Elaine Russell Programme Manager BCSS FFWS Pilot

1. 06.01.11 Fit for Work Service - ‘Find it in B’ham - breakfast Elaine Russell Programme Manager BCSS FFWS Pilot

2. Dame Carol Black's report, Working for a healthier tomorrow – Review of the health of Britain's working age population, Presented to the Secretary of State for Health and the Secretary of State for Work and Pensions, 17th March 2008 6 % of employees off work more than 20 days accounting for 43 % of sickness absence Early intervention aids recovery and return to work but minority covered by employers' Occupational Health schemes Recommendation: Changes to the MED3 / MED5 or ‘sick note’ &…. Pilot a Fit for Work service Work-related health support Case-managed, multi-disciplinary service for patients in early stages of sickness absence Supporting GPs by providing referral options – building care pathways, where needed Background

4. Employee visits Doctor and receives Statement Signed as may be fit for work with adaptations Manager arranges a discussion With employee Signed as NOT Fit For Work Follow usual process Employee classed as not fit and remains off sick Adaptations can’t be supported by manager Discussion on advice and early return to work Manager and employee agree on adaptations Manager agrees this is reasonable Employee believes they cannot work despite adaptations Employee returns To work, Inform HR & Pay team Contact HR policy team or advice Manager does not agree this is reasonable

5. How the model could work

6. Service primarily for those in work but off sick Not for short-term illness Typically those off 4-6 weeks and struggling to return to work Service also can help those in employment suffering from long-term health problems Plus defined group of Jobseekers Allowance claimants Access to service primarily through referral by GP Also referral from other health services People will also be able to refer themselves (self-referral) Employers, Jobcentre Plus could encourage self-referral Service has an information and advice function, which screens self-referrals Some referred for case management Some supported through advice and information

7. Referral into service Administrative screening, advice and engagement (managing expectations of service) Assignment to case manager Action planning On-going support and co-ordination of action plan Work (maintenance or RTW, sustainability) Process

10. Initial contacts by phone Advice and education (health condition, self help and psycho-educational) Work focused goals Signposting to other mainstream and specialist services (mindful of importance of IAPT, Physio and Health trainer services)/housing, debt, social services, etc.. Work place assessments Communication with employer – 3 way dialogue essential Advocacy where needed Assessment and follow up meetings on sessional basis Some follow up and progress checks by phone Information and advice – phone and e-mail Action Planning

11. Prompt access GP referrals contacted within 2 working days GP referrals assessed within 10-14 working days Self-referrals screened within 2 working days Assessment leads to Return to work plan, setting goal for return to work Advice on self-help and access to other services Liaison with employer on workplace changes Information and advice service Help with contacts: NHS and other Advice on self-help

12. BCSS Fit For Work Service Pilot Governance Structure NHS BEN BHWP CEO Sponsor Health, Work & Wellbeing/ Tribal Chair Dr Richard Mendelsohn Government Office West Midlands Strategic Health Authority PCTs, LAs, Jobcentre +et al (Internal Comms for dissemination as appro) Fit For Work Board FFW Team Ingeus Team Clinical Advisory Group Operations Group Communications Group

13. Will / should the GP make a full assessment of the employee’s specific job? No. They will factor in anything they know about the employee’s job, but the advice they give will be based on an assessment of the physical limitations of the employee’s condition, and contain simple, common sense recommendations about possible work place adaptations to help facilitate a quicker return to work Is the doctor’s advice about temporary adaptations in a ‘maybe fit for work’ statement legally binding? The doctor’s advice is ‘advice’ & is intended to give managers & employees greater flexibility & better information to manage sickness absence. Managers have an obligation to consider temporary adaptations or reasonable adjustments where appropriate. Employers ultimately have the discretion to choose whether & how to act on the doctor’s advice & recommendations in these circumstances. FAQS 1

14. If the doctor advises that an employee is ‘not fitfor work’, does this mean that the employee has to stay off work? Sometimes the employee will be able to return to work when the doctor has advised that they are not fit for work. This may be because the employee has recovered faster than the doctor expected or the doctor did not know of aspects of the work or the support that ACAS or FFW can provide, which means that the employee can return to work earlier. Can managers request a Statement advising that the employee has become ‘fit for work’? No. The Statement does not include an option for GPs to advise patients that they have become fit for work. It is a myth that an employee needs to be ‘signed back’ to work by a doctor, & that employees need to be fully fit to return to work. Where employees decide to return to work but managers have significant concerns about their readiness to do so, they should make a referral to Occupational Health for a detailed assessment & advice &/or seek advice from HR in the first instance. FAQs 2

15. What if temporary adaptations cannot be implemented or immediately implemented? If the doctor has given a ‘maybe fit for work’ Statement, but the temporary adaptations to facilitate a return to work cannot be implemented, or implemented immediately, then the Statement has the same function as if the doctor had advised ‘not fit for work’ and the employee will revert to sick leave. The employee does not need to go back to their doctor for a Statement signing them ‘not fit for work’. How will managers know that returning to work won’t make the employee worse? In the past too much emphasis was put on the sick note & not enough emphasis on what the employee felt they were capable of doing to remain in work. Managers need to informally assess the employee’s fitness for work based on evidence from the GP, what the employee says they feel capable of doing, knowledge of the work & workplace, & temporary workplace adaptations that might be implemented. FAQs3

16. Free phone 0800 321 3180 ffw@ingeus.co.uk ffwsadmin@nhs.net Elaine Russell – FFW Programme Manager 0798 9998 501 elaine.russell@bhwp.nhs.uk