Occupational health practitioners and providers have applauded the government’s ‘unprecedented’ focus on expanding access to OH in this week’s Budget and health and disability white paper, but emphasised that more still needed to be done.
The consensus was that, while not of course a commitment yet to make access to OH universal, the proposals outlined were nevertheless a positive step in the right direction.
As highlighted on Budget day this week (Wednesday), SOM (the Society of Occupational Medicine) and the Commercial Occupational Health Providers Association (COHPA) welcomed the focus on workplace health by chancellor Jeremy Hunt.
However, universal access to OH needed to be the next critical step to addressing health-related economic inactivity, they both argued.
Dr Shriti Pattani, president of SOM, said: “We welcome the unprecedented focus on occupational health in this year’s Budget announcement. Specialist OH providers stand ready to deliver what is needed to tackle economic inactivity related to ill-health and universal access is the next critical step.
“Specialist occupational health knowledge is the heart of workplace health in terms of both strategy and delivery, and we would like to see the Government be clear in its intent to utilise OH expertise to ensure an evidence-based and targeted approach to workplace health.”
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COHPA chair Alan Ballard highlighted how it was launching a guide, Introduction to Occupational Health for SMEs, to help steer employers in the right direction.
Faculty of Occupational Medicine president Dr Steve Nimmo agreed with this sentiment. He said: “It was fantastic to hear the chancellor recognise the importance of occupational health during his budget speech. We believe universal access to occupational health would be the most effective approach to keeping people in work and boosting the economy. However, these latest steps are welcome and we are pleased that the value of occupational health is being acknowledged at the highest level of government.”
Support for OH subsidy model
Dr Nimmo in particular welcomed the £25m funding chancellor Jeremy Hunt said would be put behind the new subsidy pilot for SMEs to access occupational health, the ‘Innovation Fund for Occupational Health’.
We believe universal access to occupational health would be the most effective approach to keeping people in work and boosting the economy.” – Dr Steve Nimmo, Faculty of Occupational Medicine
He also supported the announcement of two new consultations. The first of these will evaluate opportunities to incentivise uptake of OH for employers through taxation, the second will explore increasing employer engagement with OH by regulation or other levers.
Dr Nimmo pointed out that this latter consultation would consider “a process of kitemarking and professional accreditation to assure quality of occupational health services”. This, he emphasised, could – and perhaps should – be delivered by the existing SEQOHS accreditation scheme run by the faculty.
Katharine Moxham, spokesperson for the group risk body Group Risk Development, said of the proposals: “It’s really encouraging to see government acknowledging the human wastage that long-term sickness absence from the workplace can bring and announcing positive steps to de-risk the journey back into work. It needs to go much further, however, in addressing how people fall out of work in the first place, as well as how to encourage them back.
“We must deal with the question of how people end up being economically inactive in the first place. In many cases, employees wouldn’t leave work if they were better supported by their employer.
“The support is available for companies to offer: they will find help within their benefits package – via their, private medical, occupational health or other benefits. For example, as well as meeting the costs of long-term sick pay, a group income protection policy will include access to help from vocational rehabilitation experts, and access to advice and support with both short- and long-term health conditions and making reasonable adjustments under the Equality Act 2010.
“So, it’s time for government to be proactive and encourage more employers to move towards providing a better level of long-term sick pay and support during absence. This will mitigate the number of absences, and get people back to work. Group income protection providers can help deliver that outcome for employers and employees alike, while saving the state considerable effort and cost,” Moxham added.
More still needs to be done
David Williams, head of group risk at health insurer Towergate Health & Protection, also said it was “pleasing” that the government had recognised the benefit of employer-led occupational health services. “But we believe more needs to be done to support employees to ensure their physical and mental health is maintained,” he cautioned.
“The right employee benefits, including group income protection, private medical insurance and cash plans, all directly aim to reduce illness in the workforce. Then you have the added-value services within benefits such as group life assurance and critical illness etc, which are specifically designed to support people to stay in work and return to work after illness.
“Providing employee benefits for the masses has a better impact than tax breaks for a select few, and we’d encourage employers to look at these if they want to retain their workforce and be seen as an employer of choice,” Williams added.
Occupational health needs to be one of many workplace health interventions available so that people can get access to what works for their situation at the right time.” – Angela Matthews, Business Disability Forum
Angela Matthews, head of policy at the Business Disability Forum, described the focus on OH as “positive”. She said: “We know that quality occupational health support can make a significant difference to the working lives of disabled people but often a more collaborative approach between occupational health providers, employers and employees is needed.”
But Matthews also cautioned: “Occupational health, however, needs to be one of many workplace health interventions available so that people can get access to what works for their situation at the right time.
“The chancellor said that the Budget is about ‘breaking down barriers that stop people working.’ While we welcome many of the measures, we do not believe today’s announcements go far enough to achieve this for employees and potential employees with disability and long-term conditions.
“People cannot work – get work or stay in work – if their conditions are not ongoingly supported and managed by the appropriate NHS interventions. Employees working in our member organisations are still on NHS waiting lists and are off sick while medical procedures are still being postponed,” Matthews added.
Matthews also emphasised that, too often, return to work remains a health outcome largely ignored by the NHS in how it treats and support patients.
“The support available for people who experience life-changing illness or disability is often limited and fragmented once they leave hospital,” she highlighted.
“Work and health settings must join up and provide better, more work-ready effective interventions to ensure people can supportively and safely phase back into employment.
“For many disabled people receiving support from the government’s Access to Work scheme has made having a job possible. Yet, Access to Work only currently supports people already in work or who have an interview arranged.
“A ‘back to work’ investment must include Access to Work being available to anyone with a disability who is looking or who wants to look for employment. Access to Work is currently overwhelmed and under-resourced, but investment to expand it could make a huge difference, both to the inclusion of disabled people in the labour market, and for the wider economy. We were disappointed not to see this mentioned in the Budget or white paper,” Matthews added.
The Institution of Occupational Safety and Health (IOSH) argued the government still needed to dig deeper into the root cause of increasing long-term sickness and set out how it proposes to manage it.
Ruth Wilkinson, IOSH head of policy, said: “It’s all well and good saying we want people to return to work and offering incentives for this. You cannot expect older people or those who have been on sick long-term to just turn up at work. Many of them have specific requirements in the workplace to enable them to do their jobs, not just effectively but safely and healthily.
“What we need are improvements in levels of awareness regarding issues of disability and illness and clear strategies and policies to show how this is going to be managed and how businesses will support people. This can only be done by prioritising a more robust system for employers to accommodate individual needs.
“Good, well-managed work is vital for people’s health and wellbeing. For work to be good, it must be safe, healthy, supportive and accommodate people’s needs. We are calling on the government to go deeper into the root cause of the increase in long-term sickness by setting out how it proposes this can be prevented and managed and for businesses to consider some key questions, including how they might offer appropriate support, reasonable adjustments, rehabilitation and return-to-work programmes for employees,” Wilson said.