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Sickness absence and the Health and Work Service. Lucy Dugmore, Sickness Absence Policy, DWP. Sickness absence in Great Britain. 46% of long term absentees (4 weeks+) are over-50 compared with 27% of employee population overall 52% of long term absentees are disabled

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sickness absence and the health and work service

Sickness absence and the Health and Work Service

Lucy Dugmore, Sickness Absence Policy, DWP

sickness absence in great britain
Sickness absence in Great Britain

46% of long term absentees (4 weeks+) are over-50 compared with 27% of employee population overall

52% of long term absentees are disabled

Type of employer: 31% large, 27% small & medium, 15% micro

Source: DWP analysis of Labour Force Survey Oct 2010-Sept 2013 and data relating to Young V. and Bhaumik, C (2011), Health and Well-being at Work: a survey of employees. DWP Research Report No. 751

review of sickness absence dame carol black and david frost
Review of Sickness Absence (Dame Carol Black and David Frost)
  • The recommendations called for a number of improvements including:
    • A state-funded Health and Work Service from 2014
    • The abolition of the Percentage Threshold Scheme to fund this service
    • Updated employer charter on sickness absence management
    • Access to Universal Jobmatch for those requiring job change
    • Retention of tax relief on Employee Assistance Programmes
    • Abolition of SSP record-keeping requirements
    • Publication of revised fit note guidance
    • Budget and Autumn Statement 2013: tax exemption on medical treatments recommended by the Health and Work Service or employer-arranged occupational health services

The Health and Work Service will be delivered across Great Britain, with a unified brand and scope but will be delivered by different providers.


Agency agreement between DWP and Scottish Government to enable Scottish Government to deliver on behalf of DWP

Delivery by building on existing occupational health capacity and expertise in the public sector in Scotland

England and Wales

External procurement

To be provided by Health Management Ltd, a Maximus company


Same service and outputs across Great Britain

Implementation late 2014

Phased introduction*

Full roll-out by May 2015*

* this approach will only be confirmed once delivery plans finalised.


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. It has two component elements:

*4 – 6 weeks of sickness absence has been identified as a critical point for not returning to work

Health and Work Service

  • Assessment
  • Available to employees on, or expected to reach, 4 weeks* of sickness absence
  • Referral through a GP in the first instance or employer (exceptional case), with the employee’s consent
  • Provides an occupational health assessment identifying all issues preventing a return to work, culminating in a Return to Work Plan (RtWP)
  • The RtWP will identify measures, steps or interventions that would facilitate a return to work and make appropriate recommendations.
  • This will be delivered by telephone or face to face where appropriate


  • Available for all employees, employers and GPs in GB
  • Provides health and work advice to enable return to, or retention of, work
  • This advice will be provided by occupational health advisers or other appropriate professionals
  • This will be delivered via a website and telephone line

The Health and Work Service will provide advice for employers who have no access to internal occupational health and, where an employer does have access, it will complement existing provision

Employer OH

Full range of occupational health functions, including protecting and promoting health at work

Specific and responsive to needs of employer


Focus on sickness absence, particularly at four weeks

GP primary referrer – embedding OH into normal health practice

  • 1 in 10 employees in small businesses have access to OH – HWS will especially benefit SMEs who have limited access;
  • existing OH support will be a consideration for GPs when considering a referral;
  • service will consider current position and engagement with employer OH during an assessment;
  • the HWS will handover to existing provision via recommendations in the Return to Work Plan, if appropriate;
  • detailed interactions will be identified and communicated, including in guidance, to employers when a supplier has been appointed.
  • tax exemption on health-related recommendations extended to employer OH

Individual Return to Work Plans will also include all of the necessary sickness absence information that employers need for pay and HR purposes; replacing fit notes for these employees.

Other evidence*

Other evidence*

Evidence of sickness absence

7 day self-certification period

GP fit note

Return to Work Plan

Employee on sickness absence

Referral by GP



Return to




Referral by employer

Case Management




6 weeks absence

4 weeks absence

Employer contacted as necessary

Employer OH contacted as necessary

Employer/ Employer OH oversees recommended interventions

Tax exemption on medical treatments up to £500


action/ involvement