The Law in More Detail

New National Health & Work Service Launched

The Government’s new National Health and Work Service, will come into effect in selected geographical areas from October 2014, (nicely coinciding with when more staff start to take time off with colds and flu!) and nationally, the target date for introduction is from May 2015.

Part of the rationale behind the new Service, as with the introduction of ‘fit notes’, which replaced the old ‘sick note’ in 2010, is to get employees back to work from sick leave, thereby improving business productivity and reducing the strain on state benefits. (The Government is part funding this new scheme by removing the SSP claw back that was available under the Percentage Threshold Scheme. This has now been withdrawn.)

Apart from the obvious name change, which clearly shifted the focus away from ‘sickness’ to ‘fitness’ to work. The idea behind the introduction of ‘fit notes’ was to help doctors to provide advice to their patients about the effects of their health condition and how they might be able to return to work while they recover. The ‘fit note’ also aimed to help employers support their employees back to work as soon as possible and reduce days of lost productivity.

Continuing this ‘back to work’ theme, the National Health and Work Service will provide an occupational health assessment and general health and work advice service to employers, employees and general practitioners (GP’s). The aims of the new Service are to:

• Provide an incentive for employers to manage attendance effectively;
• Encourage the early return to work of employees by directly including them in the proposals for their recovery;
• Reducing the amount of lost wages;
• Reducing the huge bill to employers of sick pay and associated costs;
• Reducing the state’s health-related benefit costs.

This is encouraging! In the past, some Occupational Health providers have not been helpful to management, whereas the terms of the new contract make it clear that one of the aims is to get staff back into work.

Procedure

There are two elements to the service: assessment and advice.

Once the employee has been off sick for 4 weeks (or they are expected to be off for 4 weeks), their GP will be able to refer them for an assessment by an occupational health professional, whose main objective will be to assist the employee back to work. (as stated above, this might be seen as a welcome clarification, as some Occupational Health advisors have appeared to be biased towards the employee). If there is no GP referral, after 4 weeks, the employee may be referred for an assessment by their employer.

Employers, employees and GP’s will also be able to access advice through a telephone helpline and website.

Once a referral has been made, the case will be allocated to a case manager who will organise the assessment and liaise with the employee, employer and (if any) internal occupational health provider.

The assessment may be carried out over the telephone or face-to-face.

Following an assessment, a ‘return to work’, plan will be produced, with recommendations to assist the employee to return to work more quickly and information on how to get appropriate help and advice. The plan may, for example, include recommendations for medical care, working from home or retraining.

In order to mitigate the risk of the cost falling on the employee, as a taxable benefit in kind, the Government will introduce a tax exemption of up to £500 for each employee on medical treatments recommended by the Health and Work Service or arranged by the employer.

Whilst overall the aims of the new Service are laudable and there are clear advantages, there are also a number of concerns over how the Service will work in practice and how effective it will be.

Concerns

Initial proposals indicate that the employee will be able to see the return to work plan first and it will be issued to the employer and GP with the employee’s consent only. However, where an employee refuses to give their consent this may frustrate the whole idea of the Service and lead to some distrust amongst employers in employees and their motives for withholding consent and may breed a lack of confidence in the new Service.

Also, the Service and cooperation with it, is not compulsory and the referral for an assessment itself is dependent on the employee’s consent. If an employee does not consent to a referral, this may also add to an employer’s distrust of their employee and undermine confidence in the Service.

It is not clear to what extent, if at all, the case manager or occupational health specialist will engage with the employer once a referral has been made in order to understand the employee’s role and workplace and to allow the employer to have some say in the recommendations and ways of assisting the employee’s return to work. If the employer is not allowed any (or any meaningful) input, there will be a risk of the Service losing its appearance of independence and impartiality and instead, appearing to simply act as an advocate for the employee. Also, if the employer is not allowed any input, it may lead to recommendations which are impracticable, ineffective and not business-orientated.

Whilst it is important to note that the Service will run alongside an employer’s pre-existing occupational health practice and procedure, it is not known whether employment tribunals will view employers as unreasonable if they ignore the new free Service and stick to their own policy. It also remains somewhat of a mystery as to how two lots of occupational health services, employers and Governments, will be able to co-exist and run alongside each other peacefully.

Although most of the concerns so far have come from employer’s representatives, some employee groups and trade unions have expressed their concerns that employees participating in the scheme will be forced or pressured back to work too early and that the motives behind the Service are about saving money.

Only time will tell whether these and any other concerns are realised. Further guidelines are expected before the Service goes live apparently.