A better way to manage long term ill health?

A new, state-funded occupational health assessment service is now operational. The so far under-publicised service, branded ‘Fit for Work’, aims to provide a simple and cost effective way for employees, employers and GPs to work together to facilitate the return to work of employees who are on long term sick leave. The hope is that the scheme will reduce the incidence of those employees falling out of work and falling into the benefits system.

The Fit for Work service offers free advice to employers in relation to health issues affecting their staff through its website and by telephone, including advice in relation to adjustments that could be made to help an employee remain in, or return to, work.

A key component of the scheme is the ability of an employee’s GP or the employer to refer the employee for a free occupational health assessment. This part of the service has only recently commenced in parts of England and Wales. Employer referrals will be possible from this autumn, once the GP referral scheme has been rolled out nationwide.

Upon referral, an occupational health professional contacts the employee to undertake an assessment, in most cases by telephone. A report is then prepared with a view to the employee and occupational health assessor (known as a case manager) agreeing a Return to Work Plan which can be provided to the employer. Where appropriate, the plan will include a proposed timetable for interventions and adjustments which could help to enable the employee to return to work.

However, there are factors which may inhibit the effectiveness of the service. A referral can only be made with an employee’s consent; an employer can only make a referral after the employee has been absent for four consecutive weeks; the Return to Work Plan can only be disclosed to the employer with the employee’s consent and if it is disclosed, parts of it may be omitted at the employee’s request, and the employer is not obliged to follow the advice in the Return to Work Plan. However, employers who propose to ignore the recommendations of a plan should firstly seek advice, as to do so may expose a business to claims of disability discrimination and/or failure to make reasonable adjustments.

The Department of Work and Pensions (DWP) predicts that GPs will refer 36% of eligible patients for an occupational health assessment, but there are concerns about how thoroughly and uniformly GPs have been briefed on the eligibility criteria and that this could lead to anomalies between practices. Some employers may be worried that, because most assessments will not be conducted on a face to face basis, the assessments will not be as robust and helpful as they could be. If a business requires occupational health advice which is swift and commercially aware, private occupational health professionals may remain the best option.