The Health and Work Service will provide occupational health advice and support for employees, employers and GPs to help individuals with a health condition to stay in or return to work.
To justify the launch of this scheme the government cites the following:
- Nearly a million employees a year reach the four-week sickness absence point
- The State spends around £12bn a year on health-related benefits and £2bn a year in healthcare, sick pay reimbursement and foregone taxes
- Employers face an annual bill of around £9bn for sick pay and associated costs
- Individuals miss out on £4bn a year through lost earnings
- Around 300,000 people fall out of work and into the welfare system because of health-related issues
One thing the paper doesn’t mention is the dismal failure that ‘fit notes’ have been since their introduction in April 2010, perhaps the real reason for the introduction of this supplementary scheme. Fit notes, which replaced sick notes, were designed to encourage GPs to look at ways in which an employee might return to work, perhaps on a phased or ‘light duty’ basis. In practice the vast majority of GPs completely ignore this section of the form and continue to sign off employees as ‘unfit to work’ with little or no analysis of the alternatives.
And so the Health and Work Service, which is due to start late this year, has two elements:
- Assessment: Once the employee has reached, or is expected to reach, four weeks of sickness absence they will normally be referred by their GP for an assessment by an occupational health professional, who will look at all the issues preventing the employee from returning to work.
- Advice: Employers, employees and GPs will be able to access advice via a phone line and website.
The primary referral route for an assessment will be via the GP. Guidance will make clear that referral should be the default option, unless individuals meet the criteria for when referral maybe inappropriate.
Following an assessment, employees will receive a return to work plan containing recommendations to help them to return to work more quickly and information on how to access appropriate interventions. The new service will complement, rather than replace, existing occupational health provision and will fill the gap in support where that currently exists.
A tax exemption of up to £500 a year per employee on medical treatments recommended by the Health and Work Service or employer-arranged occupational health service will be introduced. Without such tax exemption, the payment would be treated as a taxable benefit in kind, liable to income tax and employer National Insurance contributions.
The service will be funded through the abolition of the Percentage Threshold Scheme (PTS) from 6 April 2014 – which the government claims is an outdated system that has not encouraged active management of sickness absence by employers.
The Health and Work Service will, says the government, provide advice at an appropriate point to reduce the time an employee is on sickness absence. With the employee’s agreement, they are referred by their GP – the main referral route – for an occupational health assessment. They are contacted and assessed promptly, and a return to work plan provided within an agreed time limit.
GPs, employers and employees will be able to access independent and objective advice on issues preventing a sustained return to work and on how to prevent sickness absence occurring. The service is impartial and does not assume an advocacy role for one group or the other. It complements, rather than replaces, existing employer occupational health provision. The service will be work-focused because it is not designed to provide on-going clinical care, but to focus on getting people back to work.
The Health and Work Service will, says the government proposal, be accessible and available at appropriate times to all customers and will set out to provide a straightforward method for GPs and, where appropriate, for employers to refer employees for an assessment. The service will be available at least Mon-Fri 9am-5pm, with advice being available via a phone line and website.
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