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Fit for work -

Are you ready?

Issues forum – April 2010

Fit for work - Are you ready?

Why was this necessary? 1
A change of emphasis 2
Expected benefits 2
Impact on claims 2
12 Steps to prepare for the
Fit Note 3
Government’s here to help! 4
Golden rules for implementing
health in the workplace 4
Conclusion 5

Fit for work - Are you ready? – April 2010

Fit for work -
Are you ready?
From 6 April 2010 the Sick Note has been
replaced by the Fit Note. This is the first
change in the way sickness absence is
reported in over 80 years with the aim of
shifting the focus to what employees can
do as opposed to what they can’t do. It is
essential that businesses are ready to take
advantage of the potential benefits the new
system brings as well as understanding the
potential pitfalls.

Why was this necessary? This indicates that the current system is
failing a large number of individuals in the
The government’s first ever review of the UK and one area considered responsible
health of Britain’s working age population is the out dated Sick Note. One of its major
was published in March 2008 and carried flaws is the fact that it focuses solely on
out by Dame Carol Black. Her report what an individual is unable to do. There is
identified that the annual cost of ill health no encouragement for GPs to suggest how
is more than £100 billion, with 175 million an injured employee could return to work.
working days lost per year. Evidence As Dame Carol Black states “it reflects
indicates that the UK lags behind many an age when an employer expected an
other developed countries where the employee to do a specific job rather than
positive impact of effective early health care today’s flexible workplace”. The Fit Note
“The Sick Note reflects an age when an intervention has long been recognised. For aims to change all this.
employer expected an employee to do example in Scandinavia 50% of individuals
a specific job rather than today’s flexible return to work following a major injury and in
workplace” the US it’s 33%, but in the UK the figure is a
lowly 16% (Bonato and Lusinyan 2004).
Dame Carol Black
A change of emphasis
GPs will now be asked to play a more
active role in making recommendations
to employers regarding their patients’
capabilities to work. Rather than just stating
they are either physically or mentally too
unwell the new system will allow doctors
the following two options:

• Unfit for any type of work OR

• Fit for some type of work.

When the injured party is assessed as being

“fit for some type of work” GPs will need to
decide on one of the following options,
whilst also providing a small amount of
information for employers.

• Phased return
• Altered hours
• Altered duties Expected benefits Impact on claims
• Workplace adaptations. Organisations of all sizes should view the If the new Fit Note achieves its aim of getting
reform positively, as it will produce undoubted people back to work earlier than they might
benefits for the UK economy. For example: have previously then ultimate claims costs
Key changes could benefit with a reduction in the loss of
• Organisations should see fewer of their earnings component. It also raises issues
• Move to focusing to what people
employees signed off sick, with obvious around an injured party mitigating their
can do opposed to what they benefits through reduced absence losses, as they have a duty to do, especially
can’t do
• Evidence shows that better sickness if the employer is able to accommodate the
• Discourage the notion that management leads to reduced costs recommendation contained in the Fit Note.
somebody has to be 100% and increased company productivity. Despite an employer being flexible an injured
fit before returning to work (Pricewaterhouse Coopers 2007) party could still feel unable to return to work.
The ultimate effect of this change within the
• Encourage a dialogue between • GPs will be providing more information
claims process will not be seen for a number
employers and employees to on how an individual’s health condition
of years.
facilitate an earlier return to work affects their ability to complete their
work, alongside how these could be
• The longest a GP will be able QBE believes that the most effective way
accommodated in the workplace. This
to sign somebody off sick for is of managing the cost of work related
will hopefully lead to more collaborative
to be reduced from 6 months to claims is by implementing effective absence
approach between employers and
3 months. management procedures. QBE’s online
employees to reduce unnecessary
Minor Injury Management Service has
demonstrated 29% quicker return to work
• People will have fewer forms to deal with a loss of earning saving of over a £1000
with. From the 6 April 2010 the Med 5 per claim, notwithstanding the hidden costs
form will no longer be in use, replaced savings.
by the new Med 3 form.

