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06.01.11. Fit for Work Service - ‘Find it in B’ham - breakfast. Elaine Russell Programme Manager BCSS FFWS Pilot. Dame Carol Black's report, Working for a healthier tomorrow – Review of the health of Britain's working age population,

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Fit for Work Service - ‘Find it in B’ham - breakfast

Elaine Russell

Programme Manager BCSS FFWS Pilot

Dame Carol Black's report, Working for a healthier tomorrow

Review of the health of Britain's working age population,

Presented to the Secretary of State for Health and the Secretary of State for Work and Pensions, 17th March 2008

6 % of employees off work more than 20 days

accounting for 43 % of sickness absence

Early intervention aids recovery and return to work

but minority covered by employers' Occupational Health schemes

Recommendation: Changes to the MED3 / MED5 or ‘sick note’ &….

Pilot a Fit for Work service

Work-related health support

Case-managed, multi-disciplinary service for patients in early stages of sickness absence

Supporting GPs by providing referral options – building care pathways, where needed

Employee visits

Doctor and



Signed as may

be fit for work




arranges a




Signed as NOT Fit

For Work

Follow usual



classed as not

fit and remains

off sick


can’t be

supported by


Discussion on

advice and

early return

to work

Manager and


agree on


Manager agrees

this is



believes they

cannot work





To work,

Inform HR

& Pay team

Contact HR

policy team

or advice

Manager does

not agree

this is


Service primarily for those in work but off sick

Not for short-term illness

Typically those off 4-6 weeks and struggling to return to work

Service also can help those in employment suffering from long-term health problems

Plus defined group of Jobseekers Allowance claimants

Access to service primarily through referral by GP

Also referral from other health services

People will also be able to refer themselves (self-referral)

Employers, Jobcentre Plus could encourage self-referral

Service has an information and advice function, which screens self-referrals

Some referred for case management

Some supported through advice and information

Referral into service

Administrative screening, advice and engagement (managing expectations of service)

Assignment to case manager

Action planning

On-going support and co-ordination of action plan

Work (maintenance or RTW, sustainability)


Initial contacts by phone

Advice and education (health condition, self help and psycho-educational)

Work focused goals

Signposting to other mainstream and specialist services (mindful of importance of IAPT, Physio and Health trainer services)/housing, debt, social services, etc..

Work place assessments

Communication with employer – 3 way dialogue essential

Advocacy where needed

Assessment and follow up meetings on sessional basis

Some follow up and progress checks by phone

Information and advice – phone and e-mail

Action Planning

Prompt access

GP referrals contacted within 2 working days

GP referrals assessed within 10-14 working days

Self-referrals screened within 2 working days

Assessment leads to

Return to work plan, setting goal for return to work

Advice on self-help and access to other services

Liaison with employer on workplace changes

Information and advice service

Help with contacts: NHS and other

Advice on self-help

BCSS Fit For Work Service Pilot Governance Structure


BHWP CEO Sponsor

Health, Work & Wellbeing/ Tribal


Dr Richard Mendelsohn

Government Office West Midlands

Strategic Health Authority

PCTs, LAs, Jobcentre +et al

(Internal Comms for dissemination as appro)

Fit For Work Board

FFW Team

Ingeus Team

Clinical Advisory Group

Operations Group

Communications Group

faqs 1
Will / should the GP make a full assessment of the employee’s specific job?

No. They will factor in anything they know about the employee’s job, but the advice they give will be based on an assessment of the physical limitations of the employee’s condition, and contain simple, common sense recommendations about possible work place adaptations to help facilitate a quicker return to work

Is the doctor’s advice about temporary adaptations in a ‘maybe fit for work’ statement legally binding?

The doctor’s advice is ‘advice’ & is intended to give managers & employees greater flexibility & better information to manage sickness absence. Managers have an obligation to consider temporary adaptations or reasonable adjustments where appropriate. Employers ultimately have the discretion to choose whether & how to act on the doctor’s advice & recommendations in these circumstances.

faqs 2
If the doctor advises that an employee is ‘not fitfor work’, does this mean that the employee has to stay off work?

Sometimes the employee will be able to return to work when the doctor has advised that they are not fit for work. This may be because the employee has recovered faster than the doctor expected or the doctor did not know of aspects of the work or the support that ACAS or FFW can provide, which means that the employee can return to work earlier.

Can managers request a Statement advising that the employee has become ‘fit for work’?

No. The Statement does not include an option for GPs to advise patients that they have become fit for work. It is a myth that an employee needs to be ‘signed back’ to work by a doctor, & that employees need to be fully fit to return to work. Where employees decide to return to work but managers have significant concerns about their readiness to do so, they should make a referral to Occupational Health for a detailed assessment & advice &/or seek advice from HR in the first instance.

FAQs 2
What if temporary adaptations cannot be implemented or immediately implemented?

If the doctor has given a ‘maybe fit for work’ Statement, but the temporary adaptations to facilitate a return to work cannot be implemented, or implemented immediately, then the Statement has the same function as if the doctor had advised ‘not fit for work’ and the employee will revert to sick leave. The employee does not need to go back to their doctor for a Statement signing them ‘not fit for work’.

How will managers know that returning to work won’t make the employee worse?

In the past too much emphasis was put on the sick note & not enough emphasis on what the employee felt they were capable of doing to remain in work. Managers need to informally assess the employee’s fitness for work based on evidence from the GP, what the employee says they feel capable of doing, knowledge of the work & workplace, & temporary workplace adaptations that might be implemented.

Free phone 0800 321 3180

[email protected]

[email protected]

Elaine Russell – FFW Programme Manager

0798 9998 501

[email protected]