The Department for Work and Pensions has published guidance for employers, employees and GPs on the new Fit for Work service (FFW), which is being phased in during 2015.
Employers and HR Directors can think of the Fit For Work service as another tool in the managing sickness absence toolbox. Below is a summary for employers of the FFW service, how it works, how to use it and what to expect from it.
What is Fit for Work (FFW)?
FFW is a service providing free occupational health assessments and return to work plans to assist employees who have been on sickness absence for 4 weeks or more to return to work.
Fit for Work (FFW) provides two services to help with the management of sickness absence :
- Free health and work advice through its website and telephone advice line, to help with the management and prevention of sickness absence. The telephone number is 0800 032 6235. Lines are open 8:30am – 6pm Monday to Friday. FFW can give employees, employers and GPs advice about work-related health matters (when an employee’s health condition is affecting them at work) or when an employee is off sick from work. FFW states that their advice can help identify adjustments that could help an employee remain in, or return to, work.
- Free referral for an occupational health assessment for employees who have reached, or whose GP expects them to reach, 4 weeks of sickness absence.The occupational health assessments areconducted for the most part over the phone, and where appropriate, in person by a case worker. Assessments can last an hour and often last longer.
The assessment will result in a Return To Work plan with recommendations designed to remove obstacles that are preventing the employee returning to work
An FFW online advisor describes the FFW service : “think of FFW as a service the GP might refer you to, like a physio, to help you return to work”.
Employers may need to change their sickness absence policies to reflect the availability of FFW. It’s a good opportunity to review and update your sickness absence policies and workplace wellness schemes. Please contact us for help, advice or to discuss any concerns.
Fit For Work health assessment, who is eligible for a referral?
To be eligible for a referral, the employee must:
- Be employed
- Live in England, Scotland or Wales
- Have been absent from work for 4 weeks or more (include self-certified sickness absence)
- Be likely to return or make a phased return to work
- Have not been referred to a FFW scheme for 12 months, nor received a Return To Work plan
- Have agreed to the referral to FFW,
Fit For Work health assessment, who makes the referral?
GPs are currently able to refer eligible employees for an occupational health assessment, but employers will also be able to make a referral in future. The guidance suggests that a referral to FFW is the “default” position but it is not mandatory; employers can’t insist an employee is referred to a FFW scheme.
The FFW referral becomes an option after an employee has been absent from work for 4 weeks. This includes absence self-certified by the employee.
A GP can make a referral before or after 4 weeks if he/she considers it appropriate. A referral won’t always be made. The guides suggest that GPs will exercise their professional judgment about the appropriateness of a referral. For example, recovery after hip replacement surgery: a GP may consider that referral is not suitable at 4 weeks, but that it is at 6 weeks.
The employee guidance suggests that an employee advises their employer when they have been referred to FFW by their GP.
There is no requirement for employers to contact the employee’s GP before they refer an employee to FFW. If FFW receives duplicate referrals they will be combined.
There is no limit on the number of eligible employees that can be referred to FFW by an employer, but an employee can only be referred for one assessment in any 12-month period.
Do employees have to agree to a Fit For Work health assessment?
No. The guidance confirms that employees do not have to engage with the Fit For Work service. The guidance also confirms that it is up to the employer on what actions to take e.g disciplinary, should an employee not wish to engage with FFW scheme.
Fit For Work health assessment, the process
Click This video produced by Fit For Work for a useful introduction and explanation on how the process works
FFW is delivered by registered occupational healthcare professionals who have occupational health qualifications; have occupational health experience; or are able to demonstrate experience and skills appropriate to working in an occupational health context. They will be trained, “appropriately supervised” and under the overall direction of an accredited specialist in Occupational Medicine. They will also have access to professionals with appropriate competencies in musculoskeletal and mental health conditions.
Once an employee is referred, FFW anticipates contacting the employee to make an assessment by telephone within 2 working days. The occupational health professional who carries out the assessment becomes the employee’s case manager for the whole FFW process.
If a face-to-face assessment is necessary, (expected only in a minority of cases), the assessment will take place within 5 working days of this being decided. It will take place at a location within 90 minutes’ travelling time by public transport from the employee’s home address and the employee can claim reasonable travel expenses from the FFW provider. If the employee is unable to travel, alternative arrangements will be considered (presumably a home visit, but the guidance does not state what these may be).
