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Fit for work

Do you know about the government’s Fit For Work service? Maudsley Learning have the lowdown – and explain what it could do for your business

In November 2011, a government-commissioned review of sickness absence recommended that an independent assessment service should take over return-to-work assessments from GPs. It also proposed that employers that take on people with long-term conditions should be given tax breaks. The review, led by Professor Dame Carol Black, National Director for Health and Work, and former Head of the British Chambers of Commerce, David Frost, claimed that the changes could save employers £100 million per year from reductions to sick pay bills.  

In response to the review, in January 2013, the Government unveiled a new independent assessment and advisory service which employers would be able to make use of in order to address sickness absence and get employees back to work. And, in February 2014, the new “Health and Work Service” was officially launched by the Government.

The Department for Work and Pensions then announced that the five-year £170 million contract for running the service, now known as ‘Fit for Work’, in England and Wales has been awarded to occupational health provider Health Management. The service in Scotland will be run by the Scottish Government.

What does this service offer?

  • The service will consist of free health and work advice through a website and a telephone advice line, plus free referral for an “occupational health” assessment for employees who have reached, or whose GP expects them to reach, four weeks of sickness absence.
  • An employee referred for assessment may receive a return-to-work plan that will provide advice and recommendations to get them back into work. This can be accepted as evidence of sickness absence in the same way as a GP-issued fit note.
  • The service is not mandatory, and so will require employee consent at every stage. Consent, the guidance stresses, “must be explicit, informed and freely given and should be obtained at each point in the process”.
  • Employers are being advised to update their sickness absence policies to reflect the availability of the service and communicate its existence to employees and managers.
  • GPs or employers will be able to refer employees into the service.
  • Employees will be contacted within two working days of referral. An initial assessment will normally take place over the telephone.
  • If required, a face-to-face assessment will take place within five working days.
  • Employees will be discharged when they have returned to work or at the point it is deemed the service can no longer provide further assistance, with a three-month cut-off.
  • A £500 tax exemption will apply to medical treatments recommended by a healthcare professional either as part of Fit for Work or an employer-arranged occupational health intervention.
  • Under existing tax rules, the cost of any medical intervention funded or provided by an employer is likely to be liable to tax either as a benefit in kind or a payment of earnings, with employer and employee national insurance contributions (NICs) also due.
  • There will now be no charge to income tax or NICs on payments up to the limit of £500 per employee per tax year. Any payments over the £500 limit remain liable to tax and NICs on the excess

What do experts have to say about this service?

Maudsley Learning hosted a breakfast discussion in January 2015 about the Fit for Work service with an expert panel comprising: Nick McGruer, Deputy Director Health and Work, Health, Disability and Employment Directorate, Department for Work and Pensions; Dr Clare Gerada, GP and Immediate Past Chair, Royal College of General Practitioners; Professor Stephen Bevan, Director, Centre for Workforce Effectiveness; Stuart Lewis, Head of Claims, MetLife. 

Nick described the Fit for Work service as a step into ‘unchartered territory’ and a ‘start of a long journey to look at the sickness agenda’. With 131 million days lost to sickness absence, costing £9 billion to employers and £15 billion to the UK economy in terms of lost output, the need for the service is justified. However, with 300-350 thousand people flowing from work to sickness benefits and less than half getting back to work, Stephen emphasised that ‘good work’ (and not just work) is key for the return to work process to be beneficial for an employee. Clare emphasised the role of GPs who will play a key part in this process and have the challenge of balancing care and advocacy.

Whilst theFit for Work service brings undoubted benefits, it is not without challenge. In particular, the panel discussed the need for employers to be mindful of the potential risk of presenteesism associated with a graduated return to work.  Practical support measures such as the Fit for Work service must be complemented by a leadership culture and duty of care. Questions remain as to whether the service should be mandatory. And, there is still debate around the timeliness of the intervention alongside ease of access to support.

The Fit for Work service is an important service covering a broad spectrum of industries and health issues (both physical and mental).  In its evolution the aim is to reach SMEs who do not access any other occupational health services. The general consensus from our panel discussion was to watch as the service grows, in anticipation of the real impact the service might have on people and workplaces.


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