Fit for Work


The new national occupational health service Fit for Work completed its roll out across Britain in September 2015. Employers and GPs can now refer employees who have been, or are likely to be, off work sick from work for four weeks or more to the 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 government-commissioned review, Health at Work – an independent review of sickness absence, by Dame Carol Black and David Frost. 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, and each year over 300,000 people fall out of work and onto health-related state benefits.


The review recommended that thegovernment 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. They will explore the issues that might be preventing a return to work, including work-related and wider personal issues as well as health matters. They will then work with the employee to agree a personalised return-to-work plan which will direct them towards services to help them overcome any obstacles keeping them away from work. The plan will provide 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 is aimed particularly at small and medium-sized businesses (SMEs) with no or limited occupational health support, although it is also available for larger employers who wish to complement their existing services.


In addition, the service 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 (Tel: 0800 032 6235; www.fitforwork.org).


The TUC welcomed Fit for Work and said it may be helpful for many workers otherwise denied any kind of access to occupational health support or advice. But it also outlined a number of reservations about the new service.


The TUC is concerned that Fit for Work aims to help people return to work rather than to help them get well, and that people may find themselves under pressure to return to work before they feel well enough. It 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 it fears that many employers will simply ignore the recommendations, but still expect their workers to return to work.


A further concern is 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 occupational health support.


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


Nevertheless, the TUC has encouraged unions to ensure that employers embrace Fit for Work in a positive way and that workers are offered union support.


“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,” it says.


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 and http://www.fitforworkscotland.scot.