(Taken from the DWP’s Fit Note Guidance

2 for Employers)
Fit for work - Are you ready? – April 2010
12 Steps to prepare for the lack of cross disciplinary communication.
Fit Note There needs to be a coherent approach
between key business areas including
1. Understand the change of HR, Occupational Health, Risk
emphasis: Essentially the Fit Note does Managers, Health and Safety, line
not change an employer’s obligation to managers and operational managers.
its employees; the underlying objective
is to encourage open dialogue between 5. Understand its limitations:
all parties, with GP’s being encouraged Employers are often frustrated by GPs,
to play a more active role in the process. but they must understand the challenge
The Department of Work and Pensions facing them in managing absence.
(DWP) have however made it clear that A GP spends on average 10 minutes
“it is the employer’s responsibility to per person and are expected to gain
carry out a risk assessment (when information, make a judgement, decide
appropriate) when an employee returns on treatment and write the Fit Note.
to work to ensure there is minimal risk Under the new system they are also
to the employee and others in the allowed to assess individuals over
workplace.” the phone. It is also important to
understand that the information they
2. Educate all key stakeholders within receive regarding work and job roles
the business: The DWP and TUC have comes from the patients themselves.
issued complementary guidance and A GPs role is to act in the best interest
ACAS is offering training courses to of their patient. There is the potential
help businesses prepare. This employer has failed in its duty to make
for conflict when GPs are faced with a
information should be cascaded down reasonable adjustments – a requirement
patient who strongly believes that work
through the business to all those under the Disability Discrimination Act
caused or will make their injury worse.
involved in absence management. 1995. This will be a particular challenge
6. Review your policy for managing for smaller employers, as they often
3. A Fit Note can still become a sickness absence: This provides an have fewer resources and less flexibility
Sick Note: DWP have indicated ideal time for a review of sickness and to accommodate injured employees.
that employers will not be able to absence policies, as these will have to
use the note as the basis for stating 8. Be aware of support services
be updated to incorporate the Fit Note.
an employee has to return to work. available for SMEs: Alongside the
For example, employers could introduce
If no effective agreement can be reforms of the Fit Note the government
return to work risk assessments,
reached the Fit Note will work in exactly has recognised that smaller employers
considering any necessary control
the same way as the Sick Note did. need more support managing absence.
measures and/or change of duties
As a result, they have put in place
4. Be prepared for new challenges: required – to be agreed and signed by
provision such as the Health and Work
Everybody is moving into unchartered all parties before the return to work date.
Advice Hotline, Fit for Work Pilots and
territory and even the government 7. Consider the Disability Access to Work to help SMEs.
cannot fully predict what challenges it Discrimination Act (1995): Employers
will bring. Employers should consider could find themselves at an increased For information on how this service
appointing somebody within the risk of disability discrimination claims could benefit your business please
business who is responsible for i.e. the Fit Note might highlight changes contact your QBE account manager.
cascading the information to key that an employer could make to the
stakeholders, ensuring the business employee's duties or workplace that
is ready and assessing the impact. would enable them to work. Failure to
Currently, important departments consider such suggestions seriously
within the absence management could result in a tribunal finding that the
process often work as lone silos with a
Government’s here to help! Golden rules for
Fit for Work Services - new government
implementing health
funded case management service to
in the workplace
help small employers manage absence. Not one size fits all - different
www.workingforhealth.gov.uk organisations have different requirements.

Access to Work - A JobCentre service Buy in and leadership from the top
that is able to come into the work places level of a company is fundamental
and assess and determine whether any for success.
adaptations or equipments are required.
This is part funded by the employer and Communication of the financial benefit
government. www.direct.gov.uk to key stakeholders is important.
Consider using the Workplace Well
Health for Work Advice Helpline - This is Being Tool to help you build the
a hotline with trained occupational health business case for wellness.
nurses who can offer advice to any
small business about return to work. Consider the various company
www.health4work.nhs.uk departments required to implement
a successful strategy i.e. top level
management, HR, Health and Safety,
9. Understand your organisation’s role 11. Consider well-being: Research has
in managing absence: Employers line managers.
shown that the most effective sickness
should not rely solely on the GP if they absence policies do not focus solely
want to have a robust and effective Align your strategy with company goals
on managing problems. Companies
policy for absence management. and key performance indicators e.g. to
who have taken a proactive stance
Occupational Health sits outside reduce to the cost of absence.
on worker health have seen a reduction
the remit of the NHS and it is the in absence through simple steps.
responsibility of individual organisations Impact should be objectively measured
For example, the Global Corporate
to ensure their employers are fit for work. to determine success.
Challenge, encouraging employee to
10. Review Occupational Health walk 10,000 steps a day, has been
Line managers need practical skills in
Provision: By encouraging the adopted by many large organisations.
managing return to work.
emphasis on a new collaborative
12. Build a business case for wellbeing:
approach, many believe that the Strategies should not solely focus
One of the greatest challenges to
government has placed the spotlight on return to work. Consider other
change is proving that it is cost effective.
firmly on organisations’ ability to
Without being able to demonstrate the employee needs and be inventive
manage absence. One way of achieving
financial sense of investing in the health to encourage involvement!
this is by having in place effective
of a company’s employees it will be http://www.gettheworldmoving.com
occupational health provision, but
only 40% of UK companies actually do. difficult to achieve the “buy in” of
Where occupational health is in place it senior management. Key government
is often restricted to health surveillance organisations, such as the HSE and
required to comply with Health and Department of Health have worked
Safety legislation e.g. audiometric together to develop a Workplace
testing for noise legislation. Providers Well-Being Tool that helps demonstrate
(in-house or outsourced) may not be the benefits of investing in health.
proactively involved with return to work.

