Fit for Work Webinar - 4th May 2010

1. Welcome to the Fit For Work Webinar Facilitated by Lindsay Soulsby Director – People Resolutions

3. Appreciating the costs of absence management in the UK

4. Recapping on the objectives of the FFW scheme

5. Understanding how the FFW scheme works and who are the key stakeholders involved

6. Learning how the scheme will affect employers and HR

7. How much the scheme will cost to implement changes

8. What you should be doing now

10. 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

11. 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?

12. Fit for Work Scheme – What is it? Gail Kovacs

13. 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

14. 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: creating new perspectives on health and work improving work and workplaces supporting people to work

15. Work, Health and Wellbeing Dame 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

16. 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.

17. 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

18. 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

19. 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

20. Potential of adopting VR Standards Values Professional training Education Code of Ethics NIDMAR – IFDM EUSE

21. Standards Other Regulated Professional Standards UK Rehabilitation Council British Standards Institution – Publicly Available Specification 150

22. Key Concepts Work is healthy A healthy workforce is a happier, more productive workforce Prevention / early intervention Quality and standards to keep the employee and employer from harm Rehabilitation is cost effective

23. 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

24. The evolution of disability management From Rehabilitating people in order to return them to work/productivity To Returning people to work/productivity in order to rehabilitate them (G. Sokoll, 2002)

25. Fit for Work Scheme Various 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

26. The Pilot Areas Scotland-wide Dundee Rhyl Birmingham Eastern & Coastal Kent Greater Manchester Kensington & Chelsea Leicestershire North Staffordshire Nottinghamshire Wakefield District

27. General concept Each allotted £1 million At least until 2011 Develop innovative approach Assisting large numbers of individuals May assist employers as well Based on case management model Share with other pilot areas / evaluate

28. General approach FFW

30. Telephone (advice and guidance, signposting)

31. More support (CBT, specialised assessments, counselling, physio, adjustment to work)

32. Case management (initial assessment, return to work plans, interaction with employer) etcFFW

33. 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

34. 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

35. Helps employers with… Risk Management Health and Safety Job matching Sustaining a satisfied and secure labour market Mobility / transferability

37. 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 Note Developing a Mental Health and Employment Strategy for people with mental health conditions

38. For Employers Providing 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)

39. In general Introducing Health, Work and Well-being Coordinators Creating the National Centre for Working-Age Health and Well-being Expanding NHS Plus

40. Similar models in place Royal Mail British Telecom Dyfed Powys Police Remploy’s new OH model NIDMAR training Convergence

41. Fit Notes – A Mixed Welcome Linda Hoskinson

42. Awareness 68% of employers have little knowledge of the changes Only 5% of employers think they will reduce absence 57% of employees don’t think that their doctor is qualified to judge them fit for work 64% GPs feel ill-equipped Representatives and TU responses? Line Manager training so far? Government detailed guidance considered to be late

43. Dialogue Purpose of the ‘fit note’ is to encourage dialogue Who will this include? GPs, Line Managers, HR, OH, EAPs, VR, Reps, Lawyers Who will co-ordinate (or case manage) this? What happens if the employee is not willing to return? Handling disagreements and grievances GP recommendations are not compulsory but……

44. Employer Action (a) Check absence policies and procedures Is your grievance process robust about disability, permanent and temporary? Contact Insurance providers Agree terms – will you reduce pay for reduced hours? SSP terms? Fairness Help educate your local GPs? Tighten links with OH, EAP, VR Require strong links with community resources

45. 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 literacy Explain 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.

46. 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)

47. Fit Notes – A Summary

48. 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)

49. Summary about what employers can do Check absence policies and procedures Training for Line Managers and HR Ensure health literacy (both mental and physical) Educate employees to ensure the scheme is accepted and seen as being fair to all Ensure access to professional advise for complicated cases when required