‘Fit for Work’ scheme for long-term illness to be scrapped

1 Dec 2017 By Marianne Calnan

Low referral rate blamed for programme’s failure as government announces possible changes to statutory sick pay

The government’s national ‘Fit for Work’ occupational health scheme is to be scrapped as part of a revised strategy to get more disabled people working. 

Fit for Work was initially established as a free, GP-led service, before being extended to allow employers to refer staff in September 2015. It offered impartial advice to employers, and occupational health assessments for employees who were off ill for four or more weeks – aiming to reduce the bill for long-term sickness by getting individuals back to work as early as possible.

However, the scheme has been beset by poor take-up and complaints from employers that felt it either replicated their own occupational health efforts or was too poorly publicised to have a significant impact on long-term illness.

After months of uncertainty over its future, the government has now pulled the plug on the scheme. A new paper, Improving lives: the future of work, health and disability, states that Fit for Work’s assessment services will end in England and Wales on 31 March 2018 and 31 May in Scotland, following “low” referral rates. Employers, employees and GPs will still have access to its helpline, website and web chat service, which offer general health and work advice, as well as sickness absence support.

In August, a survey run on behalf of People Management by GP magazine revealed that around two-thirds (65 per cent) of GPs had not referred a single person under the Fit for Work scheme in the last year and, of those who had used it at some point, 40 per cent said no one they had referred had successfully returned to work. 

The latest white paper set out government plans to change the delivery of in-work programmes, personalised financial and employment support, and specialist healthcare services. The Department for Work and Pensions (DWP) said this was to help more disabled candidates into work through partnerships with employers, charities, healthcare providers and local authorities. In a pilot phase, two employment trials will be launched in the West Midlands and Sheffield City Region combined authorities.

The government is also considering changes to statutory sick pay “to better support phased returns to work”. A consultation will be launched to consider new guidelines that may include a reduction in the current level of pay.

The government said it will invest around £39m to increase the number of employment advisers available through the NHS Improving Access to Psychological Therapies service. This offers interventions approved by the National Institute for Health and Clinical Excellence for treating people with depression and anxiety disorders.

Without giving further details of how the initiatives would work in practice, the DWP announced that the changes would be implemented alongside the 40 recommendations of the Stevenson/Farmer review into mental health. These include establishing a framework for large employers to “voluntarily report” on mental health and disability within their organisations, and to support “improved employment outcomes among disabled people” and businesses’ engagement in wellbeing issues. More than 5,000 companies have already signed up to the Disability Confident scheme to promote disability inclusion in their workplaces, the DWP said.

The government added that this “will be mindful of the impacts on disabled employees, as well as the need to create an approach for employers that is relevant and not burdensome”.

The strategy responds to a work, health and disability green paper consultation that closed earlier this year after around 6,000 responses. In June, the ONS published figures revealing that disabled people were twice as likely to be unemployed as non-disabled people – and just under half of disabled people were in work compared with about 80 per cent of non-disabled people.

Mark Atkinson, chief executive of disability charity Scope, said: “Too many disabled people continue to face barriers to entering, staying and progressing in employment, [and are] unable to fulfil their potential. The [government] pledge is an important gesture, but needs to lead to swift action to make become reality, and the government must ensure disabled people’s experiences are at the heart of all changes.”

Rachel Suff, the CIPD’s senior employment relations adviser, said she broadly welcomed the recommendations. By encouraging greater transparency and better reporting, the government can “help inspire wider change in employer practice”, she said.

Suff added that proposals such as reforming statutory sick pay to facilitate flexible working and expanding fit note certification to other healthcare professionals would need further development and legislative change. 

She emphasised that a “considerable step change” in employment practice is needed to the management of people with a disability or other long-term health condition if the government’s aims are to be realised.

In his address to the House of Commons, David Gauke, work and pensions secretary, said: “Everyone should be able to go as far as their talents can take them, but for too long disabled people and people with health conditions have been held back from getting on in work. By bringing employers, the welfare system and health services together we’re taking significant steps to ensure everyone can reach their potential.”

Prime minister Theresa May said the strategy showed the government’s determination to “break down the barriers to employment” facing disabled people: “I am committed to tackling the injustices facing disabled people who want to work, so that everyone can go as far as their talents will take them.”

But shadow disabilities minister Marsha de Cordova said cuts to the employment and support allowance were only justified through “an effective work and health programme”, which she argued the government had failed to provide.

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