The assessment (described as a “biopsychosocial holistic assessment”) will involve the employee describing their condition, their job role and any factors which are affecting their return to work. The purpose of the assessment is to identify all possible obstacles preventing their return (“including health, work and personal factors”) and for the employee and their case manager to agree a Return to Work Plan to address each obstacle and enable a safe and sustained return to work.
If the employee consents, their case manager may contact an appropriate individual at the employer, for example, a line manager or member of the employer’s own occupational health service, to assist in the creation of the employee’s Return to Work Plan. The guidance suggests that a case manager may need to do this where:
- They need a better understanding of the workplace context and any limitations than the employee is able to provide.
- The employee’s relationship with the employer is identified as an obstacle to a return, to ensure that both parties understand the impact on the employee’s ability to return and the potential constraints of the workplace situation.
Fit For Work, Return To Work Plan
The outcome of an assessment will be reflected in a Return to Work Plan (Plan) that has been agreed with the employee. With the employee’s consent, the Plan can be sent to their GP and employer (via email or by post). The employee can ask for specific parts of their Plan to be removed before it is shared with their GP or employer. Contact us or the Fit For Work advisors to see a sample Return to Work plan .
A Plan will cover a specified period of time and will state whether an employee is fit for work or whether they may be fit for work, subject to their employer being able to follow certain recommendations. Where appropriate a Plan will include a timetable for progressing interventions and for returning to work. It may also include advice for the employee and their GP and may suggest further potential sources of assistance. While all parties are “encouraged to act on the recommendations”, it remains for the employer to decide whether to implement any recommendations.
The government is hoping tax exemptions will encourage employers to support recommendations made by a Plan. It has introduced a tax exemption of up to £500 (per tax year, per employee) on medical treatments recommended to help employees return to work. This will apply to treatments recommended by health professionals at FFW and health professionals within employer-arranged occupational health services. The employer may pay medical costs of up to £500 per tax year without giving rise to a taxable benefit for the employee. The exemption applies whether the employer pays for the cost of treatment directly or reimburses to the employee and, in either case, provided the payment or reimbursement is not pursuant to a salary sacrifice or flexible benefit arrangement. The exemption will not need to be claimed from HMRC but will be applied by the employer at the time they provide the benefit.
In addition, where the employee meets the criteria for Access to Work their employer can apply for support, such as specialist aids and equipment or support workers. Contacting Access to Work may be suggested as part of a Plan if it is considered appropriate.
The employee’s case manager will contact them at an arranged point to check if their Plan is on course and will contact the employee again shortly after the return to work date. Where an employee is not fit to return in the timescales estimated in their Plan, their case manager will consider whether a further assessment is necessary. Where recommendations in a Plan have not been actioned the case manager may contact the employer to ensure that any recommendations have been fully understood. This may include “taking a facilitation role between employer and employee”. The guidance suggest that disputes at work may be considered a “complex case” and that these will be dealt with on an individual basis taking all the circumstances into account. “Support will be provided through progressing the difficulty together with appropriate signposting to appropriate agencies e.g. mediation.” Read more aboutWorkplace Mediation.
A Plan should provide sufficient information for the employer to decide on fitness for work and can be accepted in place of a fit note as evidence of sickness absence for statutory sick pay purposes. The guidance suggests that employers should refrain from requesting fit notes in these circumstances, in order to prevent unnecessary consultations with GPs. Where a patient does not consent to their Plan being shared with their employer or where the employer does not accept a Plan as evidence of incapacity, it will be for GPs to exercise their professional judgment to decide whether a fit note is required. However, an employee will need a fit note to cover the period between a referral being made and a Plan being issued. The guidance for GPs suggests that a two-week fit note should be sufficient for this period in most cases.
When does Fit For Work Plan finish?
Employees will automatically be discharged from FFW:
- Two weeks after they have returned to work (including beginning a phased return).
- On the date when FFW decide that there is no further assistance they can offer the employee, which will be either when the employee has been with the service for three months, or at the point that FFW decides that the employee will be unable to return to work for three months or more.