How should HR respond to the Fit for Work service (assuming they’ve heard of it)?

The Government’s new Fit for Work service is being launched in stages throughout 2015, allowing employers to refer employees off sick for four weeks for a free assessment of their condition. So what should HR be doing to prepare? 

In January, a survey of 500 businesses by the group risk trade body GRiD found that one-third felt they would be likely to use the Government’s new Fit for Work absence and assessment service to help staff with health conditions stay in or return to work.

That assumes, of course, employers and HR teams are currently even aware of the new service. Professor Sayeed Khan, chief medical adviser of the manufacturers’ organisation EEF, points out that the service launched just days before the country shut down for Christmas, and even then without any particular media or publicity fanfare, so its profile is low to non-existent.

“Most people – employers and GPs – simply do not know it is happening. There is supposed to be a communication strategy, but one of the problems is that everything has been so delayed – the December launch was months later than it was supposed to be. GPs know nothing about it,” says Prof Khan.

This is partly because the service is being unveiled in two stages. What launched in December was only the online and telephone advice side, including factsheets, an “advice hub” and a “live chat”.

The second – and arguably more important – arm, the telephone and face-to-face assessment service, is still at trial stage. Since mid-January this has been piloted as a “proof of concept” within 20 GP practices within the Sheffield area. The idea is that it will gradually roll-out from the spring, with the Midlands, the North West and Wales the next likely destinations.

Despite its quiet launch, Fit for Work is something HR professionals need get up to speed with. One of its more innovative elements is that employers (in practice HR departments or, in smaller firms, more probably managers or owners), as well as GPs, will be able to refer employees for assessment.

The Government has advised employers to update their sickness absence policies. HR teams will also need to consider how they approach the service in terms of liaising with local GPs and how to ensure employee consent, given that referrals will be completely voluntary.

As Prof Khan emphasises: “Referral has to be with the consent of the employee. It should be the first thing the case manager asks about, whether the employee has given their full consent.”

Employees can be referred into the service after four weeks of absence or earlier if, for example, their GP is sure ahead of time their illness will mean they are likely to be off for four weeks or more. This four-week “window” could be a stumbling block for many employers, suggests Helen Minion, wellbeing lead at the Public Sector People Managers’ Association and strategic HR partner at Derbyshire Fire and Rescue Service.

“Generally, any initiative that is going to support people who have been off sick back into work has to be good. What is perhaps less encouraging from an HR perspective is having to wait until someone has been off for four weeks before the process can begin. At Derbyshire, for example, we do a lot of proactive work and intervention much earlier than that, often designed in fact to help people stay at work and not go off in the first place,” she says.

“I wonder whether from an SME perspective it risks simply adding another layer of complexity. We also try to encourage line managers to take greater responsibility for managing sickness absence so if it is going to end up putting responsibility back on to HR, because of the issues around referral, then that could potentially be a backwards step,” she adds.

Feedback from members of the Federation of Small Business (FSB) suggest the loss of the Statutory Sick Pay Percentage Threshold scheme, which the Government abolished to pay for Fit for Work, may outweigh the benefit of being able to access this new service, according to FSB policy adviser David Nash. The voluntary nature of the service may also lead employers to ask if it is worthwhile.

“The assumption within the Frost/Black report that first recommended setting up this service was that referral after four weeks would be mandatory or very much expected. The fact someone can refuse to be referred in – and we appreciate there could be very good reasons for that around patient confidentiality – does ring alarm bells for us,” he says.

“If someone’s going to be able to say ‘no’, then that’s not going to do anything to help the SME with their statutory sick pay costs or get that person back to work more quickly,” he adds.

And, if the GRiD survey potentially bodes well, polling by the CIPD suggests the service has so far received a very muted welcome from employers and HR teams, argues research adviser Jill Miller.

“The proportion of organisations that believe the service will not help them manage long-term sickness absence more effectively is slightly higher than the proportion that thinks it will,” she points out.

Equally downbeat, especially considering the service has not even properly launched yet, was the fact more employers in 2014 (35%) reported they would not be accessing the service than in a similar poll in 2013 (28%).

Prof Khan, for one, argues this negativity needs to be resisted. We should be careful about rushing to cast judgement on something that has barely yet been born, he says.

“We mustn’t come to this with pre-judged beliefs and, let’s not forget, there is £170 million of taxpayers’ money being put into this so, rather than bitch about it, let’s try to make it work, particularly for the SME community where there has up to now been a massive gap in terms of this sort of provision.”

Fit for Work Service – a timeline

November 2011 – Dame Carol Black and David Frost publish an independent review of sickness absence in the UK

January 2013 – the Government responds to Black/Frost review, accepting its recommendation for the creation of a new health advisory and assessment service.

March 2013 – Chancellor George Osborne announces he will be scrapping the Statutory Sick Pay Percentage Threshold scheme to fund the new service.

December 2013 – Osborne’s Autumn Statement outlines a £500 health interventions tax break.

February 2014 – new “Health and Work Service” is officially unveiled by the Government.

August 2014 – Department for Work and Pensions announces the five-year £170 million contract for running the service in England and Wales has been awarded to occupational health provider Health Management. The service in Scotland will be run by the Scottish Government.

November 2014 – the Government announces the new service will now be known as Fit for Work.

December 2014 – The Fit for Work website and telephone advice line is launched. Assessment pilots start across Sheffield.

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January 2015 – the £500 healthcare tax break is introduced.

 Government information about Fit for Work

To accompany the launch, the Department for Work and Pensions has issued guidance for employers. This outlines that:

• The service will consist of free health and work advice through a website and telephone advice line, plus free referral for an “occupational health” assessment for employees who have reached, or whose GP expects them to reach, four weeks of sickness absence.
• An employee referred for assessment may receive a return-to-work plan that will provide advice and recommendations to get them back into work. This can be accepted as evidence of sickness absence in the same way as a GP-issued fit note.
• The service is not mandatory, and so will require employee consent at every stage. Consent, the guidance stresses, “must be explicit, informed and freely given and should be obtained at each point in the process”.
• Employers are being advised to update their sickness absence policies to reflect the availability of the service and communicate its existence to employees and managers.
• Employees will be able to be referred into the service by their GP or by their employer.
• Employees will be contacted within two working days of referral. An initial assessment will normally take place over the telephone.
• If required, a face-to-face assessment will take place within five working days.
• Employees will be discharged when they have returned to work or at the point it is deemed the service can no longer provide further assistance, with a three-month cut-off.

How the £500 tax exemption will work

• The £500 tax exemption will apply to medical treatments recommended by a healthcare professional either as part of Fit for Work or an employer-arranged occupational health intervention.
• Under existing tax rules, the cost of any medical intervention funded or provided by an employer is likely to be liable to tax either as a benefit in kind or a payment of earnings, with employer and employee national insurance contributions (NICs) also due.
• The key change is there will now be no charge to income tax or NICs on payments up to the limit of £500 per employee per tax year. Any payments over the £500 limit remain liable to tax and NICs on the excess.