Fit for Work service: frequently asked questions

A series of roadshows have been held recently to explain how to use the Government’s new Fit for Work service. Here are the answers to common questions asked by delegates at the events.

Fit for Work, a free service designed to help people who are off sick for four weeks or more to return to work, has been visiting cities throughout England and Wales with a series of employer roadshows.

The series of full-to-capacity events were designed to help employers understand Fit for Work and how to refer their employees, as well as discuss the issue of long-term sickness absence and put questions to a panel of experts.

Fit for Work representatives teamed up with workplace advice and conciliation service Acas to deliver a comprehensive briefing to attendees. David Frost CBE also visited parts of the country with the Fit for Work team, giving a presentation on why he recommended Fit for Work in his 2011 “Independent Review of Sickness Absence” report.

Each roadshow event concluded with a question and answer session, where attendees could put their questions to a panel of experts, including Frost and representatives from Fit for Work, Acas and the UK Government’s new Work and Health Unit.

Lisa Willis and Lina Tan, OH advisers at Tesco, who attended the Reading roadshow, said: “We thought it was a really useful event – there were a lot of people asking about the role of occupational health and how it works so it was definitely helpful for those people to come along and learn more about the sector.

“It was great to hear about the future plans for Fit for Work too – at Tesco we’re encouraging our managers to refer their employees and educating them about how it all works.”

Mike Dilke, owner of RelaxBack UK, who attended the London roadshow, said: “I run a business that supplies high-end ergonomic furniture to companies for their staff. As such, I’m very interested in the issue of musculoskeletal conditions, which can often cause long-term sickness absence.

“The event in London was a really useful and informative event. I was very interested to hear the statistic from Fit for Work that if people can be helped back to work around the 28-day mark then they are far more likely to stay in work, which was something I didn’t know before.”

Below is a selection of key questions asked by employers across the country to the panel at the roadshow events.

Is the service now fully up and running across Great Britain?

Yes, Fit for Work is fully available for advice and referrals across England, Wales and Scotland.

In England and Wales it is delivered by Health Management Ltd and in Scotland by the Scottish Government, where it is called Fit for Work Scotland.

Employers can now refer eligible employees for a free OH assessment, as well as access free information, via the advice line.

How can I refer someone to Fit for Work?

You can refer eligible employees to the service online at or call 0800 032 6235.

Just follow these three simple steps:

  1. Visit and select the “Refer an employee” button.
  2. Enter your company/employer details.
  3. Check all the information on the referral form is correct and click submit to refer your employee to Fit for Work.

How do the face-to-face assessments work?

The vast majority of referrals will be done over the phone. However, if a person requires a face-to-face assessment (which we would offer if there were communication issues), they would never have to travel more than 1.5 hours for the appointment, and can reclaim the cost of their travel.

If I have an employee who works in England but lives in Scotland can I still refer them?

To make an eligible referral to Fit for Work would require the employee to live in England or Wales. As mentioned, Scotland has its own separate service, Fit for Work Scotland, which the employer can refer into.

What is in the Return to Work Plan and who in the business will receive it?

The Return to Work Plan is produced by the Fit for Work case manager who has an OH background; whereas a fit note is produced by a GP who may not be an expert in OH. The Return to Work Plan has a separate section that operates the same way as a fit note, and can be separated from the confidential Return to Work Plan.

The Return to Work Plan will make recommendations about how to overcome obstacles often caused by biopsychosocial factors that prevent a return to work and encourages the employee to work through recovery. The Return to Work Plan will either be received by the employee’s line manager or HR department, with the employee’s consent.

How does the service work with the fit note?

The Return to Work Plan has the same status as a fit note and employers can accept the Return to Work Plan as evidence of sickness absence in lieu of a fit note, so the employee will not need to return to their GP for a fit note.

What about employees who refuse to give consent to be referred to Fit for Work? Is there anything that can be done?

If they refuse to give consent, they cannot be referred to Fit for Work – it is a voluntary, consent-driven service. Fit for Work is just one of the things that you, as an employer, can offer as support to an employee on long-term sickness absence. Hopefully, the more people hear about Fit for Work, the more they will understand that it is designed to help them and will be willing to give consent. You or your employee can also contact the advice line for information and advice, without a referral.

What about long-term intermittent sickness absence – what can we do about that?

Employers can refer after a spell of four weeks’ absence, but before this point, or for shorter, intermittent spells, the free advice line is open, 8.30am to 6pm on weekdays, and it is designed to help people wanting advice about any health and work-related issues.

Employers that have an employee on intermittent sickness absence could call the advice line and speak to a trained health professional who could offer employer or employee advice and support. The advice line number is 0800 032 6235 in English, and 0800 032 6233 in Welsh.

If we receive a Return to Work Plan and we, as an employer, do not agree with the plan, or some of the recommendations, can we call and speak to a case manager?

Yes, you would be able to speak to the case manager (your employee should have the same case manager throughout the process) and discuss any concerns or queries you may have, provided your employee has consented. Otherwise, there is the advice line available for support and to help answer any of your questions.

At what point in the referral process is the employer contacted?

If the employee has given their consent for Fit for Work to speak to their employer, they would usually be contacted before the plan is completed to get the employer’s input – for example, there may be adjustments needed at work that the employer can advise on. We often advise employees that it is a good idea for us to speak to their employer.

What if the employee does not want to share the Return to Work Plan with their employer or GP?

The plan is broken down into “obstacles” and the employee can choose which of these they share with the GP and the employer. We always encourage an employee to share any relevant obstacles with all parties. We do, however, rely on the employee’s agreement to this.

How did you engage with GPs and have they had roadshows?

Fit for Work has approached Clinical Commissioning Groups across England and Wales and arranged meetings with GP engagement lead, Dr Sundar Thava. The service also had a large team of Fit for Work ambassadors that made visits to GP practices up and down the country to explain Fit for Work and show them how to make a referral. All GP practices in England and Wales also received a pack containing our information and guidelines for the service and we have spoken at a large number of GP events.

Why is a referral only available once in a year, and why does the referral only last for three months?

The Fit for Work service just wouldn’t be able to have an “unlimited referral” service unfortunately – but it is being monitored closely in its early stages.

The likelihood is that most people will return to work within three months, and, if they are unable to, then they will be referred into the care of their GP. It is important to bear in the mind that it is still the first year of this service – decisions have been made based on David Frost’s 2011 review on sickness absence about the optimal point of intervention, which is seen as 28 days.

How does Fit for Work work with existing occupational health services?

Fit for Work is there to enhance the work of existing OH services, not replace it. A case manager will always check whether or not an employee has access to existing OH provision at work. Some companies are using Fit for Work as a front line for all absence routinely at four weeks, with escalation to in-house services for more complex cases or where a return to work is not made within three months. This can free up their OH services to focus on other statutory requirements or on more proactive services.

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