The Government has launched a new Fit for Work Service providing free work related health advice and free referrals for occupational health assessments. There is also a new tax exemption of up to GBP 500 per year, per employee on medical treatments recommended to help employees return to work. Here we explain how this will work, our views on how this will impact on current occupational health provisions, and practical tips in light of these changes.

Website and telephone advice

Launched in December 2014, this provides free advice to employees, employers and GPs about  work-related health matters and when an employee is off sick from work. The website can be found  here.

Referral service

This service is being introduced on a phased basis, and is due to be fully in place by May 2015. It  will mean that employees who have been absent from work for 4 weeks or more due to illness and who  have a reasonable likelihood of making at least a phased return to work can be referred for an  occupational health assessment for free. There is some additional criteria which is explained under “Who can employers refer for a Fit for Work  assessment”.

It is expected that most referrals will be by GPs. However employers can also make referrals if  they wish to. The employee must consent to the referral.

How will the assessments work?

Assessments are carried out by registered occupational healthcare  professionals. Once an employee is referred, Fit for Work aims to contact the employee to make an  assessment by telephone within two working days. If a face-to-face assessment is necessary, the  assessment will take place within five working days of this being decided.

The purpose of the assessment is:

  • To identify all possible obstacles preventing the employee’s return to work (including health,  work and personal factors)
  • For the employee and their case manager to agree a return to work plan (a Plan) to address any  obstacles and enable a safe and sustained return to work

If the employee consents, their case manager may contact the employee’s line manager, the  employer’s occupational health officer, or another appropriate individual at the employer to assist  with and have input into the Plan.

Employees will automatically be discharged from Fit for Work:

  • Two weeks after they have returned to work (including a phased return)
  • When Fit for Work decides there is no further assistance they can offer the employee (this will  be either when the employee has been with the service for three months or more or where Fit for  Work decide that they will be unable to return to work for three months or more

Return to work Plan

The outcome of the assessment will be reflected in the Plan. If the employee consents, a copy will  be provided to their GP and employer. The Plan will:

  • State whether the employee is fit for work or whether they may be fit for work, subject to the  employer following certain recommendations
  • Include steps or actions that can be taken by the employer, the employee and their GP to help  support a return to work as quickly as possible

All parties are encouraged to act on the recommendations, but it is not mandatory to implement  them. If recommendations have not been actioned, Fit for Work may contact the employer, and if  appropriate, may adopt a facilitation role between the employer and employee.

Impact on fit notes

Once a Plan has been issued, this can be accepted by employers in place of a fit note for statutory  sick pay purposes. The Plan should, in most circumstances, provide the information need to  determine fitness for work in which case the employer should not request a fit note and GPs are not  obliged to issue fit notes if a Plan has been issued.

However, employees will need a fit note to cover the period between the referral being made and the  Plan being issued. A fit note would also be required where the employee chooses not to share the  Plan with their employer.

How will this work with employers’ existing occupational health services?

It is intended that Fit for Work will complement and not replace any occupational health services  provided by employers and it will not offer a fully comprehensive service. For example, employees  will be discharged from  Fit for Work relatively quickly: two weeks after they return to work or if  they do not return to work (or Fit for Work do not expect them to return to work) within three  months. Employers who rely solely on this may well find themselves without occupational health  provision for employees who are off for longer than three months or who go off on sick leave again  after returning to work.

Tax exemption for recommended medical treatments

From 1 January 2015 the Government has introduced a tax exemption for employers who fund the cost  of medical treatments provided the medical treatment is recommended by a health professionals from Fit for Work or from within the employers’ occupational  health service. This is to encourage employers to fund such treatment. The tax exempt expenditure  is limited to GBP 500 per employee, per tax year.

To qualify, the employee must have been absent (or a health care professional must have assessed  them as not fit for work or may be fit for work) for at least 28 consecutive days due to ill health  or injury.

The exemption should be applied by the employer at the time they provide the benefit. Any payments  over the GBP 500 limit will remain liable to tax and NICs on the excess.

Referrals - Key points to note

  • Employee consent is key. Employees cannot be referred unless they consent
  • As well as this, employers will only be contacted about a referral and will only receive a copy  of the Plan if the employee agrees. This means that a Plan can be agreed between the employee and Fit for Work without any input from the employer
  • There is a risk that where Plans are agreed without any employer input that employers may feel  that they are unworkable from a business point of view
  • The employer decides whether to implement any recommendations made in the Plan. However, if it  does not then the onus would then be on the employer to justify why not (and this of course has to  be considered in the light of any reasonable adjustments and / or disability discrimination obligations)

Who can employers refer for a Fit for Work Assessment?

Employees who have:

  • Been absent for work for 4 weeks or more (GPs can refer earlier than 4 weeks, if they consider  that an employee will be absent for 4 weeks and an earlier referral may be beneficial, or later  than 4 weeks if appropriate)
    A reasonable likelihood of making at least a phased return to work
  • Not been referred for a Fit for Work Assessment already in the last 12 months and have not  received a Fit for Work plan
  • Provided consent to be referred

Tips for employers

  • Although this is a free service it unlikely that you will want to make referrals to Fit for Work  rather than to your own occupational health providers. For example, it is not clear how robust the  assessments will be, especially given that the default position is that they will be carried out  over the telephone. As well as this, given how quickly employees are discharged, for the majority  of employers this will not provide a sufficient occupational health service by itself
  • You should be prepared for employees to be referred by their GP and to receive return to work  plans through this service. In particular, ensure managers and relevant staff know
    • What they should do if they are contacted by Fit for Work, for example if they receive return to  work plans or are asked to provide input on return to work plans
    • That return to work plans from Fit for Work can, and should generally, be accepted in place of  fit notes
  • Consider the need to update your sickness and absence policies. For example, to make employees  aware of this service and that Fit for Work plans can be accepted in place of fit notes
  • Where you receive a Fit for Work plan consider how you can support its recommendations alongside  any reasonable adjustments and/or disability discrimination obligations
  • If you are concerned that the plan is not reasonable or appropriate (for example where it was  decided with no employer/business input), you will need to justify departing from it in light of  reasonable adjustments and disability discrimination obligations