This month in Ask OH, an experienced occupational health (OH) adviser answers questions on the likely impact of the new Fit for Work service, the cost-effectiveness of flu vaccinations and the value of mental health first aid.
I am aware that the Government’s new Fit for Work service is going live in 2015 and it will include assessments of fitness for work. What impact do you think this could have on in-house OH services in workplaces?
If the delivery of the new Fit for Work service is managed well, it should increase the awareness of OH across the business world, especially among small and medium-sized enterprises. However, some OH providers may be concerned about damage to their reputations should they provide any assistance as part of this service. This is partly in response to widespread criticism of the work capability assessments carried out by OH provider Atos, which has now relinquished the Fit for Work contract. It should also be noted that these assessments were undertaken to determine the work capability of people who were incapacitated and receiving benefits, but the new Fit for Work service will be for people in employment who have been on sickness absence for four weeks or more, which is a different demographic.
The Fit for Work service will now be provided by OH supplier Health Management in England and Wales. It is owned by US firm Maximus, which will also take over the Work Capability Assessment (WCA) programme.
It is crucial that the Fit for Work implementation is well balanced and thought through. Some practitioners in OH services within companies are concerned that their employers will make changes to their services, but as Fit for Work only focuses on one element of OH, I do not believe this will be the case. While the service states that referral will occur after four weeks of sickness absence, I expect the demand for the service will push this up to six weeks – and this only relates to the referral, not the consultation itself. It will be interesting to see the results of pilots of the service, as this will affect the rollout to the rest of the country.
Another concern is the limited number of qualified OH advisers and small number of nurses in OH education, which will cause problems with the recruitment of OH practitioners. On the plus side, those who are qualified may see a rise in salaries based on supply and demand.
Do you think employers should offer an influenza vaccine to their employees?
Research on this was released in 2014 in the article Vaccines to prevent influenza in healthy adults, which was published in the Cochrane Database of Systematic Reviews.
My opinion, though, is that OH practitioners should always ask what the risks and benefits are of any measure that they intend to implement in their organisation. Flu vaccines are freely available from GPs to at-risk groups, so OH advisers should be wary of implementing vaccines unless a clear rationale is made. The Cochrane research shows that the impact of flu vaccines on absence is low and it is costly to implement a programme. This is not just because of the time off work required for employees to attend, but also due to the cost of the vaccines and the training required. I would suggest a more cost-effective approach for employers is to focus on educating those employees who should consider getting the vaccine.
Vaccines are an invasive procedure and it is worth finding out how many people in the business have ever had the flu. Employees will sometimes report a cause of absence as flu when they return to work after being off for one to three days, but most people with actual flu are sick for one to two weeks and are very unwell. One caveat I would also add is that, in a hospital setting, the purpose of the vaccine may be the protection of patients rather than employees, which is a different matter.
Do you think the Mental Health First Aid course has value in tackling mental ill health in the workplace?
Mental Health First Aid is a very important tool for HR, OH, first-aiders and managers. It raises general awareness of mental health conditions and provides simple techniques that employers can use to support a person who presents in an emotional state at work. I attended the course myself a few years ago and then used the information gained to put together a slideshow that could be used to train all the managers and first-aiders in the organisation.
Feedback showed that they had a greater understanding and felt more confident dealing with colleagues with chronic or reactive mental health decline as a result. Further information is available on training in mental health first aid here.
With increasing absences due to stress, anxiety and depression, this is a way to raise awareness across a business. After all, we take general first aid as being part and parcel of health and safety at work, and mental health first aid is an extension of this.