Sickness absence and the Health and Work Service

Lucy Dugmore, Sickness Absence Policy, DWP

2Department for Work & Pensions

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

3Department for Work & Pensions

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

4Department for Work & Pensions

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

• Scotland– 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

• Overall– 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.

5Department for Work & Pensions

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

Advice

•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

6Department for Work & Pensions

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

HWS• 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

7Department for Work & Pensions

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.

7 day self-certification

period

4 weeks absence

GP fit note

Employee on sickness absence

Referral by GP

Return to Work Plan

Return to Work

Employer contacted as necessary

Employer OH contacted as necessary

6 weeks absence

Employer/ Employer OH oversees recommended interventions

Tax exemption on medical treatments up to £500

Evidence of sickness absence

HWSaction

Case Management

Employeraction/ involvement

HWSAssessment

Discharge Follow up

Referral by employer

Other evidence* Other evidence*