DWP report: Take-up for Fit for Work service lower than expected

Take-up for the Fit for Work service has been lower than expected, according to a report published by the Department for Work and Pensions (DWP).

The Evaluation of the fit for work service pilots – first year report, published on 1 March 2012, found that, by the end of March 2011, 6,726 employees had taken up the service offered by the pilot schemes, which is about 40% of the number expected.

The main reasons for the lower-than-expected take-up were the difficulties in generating the expected level of referrals from GPs and employers, and that the size of the core population of long-term sickness absentees may have been overestimated.

From April to June 2010, following Dame Carol Black’s 2008 review of the health of Britain’s working age population, 11 pilot Fit for Work services were established to provide personalised, case-managed support for employees in the early stages of sickness absence or ill-health in order to expedite return-to-work and support job retention.

The DWP commissioned a consortium involving the Institute for Employment Studies (IES), the Fit for Work Research Group at Liverpool University, the Social Policy Research Unit (SPRU) at the University of York and the National Institute of Economic and Social Research (NIESR) to evaluate the pilots.

The report found that both the volume and profile of employees were not in line with expectations. Take-up was significantly lower than expected and the 6,726 employees helped by services in the first year were much more likely to be people struggling at work with a health condition rather than the primary target group of people on a period of sickness absence from work.

The report also found that most employees had multiple needs. In addition to health conditions, most employees had other problems or concerns, which together presented significant risks to staying in work. Particularly complex cases involved combinations of multiple health conditions, personal difficulties and problems with their employer.

The evidence from service providers, employers and employees suggests that a successful approach to helping sickness absentees back to work includes:

  • Quick access to an holistic initial assessment;
  • Ongoing case management to identify latent concerns (often non-medical) and maintain momentum towards a return to work goal;
  • Fast access to physiotherapy or psychotherapy if required;
  • Facilitating better communication between employee and employer, and providing advice for return-to-work options; and
  • Advice to improve and manage longer-term health conditions.

Jim Hillage, director of research at the IES, said: “Helping employees get back to work from sickness absence as quickly as possible is a good thing for everyone concerned.

“If someone is absent for six months or longer due to ill-health, they have an 80% chance of being off work for five years. Staying in work is generally good for people’s health and a rapid return can improve workplace productivity and reduce the flow onto incapacity benefits.

“Often, employees who are off sick for some time are suffering from more than just a straightforward medical condition. The Fit for Work service can support GPs and help their patients access clinical services and also help them cope with other problems at home or in the workplace which prevent them then going back to work

“The Fit for Work service pilot projects worked with employees suffering from a range of conditions, from mild anxiety or depression to musculoskeletal problems like back pain. Some offered accelerated access to physiotherapy or psychotherapy. All offered a case-management service to help employers work with their employer to make changes to their workplace or role, such as altering their working pattern, type of work or team to accommodate their health condition. They also helped with domestic issues preventing people returning to work, such as financial or housing problems.

“This kind of support is particularly useful for smaller organisations, without the access to occupational health (OH) that larger organisations have. The interim evaluation shows that this kind of intervention has the potential to fill the gap between OH and the health service.

“The final evaluation report will assess the impact of the service on overall sickness absence and whether the benefits outweigh the cost.”

The final evaluation report is due in March 2013.

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