Fit for work - Are you ready? – April 2010
Conclusion References and further QIEL has acted in good faith to provide

Despite the challenges the Fit Note will

information an accurate publication. However, QIEL
and the QBE Group do not make any
undoubtedly present, QBE welcomes Work Absence in Europe warranties or representations of any kind
the positive change in emphasis it brings. (Bonato and Lusinyan 2004) about the contents of this publication,
Organisations can no longer afford to the accuracy or timeliness of its contents,
ignore absence management, as it has been ft/wp/2004/wp04193.pdf or the information or explanations given.
proven to improve the health of employees,
Working for a Healthier Tomorrow
prevent business disruptions and reduce QIEL and the QBE Group do not have
(Dame Carol Black 2008)
the cost of claims. The introduction of the any duty to you, whether in contract, tort,
Fit Note places the onus on employers to under statute or otherwise with respect
get it right and play an active role in the to or in connection with this publication
process. QBE recommend that senior or the information contained within it.
managers consider the potential impact A Statement of Fitness for Work -
of the introduction of the fit note system to A guide for employers QIEL and the QBE Group have no
their own organisations, and place health (Department of Work and Pensions 2010) obligation to update this report or
management higher on the agenda. Without http://www.dwp.gov.uk/docs/fitnote- any information contained within it.
the implementation of a cohesive approach employer-guide.pdf
between all key stakeholders and the To the fullest extent permitted by law,
formulation of tangible objectives on Building a Case for Wellness QIEL and the QBE Group disclaim any
wellness and sickness absence it will (Pricewaterhouse Coopers 2008) responsibility or liability for any loss or
continue to be a challenge for businesses. http://www.workingforhealth.gov.uk/ damage suffered or cost incurred by
documents/dwp-wellness-report- you or by any other person arising out
Can QBE help? public.pdf of or in connection with you or any other
QBE have an in-house rehabilitation team person’s reliance on this publication or
who have a range of services available to Visit us at www.QBEeurope.com/rm on the information contained within it
policy holders to help manage sickness and for any omissions or inaccuracies.
absence. They would be happy to help
any QBE policyholders with any queries or This publication has been produced by
concerns as they get use to the Fit Note. QBE Insurance (Europe) Ltd (“QIEL”).
QIEL is a company member of the
Author biography QBE Insurance Group.
Chris Douglas,
Readership of this publication does not
Rehabilitation Advisor, QBE
create an insurer-client, or other business
Chris joined the QBE Rehabilitation Team in or legal relationship.
2009. Since qualifying as a physiotherapist
This publication provides information
in 2005 he has worked in a variety of clinical
about the law to help you to understand
settings including prisons, hospitals,
and manage risk within your organisation.
occupational health and even the sporting
Legal information is not the same as legal
fields of Africa. Chris’s main area of expertise
advice. This publication does not purport
lies in occupational health, with previous
to provide a definitive statement of the law
experience of working in Nestle UK’s award
and is not intended to replace, nor may it
winning fast rehabilitation response team
be relied upon as a substitute for, specific
and the Department of Work and Pensions
legal or other professional advice.
Pathways to Work Scheme.
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of QBE Insurance (Europe) Limited and QBE Underwriting Limited.