return to work.


The service also includes a telephone advice line and website, both of which can be used by anyone requiring work-related health advice, including employees, employers and GPs (0800 032 6235; www.fitforwork.org).


The service is aimed particularly at small and medium-sized businesses (SMEs) with no or limited occupational health support. The Health at Work report estimated that around 70% of employees did not have access to an occupational health service . The service is also available for larger employers who wish to complement their existing services. 


The TUC gave the new service a qualified welcome saying it may be helpful for many workers otherwise denied any kind of access to occupational health support or advice. But it also has also a number of reservations. For example, it says that Fit for Work aims to help people return to work rather than to help them get well and that workers may find themselves under pressure to return before they feel well enough. 


The TUC also points out that there is no compulsion for employers to implement recommendations in the return to work plan (although employers receive tax relief on expenditure up to £500 on recommended health treatment) and believes that many employers will simply ignore the recommendations, but still expect their workers to return to work.


It is concerned that employers will not accept the voluntary nature of Fit for Work and will try to insist that a person agrees to be referred or threaten to withdraw sick pay. And it is worried that the new service could undermine existing occupational health services if employers view Fit for Work as an alternative and seek to reduce the level of their occupational health support. 


Occupational health specialists have expressed concern that the service is largely delivered via the telephone, rather than face-to-face.


Nevertheless, the TUC is encouraging unions to ensure that employers embrace Fit for Work in a positive way and also offer workers union support, stating that: “Most workers would rather be well and at work than ill and off sick. We support anything that will help people recover when they are ill, and so we welcome Fit for Work.” 


The service is being run by the Scottish government through the NHS in Scotland and in England by a private company, Health Management Limited. For more information see: http://fitforwork.org.