Bettelley’s Brooding: The challenges of Fit for Work

The shift of employee responsibility from government to employers is nothing new.

Clare Bettelley

The pensions market is a case in point, as an increasing number of employers have moved from defined benefit to defined contribution schemes for their workforces in a bid to share the associated costs and risks.

Meanwhile, employers have been urged to support employee health and wellbeing through government public health programmes, such as the Change4Life campaign, which launched in 2009 to help tackle UK obesity.

But expecting employers to extend this support, for those that offer it, to occupational health services seems to me to be a step too far.

Yes, the NHS is under increasing pressure to service our needs; yes, private healthcare is unaffordable for a huge proportion of the population; and yes, workplace support for employee health should be encouraged, but should employers really be expected to step in to save the day, and is it feasible for them to do so, particularly for smaller organisations?

The government’s new Fit for Work service, which is designed to provide health and work advice for employees, employers and GPs to help staff with a health condition to stay in or return to work, presents a number of challenges for employees.

But one of the most pressing seems to be access to the service, for which employees must be classified as ‘eligible’ by either their GP or employer, because the criteria are open to interpretation.

The findings of the Department for Work and Pensions’ Exploring future GP referral to Fit for Work study, published in October 2014, found that GPs interpreted the criteria in different ways, with the referral rates higher for GPs with a positive attitude to health and work.

This subjectivity extends to GPs’ understanding of an employee’s propensity to return to work. The findings of the study found that GPs were unlikely to refer employees who they believe are unlikely to return to work anyway, or who are uninterested to returning to work at all. How can a doctor possibly assess this likely outcome during their ridiculously short consultation slots?

A bedding-in period of the service, for which guidance was launched on 2 January, is inevitable and I, for one, am interested to see how this pans out.

Clare Bettelley, associate editor, Employee Benefits