Fit for Work service scrapped in workplace health policy overhaul

Date Published: 4 January 2018

The Government has scrapped its Fit for Work service, blaming “low referral rates”. The service will come to an end in England at the end of March and in Scotland at the end of May 2018.

The announcement in December 2017 came as part of the government’s response to its Work, health and disability green paper consultation.

Since its launch in 2015, the Fit for Work service has consistently struggled with a low public profile and scepticism among both GPs and employers about its use and usefulness.

A survey by GP magazine last summer found that 65% of GPs had not referred a single patient to the service and that a lack of publicity was the cause. And a study by Willis Towers Watson last March found only 21 of HR professionals said they had used it.

Employers, employees and GPs will still be able to use the Fit for Work helpline, website and web chat facility, but the service’s key referral and return-to-work element will cease.

Although the Fit for Work service will be disappearing, the Government in its response announced a number of significant changes to fit notes, sick pay and, potentially, to occupational health itself.

On fit notes, ministers said they would look at legislation to extend fit note certification powers to other healthcare professionals, such as physiotherapists, psychiatrists and senior nurses, “along with the design and development of a set of competencies for those completing fit notes”.


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Date Published: 6 January 2015

The New Fit For Work Service in England and Wales

Over the past 12 months the Government has been developing a new service, “Fit for Work”, along with the principles of how the service will operate in practice.

Those principles are now clarified further by Fit for Work Guidance for Employers. A helpline became operational from 15 December and a gradual roll out of an assessment service is expected between January and May 2015.

What Is Fit For Work About?

A Government-commissioned report by Dame Carol Black and David Frost in 2011 led to a comprehensive review of sickness absence in the UK, from absence statistics, causes and effects. Several themes were identified including that, after four weeks’ absence, many employees slip into long term absence, despite evidence that early interventions are highly effective in reversing this trend.

In response to these findings, the Government has set up the Fit For Work service to provide free occupational health advice and support for employees, employers and GPs. Its specific objective is to help people with a health condition stay in or return to work, through the free telephone and online advice service now in operation but also, in due course, an independent health assessment and follow-up after just 4 weeks’ of sickness absence. Assessment will lead to a return to work plan and series of recommendations for employers to facilitate the employee’s return to work, normally sent by e-mail. From that point, the employee will not need a fit note unless or until he or she is discharged from Fit For Work, whether on a return to work or because a return to work has not proved possible after three months.

This is a totally new approach to sickness absence and as an employer you need to be prepared that, from this month, the first you may know that an employee has been referred to Fit For Work is through receipt of a return to work plan.

From 1 January, 2015, a tax exemption will be available for employer expenditure upon recommended medical treatments for employees (subject to maximum relief of £500 per year, per employee).

My Top Tips

  • Ensure your line managers are equipped to respond to ‘return to work’ recommendations received from Fit For Work. Is training needed? Will you nominate one person as a central point of contact?
  • Understand when there might be consequences if recommendations are not acted upon. Co-operation with Fit For Work is entirely voluntary but there may be legal implications if dismissal or disability prove relevant.
  • Review your sickness absence policies and procedures so they recognise the new Fit For Work service.
  • Consider how Fit For Work might impact on existing occupational health resources your business uses.
Date Published: August 2014

The government’s new Fit For Work Service in England and Wales will be launched during 2015.

Almost 1 million (960,000) employees were on sick leave for a month or more each year on average between September 2010 and October 2013.

  • The state spends around £12 billion a year on health-related benefits and £2 billion a year in healthcare and foregone taxes.
  • Employers face an annual bill of around £9 billion for sick pay and associated costs.
  • Individuals miss out on £4 billion a year through lost earnings.
  • Around 300,000 people fall out of work and into the welfare system because of health-related issues.

The new Fit For Work Service is predicted to cut sick pay costs to business by £80 million to £165 million a year, as well as increase economic output by up to £900 million a year.

A tax exemption of up to £500 a year per employee on payments for medical treatments recommended by the Health and Work Service or employer-arranged occupational health service will be introduced. Without such tax exemption, the payment would be treated as a taxable benefit in kind, liable to income tax and employer National Insurance contributions.

Employees on sick leave will be helped to return to work by providing them with an occupational health assessment when they reach, or are expected to reach, more than 4 weeks’ sickness absence. Employees will normally be referred by their GPs. A resulting return to work plan will be shared with their employer and GP.

A case manager will support each employee through the service’s assessment process to ensure their level of need is correctly identified along with appropriate steps to take to get them back to work.

More general health and work advice will be available to GPs, employers and employees via telephone and a website.

The Health and Work Service will be delivered by Health Management Limited, a MAXIMUS company. Discussions are yet to take place with Health Management Limited to confirm the exact approach to, and timings of, the roll-out.

I will update this page when details of the phased roll out are announced.

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Fit for Work Service Scrapped In Workplace Health Policy Overall