The end of the Fit for Work assessment service – due on 31 March 2018 in England and Wales and 31 May 2018 in Scotland – has been welcomed by health experts as a “move in the right direction”.
The Department for Work and Pensions (DWP) announced last autumn that it would be scrapping its Fit for Work assessment service, as well as overhauling its fit note scheme by extending certification powers to other healthcare professionals.
However, it told People Management that it could not yet confirm who these professionals will be – or whether they will be public or private providers.
Fit notes are statements of fitness for work, and can currently only be completed by a GP or hospital doctor.
The Fit for Work assessment service was introduced in September 2015, and gave both employers and general practitioners the power to refer employees for a free occupational health assessment when they had been absent from work for four weeks or longer.
However, in November 2017 the DWP announced that the Fit for Work service would come to an end after “low” referral rates, outlined in the Improving Lives: The Future of Work, Health and Disability white paper.
Professor Sir Cary Cooper, president of the CIPD and professor of organisational psychology and health at Manchester Business School, told People Management that Fit for Work was a “flawed scheme”, particularly when it came to helping those suffering with mental ill-health.
“Healthcare professionals don’t really know what someone with mental health issues can cope with work-wise, or what the individual would actually consider a stressful job, for example. GPs cannot be expected to know what different working environments are like,” he said.
Cooper added that organisations’ cultures and management styles needed to be taken into account for these types of assessments and, although Fit for Work “looked good on paper, it was flawed from day one”.
Healthcare consultancy RehabWorks applauded the DWP’s move to explore a more flexible approach to fit note usage by scrapping Fit for Work. Mark Armour, clinical director at RehabWorks, said the “well intentioned” scheme was “held back” because of the difficulty a national service has in understanding specific occupational issues and liaising with employers about the return-to-work strategy for their staff.
“We’ve welcomed recent news in the employee health arena that a new and more flexible model for supporting those with mental health issues in particular is to be fully explored,” Armour said.
“While the news confirming the end to the Fit for Work initiative does ultimately mean an end to one particular concept, we very much feel that it is now paving the way for a strategy that focuses on wider certification potential and more awareness.”
However, Susan Gee, group occupational health (OH) and wellbeing manager at Yorkshire Water, said the existing service had “the potential to support companies that don’t have a dedicated OH provision”. Gee said it would have enjoyed "more success if employees could have been referred to it earlier”, and will have a particularly negative impact on what SMEs can offer their staff in terms of OH.
“Although larger corporations will continue to offer internal or external OH provision, SMEs will need to source OH on a needs basis, or perhaps on a local level consider forming a cooperative where they all pay into a scheme and ‘share' a provider," Gee said.
The scheme was also slammed as a “wasted investment” after two sets of figures suggested it was underused by both organisations and doctors.
A survey run on behalf of People Management by GP magazine found that around two-thirds (65 per cent) of more than 400 GPs questioned had not referred a single person to the Fit for Work scheme in the last year.
In addition, three out of five of those questioned for the study, published in August 2017, admitted they were not sure how effective the programme was at reducing long-term sickness absence, with 15 per cent describing it as very ineffective.