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The Government's Fit for Work scheme began its roll-out at the end of 2014. However, with participation non-mandatory for employers, employees and GPs, questions have been raised about the scheme's potential effectiveness.


It was with a rather muted fanfare, perhaps due to preoccupation with election strategy, that the Government launched its Fit to Work scheme in December. Designed to complement not replace existing services, the initiative provides for free occupational health assessments, as well as general health and work guidance to employees, employers and GPs. The aim is to tackle the significant numbers of working days lost to sickness every year by giving patients easy access to telephone or online advice.  Those who have been off work for more than four weeks can be referred to an occupational health professional, such as a specialist nurse or doctor, occupational therapist, occupational hygienist, physiotherapist or counsellor.

It's no surprise that the scheme has achieved a fairly low profile, both within and outside the health sector.  While the advice service is already live, the GP and employer referral service is only currently being piloted in Sheffield and the Welsh UHB of BetsiCadwaladr. A gradual rollout is planned, with a target of autumn 2015 for nationwide referrals. Therefore, it will be some time before involvement of professionals such as occupational therapists and physiotherapists is widespread. What's more, with referrals only involving patients who have been off work for more than a month, and on a voluntary basis, this involvement could be limited anyway.

The Chartered Institute of Personnel and Development has expressed its doubts about the viability of the scheme: "Crucially this is a consent-based service, entirely voluntary on both the employee's and employer's part, which could seriously limit its effectiveness... Another potential problem is that GPs will have to exercise their clinical judgement about whether or not to refer an employee for assessment (subject to the issue of consent)."

The BMA's General Practitioners Committee has concerns about the 'occupational health referral element', believing that it may be misinterpreted as a comprehensive occupational health service. They would prefer it if practitioners to whom patients are referred, such as occupational therapists and physiotherapists, were simply called 'specially trained' health professionals.

That being said, few can doubt the need for action to address the problem. Nearly a million employees each year reach the four-week sickness absence point and the state runs up a bill of £13 billion per year for health-related benefits, not to mention £2 billion for healthcare, sick pay reimbursement and lost taxes. The Department of Work and Pensions has urged employers to update their sickness absence policies 'to reflect the availability' of the Fit for Work scheme. Time will tell if their plea is answered.

Are you a GP, occupational therapist or physiotherapist with views on the issues raised in this article? Leave your comments below.

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