Welcome to the Fit For Work WebinarFacilitated by

Lindsay SoulsbyDirector – People Resolutions

Objectives Understand the implications of the new Fit For Work

(FFW) scheme which was launched on 6th April 2010 through:• Appreciating the costs of absence management in the UK• Recapping on the objectives of the FFW scheme• Understanding how the FFW scheme works and who are

the key stakeholders involved• Learning how the scheme will affect employers and HR• How much the scheme will cost to implement changes• What you should be doing now• What you should be considering going forward to leverage

business and employee benefits

Our Speakers and Q&A Panel

Lindsay SoulsbyDirectorPeople

Resolutions

Gail KovacsDirector

KMG Health Partners Ltd

Linda HoskinsonDirector, Head of Practice People

Resolutions

Linda FletcherDirector

Arrow CMS Ltd

So, just how big is the problem?

Absence and unemployment due to ill health is costing the UK economy an estimated £100bn

Britain has one of the highest proportions of people on sickness and incapacity benefits in Europe. Numbers

have more than trebled since the 1970s to 2.7m 175m working days lost each year

http://news.bbc.co.uk/1/hi/health/7297174.stm

Why are they committed?The costs:

Ill health is estimated to cost £100 billion every year – equivalent to the annual running costs of the NHS

Confederation of British Industry estimates 172 million working days lost due to absence in 2007

This cost employers £13 billion.

2.6 million on Incapacity Benefit and Employment Support and 600,000 more each year

Taxpayers and businesses cannot afford this lost.

So, what do the experts think?

Fit for Work Scheme – What is it?Gail Kovacs

What is it? In response to Dame Carol Black’s Review,

Working for a Healthier Tomorrow, the Government established a number of key initiatives to address the challenges of improving the health and well-being of Britain’s working-age population

Fit for Work Scheme is one initiative

Government’s aim All initiatives are being developed across

Government (DOH, DWP, HSE, etc) built around three key aspirations which will

enable the delivery of the government’s broader vision:

1. creating new perspectives on health and work 2. improving work and workplaces 3. supporting people to work

Work, Health and WellbeingDame Carol Black’s vision:Prevention of illness and promotion of

health and well-being in the workplace

Early intervention for those who are employed but absent with a sick note

Improvement of the health and well-being of those within the benefits system

Government Commitment“We want to create a society where the positive links between work and health are recognised by all, where everyone aspires to a healthy and fulfilling working life and where health conditions and disabilities are not a bar to enjoying the benefits of work.”

Executive Summary – Improving health and work: changing lives. Government’s response to Dame Carol Black’s review of the health of Britain’s working age population.

Why are they committed?The impacts:If out of work, health worsens

The family is likely to fall into poverty and experience social exclusion

Individuals cannot fulfil their potential

Damage to the community in which they live

Why are they committed?The benefits:Protection against financial hardship

Promotion of quality of life

People making the most of their potential

Strong moral, social and economic case

Why Fit for Work?Medical model not working

Growing awareness of the biopsychosocial model and its relevance to sickness absence

Increased understanding that absence is not strictly a medical issue, and that absence management is key

HR staff often not equipped / trained to manage absences effectively

Potential of adoptingVR Standards

Values

Professional training

Education

Code of Ethics

NIDMAR – IFDM

EUSE

StandardsOther Regulated

Professional Standards

UK Rehabilitation Council

British Standards Institution – Publicly Available Specification 150

Key Concepts Work is healthyA healthy workforce is a happier, more

productive workforcePrevention / early interventionQuality and standards to keep the

employee and employer from harmRehabilitation is cost effective

Key Concepts Bio psycho social model – health, social

care and vocational rehabilitation

Best practice is health, occupational health and vocational rehabilitation

Best practice or better practice?

Service user involvement

The evolution of disability management

FromRehabilitating people in order to return them to work/productivity

ToReturning people to work/productivity in order to rehabilitate them

(G. Sokoll, 2002)

Fit for Work SchemeVarious and mostly health led models of

service delivery

providing personalised and timely back-to-work support primarily for people off sick from work, to enable them to make an earlier return to work than they otherwise would, and to remain there

Some services directly aimed at employers

The Pilot Areas Scotland-wide Dundee Rhyl Birmingham Eastern & Coastal

Kent Greater Manchester

Kensington & Chelsea

Leicestershire North Staffordshire Nottinghamshire Wakefield District

General concept Each allotted £1 millionAt least until 2011Develop innovative approachAssisting large numbers of individualsMay assist employers as wellBased on case management model Share with other pilot areas / evaluate

General approachPrimary Provider “Partnership”

