Black Review recommendation: government should pilot a new Fit for Work service based on case-managed, multidisciplinary support for patients in the early stages of sickness absence, with the aim of making access to work-related health support available to all – no longer the preserve of the few.
The report proposes that the Fit for Work service should be piloted comprehensively before being rolled out, with different models of service delivery and the use of providers from the private and voluntary sectors being tested.
“This would allow the best possible mix of service providers with the greatest expertise and available workforce capacity to deliver elements of the service, irrespective of whether they are from public, private or voluntary sectors,” the report said.
It cited the example of the work of the Scottish Centre for Healthy Working Lives, which is piloting a similar sort of service in Dundee, and the Welsh Assembly Government, which is testing work-focused rapid access to physiotherapy and online health and work resources for GPs.
“To be effective, the Fit for Work team would have to be based in or close to primary care,” the report said, with possible options including teams in health centres or covering a number of GP practices.
The pilots could test earlier access for those experiencing second or repetitive episodes of sickness absence within a given period, Black added.
The report estimates that if just 10% of people who go off sick were helped to stay in work, it would save taxpayers more than £100m.
And if it could reduce the flow of people leaving work to go on to incapacity benefit by just 1% this would lead to a saving for the taxpayer of some £10.5m.
With the CBI estimating that the cost to the economy of a working day lost to sickness at £77, if the service could help half of the people on long-term sickness absence to return to work just a week earlier, this could potentially save the economy £88m per year and double that for returning two weeks earlier.
The saving from reduced GP consultations and secondary care referrals could be more than £130m, money that could be ring-fenced to fund the service.
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