Fit for Work service scrapped in workplace health policy overhaul

Fit for Work service assessment

The Government has scrapped its Fit for Work service, blaming “low referral rates”. The service will come to an end in England at the end of March and in Scotland at the end of May.

The announcement in December came as part of the government’s response to its Work, health and disability green paper consultation.

Since its launch in 2015, the Fit for Work service has consistently struggled with a low public profile and scepticism among both GPs and employers about its use and usefulness.

A survey by GP magazine last summer found that 65% of GPs had not referred a single patient to the service and that a lack of publicity was the cause. And a study by Willis Towers Watson last March found only 21 of HR professionals said they had used it.

Employers, employees and GPs will still be able to use the Fit for Work helpline, website and web chat facility, but the service’s key referral and return-to-work element will cease.

Although the Fit for Work service will be disappearing, the Government in its response announced a number of significant changes to fit notes, sick pay and, potentially, to occupational health itself.

On fit notes, ministers said they would look at legislation to extend fit note certification powers to other healthcare professionals, such as physiotherapists, psychiatrists and senior nurses, “along with the design and development of a set of competencies for those completing fit notes”.

It will conduct a feasibility test to investigate whether employers could use the Advisory Fitness for Work report, which can be completed by some allied health professionals, as an alternative to the fit note.

Clinical guidelines

Fit note training is also to be integrated into GP undergraduate and postgraduate education. A study will take place to examine the feasibility of developing clinical guidelines for workplace adjustments for the top five clinical reasons people are off work sick or are on health-related benefits. And the government has pledged to explore “whether changes to the way GPs complete fit notes could support better return-to-work conversations.”

The response accepted the recommendations of October’s Farmer/Stevenson Thriving at Work report into mental ill-health (OH&W News, December 2017) and recommended that “a new flexible model” for statutory sick pay be developed “to better support those with a mental health condition, where willing and able, to return to work on a voluntary phased return and receive wages and SSP on a pro-rata basis.”

Finally, on occupational health, the government committed to setting up an expert working group to help build the evidence base around OH, to consider new funding models and “where responsibility for OH support should fall”.

Existing provision

The working group will look at methods for improving the quality of existing provision, including looking at how OH is delivered within primary and secondary care and elsewhere, “exploiting the potential of technology” and examining workforce development “so we have the expert capacity we need in the future”.

The working group is intended to report in 2019. However, the Government also revealed we can expect an independent evaluation on the lessons learnt from the Fit for Work service “in early 2018”.

Work and pensions secretary David Gauke said: “Everyone should be able to go as far as their talents can take them, but for too long disabled people and people with health conditions have been held back from getting on in work.”

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