Community Services Secondary Provider

VR / Case Management

FFW

Possible Employee InterventionsStepped approach- Website (ask a question, fact sheets, info)- Telephone (advice and guidance, signposting)- More support (CBT, specialised assessments,

counselling, physio, adjustment to work)- Case management (initial assessment, return

to work plans, interaction with employer) etc

FFW

Possible Employer Interventions Website, telephone advice and guidance Health promotion Initial needs assessment Specialised assessments (workstation / ergonomic

assessments, job demands analysis) Education and training (Wellbeing Facilitator, disability

awareness Conflict resolution / mediation Disability management services Policy development / support with compliance etc

FFW

Support with legislation The Care Standards Act 2000 The Carers (Equal Opportunities) Act 2004 The Health Records Act 1990 The Mental Capacity Act 2005 Access to Medical Records Act 1988 The Data Protection Act 1998 The Disability Discrimination Act 2005 The Health and Safety at Work etc Act 1974 The Reporting of Injuries, Diseases and Dangerous Occurrences

Regulations (RIDDOR) 1995 The Employment and Labour Relations Act 2004 The Human Rights Act 2000 Disability Rights Commission Act 1999 Equality Act 2006

Helps employers with…

Risk Management

Health and Safety

Job matching

Sustaining a satisfied and secure labour market

Mobility / transferability

Performance

PersonnelProductivity

Position Potential

Increased profitability Cost savings / effectiveness Demonstrated cost benefits Value for money Managed risks

Skilled / aware workforce Diverse population Safe and healthy team Satisfied employees Continued pool of recruits Managed risks

Improved quality / quantity Sustained levels Achieved targets Reduced disruption Managed resources

Increased market share Enhanced reputation / leadership role Corporate Social Responsibility Increased opportunity for kite marks / accreditation Positively perceived role in the community

Sustained operation Maintained growth / development Fulfilled corporate / fiscal responsibility Opportunities for Innovation Sustained recognition

Other initiatives

Increasing funding to Access to Work Improving advice from GPs about fitness for work

(National Education programme and software support)

Developing a new electronic Fit NoteDeveloping a Mental Health and Employment

Strategy for people with mental health conditions

For EmployersProviding the tools to help them understand the

costs of absence (Business HealthCheck Tool)

Providing support to address individual employee health issues (helpline for SMEs)

Providing funding for innovative and well-being measures in the workplace (Challenge Fund)

In general

Introducing Health, Work and Well-being Coordinators

Creating the National Centre for Working-Age Health and Well-being

Expanding NHS Plus

Similar models in placeRoyal Mail

British Telecom

Dyfed Powys Police

Remploy’s new OH model

NIDMAR training

Convergence

Fit Notes – A Mixed WelcomeLinda Hoskinson

Awareness68% of employers have little knowledge of the

changes Only 5% of employers think they will reduce absence57% of employees don’t think that their doctor is

qualified to judge them fit for work64% GPs feel ill-equippedRepresentatives and TU responses?Line Manager training so far?Government detailed guidance considered to be late

Dialogue

Purpose of the ‘fit note’ is to encourage dialogueWho will this include?

• GPs, Line Managers, HR, OH, EAPs, VR, Reps, LawyersWho will co-ordinate (or case manage) this?What happens if the employee is not willing to

return?Handling disagreements and grievancesGP recommendations are not compulsory but……

Employer Action (a)

Check absence policies and proceduresIs your grievance process robust about disability,

permanent and temporary?Contact Insurance providersAgree terms – will you reduce pay for reduced hours?

SSP terms? FairnessHelp educate your local GPs?Tighten links with OH, EAP, VRRequire strong links with community resources

Employer Action (b)Training for Line Managers and HR – help prepare

the options - most ‘fit notes’ are expected to say ‘Fit for Some Work’

Mental health literacyExplain to employees carefully to avoid suspicion.

(Helpful rehabilitation, rather than inappropriate pressure to return)

Prepare criteria for when adjustments and accommodations are considered unfeasible or too costly.

Professional Advice Where are you getting yours from? Physical and psychological issues GPs – limited knowledge of workplace, roles, absence

policies, legal obligations. Patient focused OH – some knowledge of workplace, few in the UK trained in

Vocational Rehabilitation. Patient focus prevails VR – trained to case-manage and resolve quickly with both

employee and organisation in mind. Links to community and NHS can be variable. (See VR Association for standards)

EAPs – the better ones already do this well, often having access to OH, medical and VR skills. Good at case-management. (See EAP Association for standards)

Fit Notes – A Summary

Summary about the scheme FFW scheme came into effect on 6th April 2010 Built around 3 key initiatives:

• creating new perspectives on health and work • improving work and workplaces • supporting people to work

Ill health costs us 100bn per year Current model is not working Many benefits for the employer as well as the government Links to other initiatives (ie Electronic Fit Note)

Summary about what employers can do

Check absence policies and proceduresTraining for Line Managers and HREnsure health literacy (both mental and physical)Educate employees to ensure the scheme is

accepted and seen as being fair to allEnsure access to professional advise for complicated

cases when required