When I published Working for a Healthier Tomorrow, my review for the government into the health of the UK’s working-age population, the most pivotal recommendation I made was to introduce the so-called ‘fit note’.
On 6 April, the fit note will come into effect, marking a momentous change for workers who have health conditions. The new system will encourage GPs to provide more helpful advice to their patients that can form the basis for discussions with their employers. The fit note reflects current medical thinking that, for most people of working age, the right work is good for health and wellbeing – and it is also good for business health and for society as a whole.
The advice from the GP in the fit note is designed to guide discussions between an employer and employee about what adjustments or changes to working practices might be possible to help get the worker back in the office safely, as soon as possible.
GPs do not need specialist occupational health (OH) expertise or a detailed understanding of their patient’s job to complete the form. Employers have detailed knowledge of their employee’s work and their workplace and so, based on the GP’s advice, the employer can consider whether or not they can make any necessary changes to support their return to work.
The recommendations in my 2008 review into the health of working-age people were not isolated proposals. They were each part of a carefully considered whole, which I hoped would improve the lives of working people and their families.
During my review, it became clear that, although many organisations, particularly larger ones, have ready access to specialist OH advice, few small businesses are in a position to provide help and support to staff who suffer ill health.
I’m delighted that the pilot OH advice line service will be extended nationwide at the start of April. The advice line will give managers in firms with fewer than 250 staff early and easy access to high-quality, professional advice on individual employee health issues from qualified OH nurses.
For employers wanting to try out new ideas to improve the health of their workforce, the new Health, Work and Wellbeing Challenge Fund will provide funding for solutions identified by organisations to meet the specific needs of their workforce. This is a competitive scheme and is aimed at small and medium-sized businesses and local partnerships. This year’s successful bids will be informed in the coming weeks.
My review estimated that the cost of working-age ill-health in the UK, in terms of working days lost and worklessness, is more than £100bn each year. For me, this highlighted the need for a functioning early-intervention service of the kind being piloted at the moment – 11 ‘Fit for Work Service’ pilots have been set up across the UK. They make access to work-related health support more widely available by providing early intervention, case-managed, multi-disciplinary support for individuals.
The re-configuration of existing health and employment services, and other relevant initiatives that are already being funded locally, will allow the Fit for Work Service to address the specific needs of the community it serves, assist employees who are currently off sick from work in their recovery and support them to return to sustained work more quickly than they otherwise would.
The success of these changes will depend on each of us playing our part responsibly, both as individuals and through our organisations, with employees fully engaged. This will call on new ways of working across traditional boundaries, to unite healthcare professionals, employers, unions and individuals in a concerted effort to promote the health of working-age people. Success in this endeavour will be of great benefit to us all.
Dame Carol Black, national director for health and work
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