Health director Dame Carol Black proposes ‘Fit for Work’ service

A ‘Fit for Work’ national workplace health service run by and from the NHS has been proposed by national director for health and work Dame Carol Black as the centrepiece of her vision for the future of workplace health in the UK.

The service, which Black suggested would probably be located within or near primary care, would see case managers being able to refer people into a range of medical and non-medical workplace health-related interventions.

These could include exercise plans, counselling and cognitive behavioural therapy, physiotherapy, occupational health and even support for areas such as housing provision or personal finances.

The wide-ranging report, entitled Working for a Healthier Tomorrow, also calculated the cost of sickness absence and worklessness associated with working-age ill health to be £100bn a year, or enough to run the entire NHS.

The report also recommended that working-age health should be brought firmly within the remit of the NHS.

“From its inception in 1948, the NHS only provided OH services for its own staff. Providing and funding OH for other workers was made the responsibility of their employers. These arrangements might have been right at the time, but it is clear they are failing to meet current needs,” she said.

Black said the remit of OH needed to be expanded to include all those of working age, not just those of working age who are off sick.

A system of accreditation of OH  and vocational rehabilitation providers to ensure consistent, formal standards was also required. And there needed to be a drive to ensure OH was not “a specialty unknown to most trainee health professionals”, she argued.

The report has been widely welcomed by employers, but the Society of Occupational Medicine warned that a Fit for Work service would need to be properly funded.

Society president Dr Gordon Parker estimated such a service would need at least a further 1,800 OH doctors if it was to have a “competent clinical lead”.

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