Fit for Work Scheme

A trial of a new Fit for Work (FFW) scheme began recently, with 20 GPs in Sheffield participating. It is expected that the scheme will be rolled out in the rest of the UK this year. The scheme may change how employers manage sickness absence but, as with any new scheme, time will tell if the scheme successfully meets its aims.

The FFW scheme will provide occupational health assessments and seek to assist employees who are absent due to sickness to return to work. It will apply to employees who have been absent for four weeks or more provided there is a reasonable prospect of return.

Currently both employees and employers can obtain free and impartial work-related health advice via a new website and telephone advice line. The referral service whereby employees can be referred to the scheme for occupational health assessments is intended to be rolled out on a phased basis by May 2015.

It will usually be an employee's GP who will make the referral to the scheme once the period of absence reaches four weeks, although this may be earlier if it is apparent any absence will last four weeks. Once the referral is made, it is intended that the process will be as follows:

1. An assessment of the employee will be carried out over the phone within two working days.
2. If a face to face assessment is necessary, this will take place within five working days following the decision to make such an assessment. This is expected not to be necessary in the majority of cases.
3. The assessment will aim to identify all possible obstacles preventing the employee's return to work and to formulate a Return to Work plan to address these. The plan will be tailored to the employee's specific circumstances.
4. The Return to Work plan will be given to the employee's GP and their employer. It will also state whether or not they are fit to work and therefore removes the need for GP fit notes once the plan is issued, unless absence continues beyond being discharged from the scheme.
5. The employee's case manager will contact them at an arranged point to discuss whether the plan is on track and identify if any further assessment is necessary. FFW may also contact the employer if the recommendations are not being followed. The employee will also be contacted again following their return to work date.
6. An employee will be discharged from the scheme when they return to work, where there is no further assistance available, or if they have not returned within 12 weeks.

It is also intended that employers will receive a tax exemption of up to £500 per tax year per employee if they fund medical treatments recommended by the FFW Service or another OH service, which may be beneficial.

Although it is anticipated that most referrals will be made by GPs, employers will also be able to refer employees to FFW if their GP has not done so after 4 weeks of absence, provided the employee has not already been referred in previous 12 months or received a return to work plan. The employee also must consent to being referred by the employer. It is not mandatory for employers to make a referral, nor to implement the recommendations made in Return to Work Plans, but doing so may assist employees to return earlier and therefore save costs associated with absence.

It is suggested by Government guidance that employers update sickness absence policies to include reference to the FFW scheme, such as explaining the existence of the service and advice available, when employees might be referred and the change in the need for fit notes.

The scheme is intended to complement existing occupational health provision by employers rather than replace it. Where the criteria apply, making a referral to FFW is considered the default position for GPs, but it is not mandatory. There are a number of circumstances where a referral to FFW is not considered appropriate, including:

• The employee is off sick for more than 12 weeks or there is no realistic prospect of return.
• Where an employee is in the hospital or in an acute phase of their medical condition.
• Where the illness is terminal, unless the GP has indicated that a return is possible.

Further, the Return to Work plans will be produced in a short time frame and are likely to be regarded as advisory only. Therefore, it would be unwise for employers to solely rely upon a Return to Work plan when assessing an employee's absence. In these circumstances, having another OH provider may be advantageous.

As the scheme has not yet been rolled out, it remains to be seen how successful it will be. As referrals are likely to be completed by GPs, the success of the scheme will be largely dependent on how efficiently doctors make referrals: without a buy in from GP's, there is little likelihood of the scheme meeting its aims.

Effectively, FFW implements a referral to Occupational Health for free, which is likely to be beneficial in terms of costs, as well as time should the intended timescales come to fruition. However, as there are certain circumstances where the FFW scheme does not apply or is inappropriate, it may also be advisable to retain the services of an Occupational Health Practitioner for more complicated or long term cases. The results of the trial currently running in Sheffield may give a clearer idea of how the scheme will work and whether it can deliver the intended results before it is rolled out across the UK.

As with a number of similar schemes, the resources the government put into the scheme may ultimately determine how successful it is. Given the new scheme is intended to augment an employer's existing Occupational Health resource, it will be interesting to see whether the scheme has the capacity to meet demands.

Additionally, the quality of information passed to the employee's case worker will also determine how useful any Return to Work plan is going to be in practice. As most referrals will only result in a telephone consultation, any plan may be limited in its practical benefit.