Occupational health

An occupational health scheme is a service which gives access to a range of professional advice and services to staff.

The European Union’s Framework Directive (EEC/89/391) requires that all workers have access to preventive occupational health services. However, the way this duty was transposed into UK law meant that in practice, only a small minority of workers have access to comprehensive occupational health support at work. A 2012 TUC survey showed that even among larger private employers and the public sector, less than half of workers had access to rehabilitation if they were injured or ill, and only 54% had any form of health surveillance. For workers in small companies the position is even worse. It has been estimated that less than 10% of workers have access to a fully comprehensive occupational health service through their employer.

One of the ten demands in the TUC’s Time for change: Health and safety manifesto, is for occupational health to have the same priority as injury prevention. It says that there are around 450,000 new cases of industrial illness every year, over 70% of which are due to stress, back pain or repetitive strain injury (RSI).

It called for much more priority to be given to this area of prevention, with stronger regulations and enforcement to stop workers being made ill by their work and for workers to have access to occupational health advice.

The TUC health and safety manifesto can be found on its website at: https://www.tuc.org.uk/sites/default/files/tucfiles/TUC_Health_and_Safety_Manifesto_Time_for_Change.pdf

NHS Occupational health services

As well as private occupational health providers, employers can access NHS occupational health services. Web-based advice and details of the occupational health services available to businesses via the NHS can be found at the NHS Health for Work website at: www.health4work.nhs.uk

As the largest employer in the UK, the NHS now has its own network of occupational health teams called NHS Health at Work providing occupational health support for NHS employees. It can be accessed at: www.nhshealthatwork.co.uk

Fit for Work

Following a report commissioned under the coalition government, Health and work: an independent review of sickness absence, known as the Black/Frost report, a new occupational health service, Fit for Work, is currently being rolled out across England and Wales (from March 2015).

Health Management Limited is providing the new service in England and Wales. The Scottish Government is delivering Fit for Work Scotland.

The new service is designed to help employees and employers to manage sickness absence and follows government concerns over statistics which showed that 960,000 employees were on sick leave for a month or more each year on average between September 2010 and October 2013. The scheme aims to save employers up to £160 million a year in statutory sick pay and increase economic output by up to £900 million a year.

Employees on sick leave will be helped to return to work by accessing an occupational health assessment when they reach, or are expected to reach, more than four weeks’ sickness absence. Employees will normally be referred by their GPs. A resulting return to work plan will be shared with their employer and GP. More general health and work advice will be available to GPs, employers and employees via telephone and a website.

The service comprises two elements: a health and work telephone helpline and online support for employers, employees and GPs; and access to an occupational health assessment for employees on a period of sickness absence lasting four weeks or more.

The service is provided on a case-managed approach, with a case manager being assigned to a case and responsible for follow-up and continuity of care. It aims to produce a “return to work plan” detailing any obstacles, recommended interventions and a timetable.

The Department for Work and Pensions (DWP) said that while the service is intended to be wide ranging, its core focus will be on musculoskeletal and mental health conditions.

The TUC says it supports anything that could help people get back to work when they are ill, and that being in a rewarding job with a supportive employer could be good for your health. But it said care should be taken over how the scheme is implemented. It says that the referral service could have significant implications for employees and that trade union representatives will need to be aware of what the new service entails and the issues that are likely to arise so they can advise members who are referred to the service. In January 2015 it produced a new guide on Fit for Work referrals for union representatives. It can be downloaded from the TUC website at: www.tuc.org.uk/node/121924

The government has published new guidance for employees, employers and GPs which is available online, together with a timetable for the referral roll-out in England and Wales and Scotland at: www.gov.uk/government/collections/fit-for-work-guidance#history