An introduction to

Sickness absence costs: - employees £4 billion in lost earnings, - the Government £2 billion in sick pay and foregone taxes; and - employers £9 billion in sick pay and associated costs. It further reduces the UK’s economic output by £15 billion per year. The longer someone is off work on a period of sickness absence, the harder it is to get back to work and research suggests that long-term worklessness is damaging to health, social and financial wellbeing. 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 In the UK, approximately 2% of total working time is lost due to sickness absence every year.

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 assessment and advisory service from 2014 [now Fit for Work] –The abolition of the Percentage Threshold Scheme to fund this service –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 Fit for Work or employer-arranged occupational health services

Fit for Work will be delivered across Great Britain with a unified brand and scope, but will be delivered by different providers. England and Wales –External procurement –Contract awarded to Health Management Ltd, Scotland –Agency agreement with Scottish Government to be put in place to deliver on behalf of DWP Overall –Same service and outputs across Great Britain –Implementation late 2014 –Phased introduction* –Full roll-out by end of May 2015* * Subject to discussion with the Supplier

Fit for Work will provide supportive health and work advice and assessments to benefit GPs, employees, and employers and help individuals with a health condition to stay in or return to work. *4 – 6 weeks of sickness absence has been identified as a critical point for not returning to work Assessment Available to employees on, or expected to reach, 4 weeks* of sickness absence. Referral primarily through a GP, or through an employer, subject to employee’s consent. Provides a professional health assessment identifying all obstacles preventing a return to work, culminating in a Return to Work Plan. The Return to Work Plan will identify measures, steps or interventions that would facilitate a return to work and make appropriate recommendations, including information on how to access appropriate interventions. The plan will be shared with their GP and employer, subject to employee consent. Assessment 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

Fit for Work will use a supportive, biopsychosocial approach with case management to help ensure individuals return to work as quickly as appropriate. *the RTWP will be provided for the employee and shared with the GP and/or employer, with the employee’s consent. 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 Fit for Work action Case Management Employer action/ involvement FFW Assessment DischargeFollow up Referral by employer Other evidence*

Summary – benefits Early intervention: the Service will provide early intervention for sickness absence and support employees back to work, it will save employers around £70 million a year in reduced sickness pay and associated costs Occupational health expertise and advice: employees and employers have direct access to occupational health expertise and advice which complements any other occupational health provisions and which will help with getting employees back to work and helping them to sustain work Improved health outcomes for employees: four weeks of continuous absence is the point which the evidence shows is when it becomes increasingly less likely that an individual will return to work, leading to negative health impacts. Tax exemption: employers will be able to claim a tax exemption on payments of up to £500 a year per employee to fund interventions recommended by the Service.

Fit for Work will provide occupational health assessments for employers with no access to internal occupational health and, where an employer does have access, it will complement existing provision. Employer Occupational Health Full range of occupational health functions, including protecting and promoting health at work Specific and responsive to needs of employer Fit for Work 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 – Fit for Work will especially benefit SMEs who have limited access. Existing OH support will be a consideration for GPs when considering a referral. Fit for Work will consider current position and engagement with employer OH during an assessment. Fit for Work will handover to existing provision via recommendations in the Return to Work Plan, where appropriate. The detailed interaction between Fit for Work and employer OH will be identified and communicated - including in guidance - to employers after the Supplier has been appointed. The Government is introducing a tax exemption for up to £500 on health-related interventions which will extend to employer OH.

Practical implications for employers Employers will have access to advice about health and work matters via web or phone; Employees are likely to be referred by their GP if they are sick for 4 weeks or likely to be sick for 4 weeks; Employers will receive a Return to Work Plan for these employees which will provide advice and recommendations and evidence of sickness for pay purposes. Employers will be able to refer employees for an assessment if a GP has not done so, after 4 weeks absence. What should employers consider before the service is introduced? Does the organisation sickness absence policy’s need to be updated to reflect the new arrangements and detailed guidance (when available)? How to communicate these changes and general information to employees and line managers? Implications when the service is introduced:

Key Milestones Key Milestones: 15 December 2014: Fit for Work advice service is live at 09 March 2015: Phased roll-out of the assessment service commences and will take place over a period of months.