Dame Carol Black calls for urgent reform to workplace health services

Dame Carol Black has called for a new approach to work-related health services, after her review found that ill health was costing the country £100bn annually.

Black, the national director for health and work, said “urgent and comprehensive” reform was needed, calling on government employers to make the UK a healthier country for workers.

Dame Black has been commissioned by the Department for Work and Pensions (DWP) to advise on how to improve the health of those in work and reduce the number claiming sickness benefits.

Proposals in the 125-page report, Working for a Healthier Tomorrow (PDF, 2.4MB), focus on keeping people healthy at work, and also on helping them return to work after illness. It recommended the launch of a new “fit for work” service to target people in the early stages of sickness.

Black questioned the current sick note system, which she said concentrated on what people cannot do instead of what they can. She recommended that doctors’ written sick notes should be replaced with an electronic “fit note”, explaining what people were able to do even if they were ill.

Dame Black added that good work-related health support was disproportionately concentrated among a few large employers.

“The aim of my review is not to offer a utopian solution for improved health in working life, but to identify factors that stand in the way and offer potential solutions,” Black said.

The report made the following recommendations to overcome the challenges, including:

• New Fit for Work service to be piloted for patients in early stages of sickness – if rolled out the aim would be to make work-related health support available to all

• If successful, Fit for Work should be extended to those on incapacity and other out of work benefits. The government should also expand provision of Pathways to Work to cover all on incapacity benefit

• Outdated paper-based sick note should be replaced with an electronic ‘fit note’, stating what people can do, not what they can’t

• Occupational health should be brought into the mainstream of healthcare provision.

Commenting on proposals for a ‘well note’, Professor Sayeed Khan, chief medical adviser at the EEF said: “Too often there is an emphasis on what the employee cannot do rather than what they can do. This system should help us tackle sickness absence in a positive manner by enabling employees to return in a role that suits both the employer and employee.

“The burden felt by many doctors relating to sicknotes may also be improved with a drive to use a new more user-friendly system which is electronic as a means of better communication between employer, employee and GP,” Khan said.

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