Big Interview: Fit for Work plan takes shape

Big Interview: Fit for Work plan takes shape

Fit for Work began its national rollout last year. Fiona Murphy speaks to Health Management Ltd's Dr Lucy Goundry, medical director of FFW, about how the service has progressed so far

Fiona Murphy: We've had the phased rollout of Fit for Work (FFW) since last March. How has it progressed?

Lucy Goundry: It was a very gradual rollout, because we wanted to test a completely new service so we had no learnings to go by.

We wanted to make sure our people are properly trained, and that we weren't overwhelmed with referrals early on, because we had case managers from all sorts of different backgrounds.

There are occupational health (OH) advisers, general nurses, mental health nurses, occupational therapists and physios. So it's quite a broad balance.

For instance, an occupational therapist might be very good at a functional assessment of a person but may have no health and safety experience. Everybody's got a slightly different nuance.

We went live with the whole country for GPs in the summer and we didn't go live for employers until September.

It's been really positive, because although the policy for the service was that it would be for largely GPs, employers have really jumped at it. Although initially it was aimed at small employers, we've actually found that large employers are very interested too.

FM: Do you have the figures of the number of employers that have signed up?

LG: It's difficult, because the DWP doesn't like us to talk figures. I would say that the referrals from employers are at least twice that of GPs on a day-to-day basis. But it changes regularly.

It depends on what media we do and publicity. But GPs seem to be slow to change their behaviours, but employers obviously have seen the need. There has been a gap in the market for some time.

FM: You said large employers have been interested. Wouldn't large employers have had OH in the first place, or any kind of private insurance?

LG: We have met with the private insurance people because obviously they would also like intervention earlier, so we actually have some common needs and we're following that up in that we're going to be asking people directly if they know whether they have private health insurance.

Unfortunately, a bit like with occupational health services, a lot of employees don't know that they have it: until they need to use it, they have no idea.

Tesco is one of the large employers that has used us and said how good FFW was. Even employers with OH services [are engaging], because we always ask whether there is an OH service in-house. If there is, and there is a need for follow-up, one of our recommendations in the return to work plan, is that the employer refers in-house.

A lot of employers, even large ones, are using FFW as a triage, so we will see the basic short-term four-week sickness absence. If the absence is ongoing, then they will refer internally and they see that as complementary rather than threatening.

FM: A big challenge for employers is presenteeism or bringing in insurance again, engaging with employees earlier than four weeks. What are your thoughts on how FFW complements early intervention?

LG: As a doctor myself, I would say why wait four weeks? It's ludicrous to wait four weeks. It would be great if we could offer some interventions to people who are presentees.

At the moment we can't. One thing I would emphasise for employers is if they keep up a good communication with their employee when they're off sick. Then actually they can say that there is a service: FFW, and if you go to your GP, he can refer you today - you don't need to wait four weeks.

If there is good communication and the employee is keen for some support to go back to work - because it all works on consent - there is absolutely no reason why the employee can't direct the person to the GP who will do an early referral.

I'd much rather see that and get someone back to work sooner. But at the moment for people who are presentees, there's no mechanism. They can use the advice line.

PTO for page 2

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