Lack of engagement

A year on, we now know that as of the end of March in England (and the end of May in Scotland) the ‘Fit for Work’ scheme will come to an end. In some ways this is not a surprise. Even after 3 years in existence barely 65% of GPs actually use the scheme to make referrals and it would seem that publicity, and a full understanding of what the scheme is all about, have been somewhat lacking.

There was certainly a healthy scepticism about ‘Fit for Work’ within many occupational health networks. How could such rigid parameters for access, for example an actual or anticipated minimum of 4 weeks sickness absence, really replace the value of an occupational health service where there is no minimum sickness absence requirement? How could a telephone assessment ever replace face to face contact in more complex or challenging cases? And, of course, how can a ‘distant’ service ever match a dedicated service where an occupational health professional knows the client organisation and its culture inside out?

‘Fit Notes’

There are government plans to extend the scope of ‘fit notes’ so that other health professionals such as physiotherapists, psychiatrists and senior nurses can certify. There’s also now an acceptance that in order to increase the effective use of ‘fit notes’ there will need to be more awareness and training amongst those who issue them. There are plans to incorporate training into GP undergraduate and post graduate learning programmes.

A ‘fit note’ is only as good as the ability of the person issuing it to understand its value to an employer and to be able make clear and tailored recommendations to employers. The goal has to be to ensure that people on longer term sickness absence in particular are not left in the wilderness and are able to benefit from appropriate and planned rehabilitation and re-integration in the workplace.

There has been discussion around taking the most common reasons for sickness absence and creating clinical guidance for assessing and planning the right workplace modifications to facilitate a successful return to work in each of these scenarios. The way GPs, or other professionals, convey their recommendations will impact positively – or negatively – on the so-called ‘return to work’ discussion.

We believe that the most effective transition from periods of sickness absence to full, productive and effective employment will occur where there is a dedicated occupational health service provided ‘holistically’ by professionals who understand their clients’ organisation, its culture and its people. This can only be achieved over time and by involving occupational health in the strategic and operational planning direction of the organisation.

If you are considering a new or different occupational health provider with a fresh and effective approach, why not contact us?