The Fit for Work Service 


The government’s Fit for Work Service went “live” in December 2014 and was gradually rolled out across the country during 2015. There is a website: http://fitforwork.org for online and telephone advice. 


Anyone can be referred to the service if they live in England, Wales or Scotland, are in paid employment, off sick and likely to return to work. The service is not available to the self-employed. A worker can only be referred once during a 12-month period.


Most people can be referred though their GP after they have been signed off work for four weeks. This would generally happen as part of a normal GP visit. In some cases, a person will not be referred, for example, if they are already ready to return to work, or if an ongoing serious issue means it is obvious that they will be off work for a considerable time. GPs can refer before four weeks if they expect the worker to be off work for more than 4 weeks. After four weeks, an employer can make a referral if the GP has not done so. Individuals cannot self-refer, and neither can hospital consultants. 


The first occupational health assessment is usually conducted over the phone, with a follow up face-to-face consultation if the occupational health professional thinks this is necessary. 


All referrals are voluntary and must be based on the worker’s informed consent. No worker should be forced to have an assessment. Although there is no obligation to accept a referral, in many cases a referral may help to support an earlier return to work. DWP guidance says: “Your consent must be explicit, informed, specific and freely given and must be given at different parts of the process”. Anyone referred for an assessment can withdraw that consent at any time. In addition, no report or plan should be sent to the GP or employer without it first being discussed with the worker, who can ask for changes, or refuse to agree to it being shared. Where a worker has any concerns or doubts, they should be encouraged to contact their union.


Following the assessment, workers are to be given a “Return to Work Plan” with recommendations to help them get back to work more quickly, and information on accessing appropriate “interventions”. Fit for Work is supposed to complement rather than replace existing health provision. 


Return to Work Plans do not replace Fit Notes but offer an alternative way to get back into work. 


There is a tax exemption of up to £500 a year per worker on medical treatments recommended by the Fit for Work Service or by an employer-arranged occupational health service. 


The Fit for Work Service will cease to be involved if a return to work has not been possible within three months of the referral. 


The TUC has welcomed any measure that could help employees return to work after illness or injury, but cautions that care must be taken not to force people back to work before they are well enough. There is also a risk that some employers may ignore the voluntary nature of the service and instead try to force staff to agree to a referral, or threaten to withhold sick pay. 


The TUC has produced guidance for reps about the Fit for Work Service, including guidance on how to negotiate with an employer proposing changes to sickness absence or sick pay rules in response to Fit for Work — Fit for Work Assessments, guidance for union reps (https://www.tuc.org.uk/sites/default/files/Fit%20for%20Work%20Guide%202015%20pdf_0.pdf). 


In England, the new system is delivered by private sector firm Health Management Limited, a division of US “health and human services” giant Maximus Inc. In Scotland, Fit for Work is delivered by the Scottish government.