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Nick Pahl
Chief Executive
Nick Pahl

Is welfare to work, working well? - a review of the report launch from the Society of Occupational Medicine

Authors: Nick Pahl Nick Pahl, CEO, Society of Occupational Medicine

01 June 2016

I formally started as Chief Executive of the Society of Occupational Medicine last month. In case you aren’t aware of the Society – it offers members a variety of benefits including a leading journal (Occupational Medicine), appraisal services, regional groups and a “find an Occ Doc” service. We are keen to collaborate with others, relaunching our conference year in partnership with the Faculty of Occupational Medicine and working with the Royal Society of Medicine (RSM). A recent meeting with the RSM was on mental health at work we heard from the Minister of State for Welfare Reform and from Time to Change, about how line and senior management can be engaged to address stigma and the effect this has on mental health.

One of the first events I went to was the excellent Work Foundation event on whether welfare to work was working well. Certainly the speakers were insightful; in particular, I found the Bromley by Bow health centre an inspiration and one that employers should take on board. My take home message was that health professionals should offer primary prevention, and that occupational medicine should be “up streamed” and part of that early intervention. Discussions that followed were also interesting – in particular Carol Black’s view that the “right support is needed earlier for people to stay at work” and how occupational medicine needs to be at the centre of this more pro-active approach. The recommendations to: ensure the assessment of disability is fully co-produced with disability groups; that payment structures better reflects the costs of helping claimants with significant barrier; improved specialist support and identifying ‘best practice’, seem eminently sensible.

A recent issue for the Society saw us disagree with a call from the BMA for self-certification to be extended to 14 days. The Society thinks it is important that the case is stated for why the current period of 7 days works well for patients and employers. We understand the strain GPs are under but from a patient perspective it is in their best interest to have a conversation sooner rather than later about how they might best return to work if they ‘may be for fit for work’. That conversation starts with their GP and their employer. The fit note states if the employee is ‘not fit for work’ or ‘may be fit for work’. If advising that the employee ‘may be fit for work’, employers should discuss potential adjustments with the employee that might help them return to work and stay in work (e.g. different hours, amended tasks).

Getting employees successfully back to work is in everyone’s interests. Stable employment is important to good health and Occupational Health professionals argue employment should be seen as a health outcome in and of itself. The longer an employee is off work the more difficult it is to return successfully. Too often with returning to work it’s all or nothing, with employers being overly risk averse. Employers can be reluctant to take someone back into the workplace until they are fully fit; however those who have access to Occupational Health value the advice they get on how to support their employees return, and they understand that returning at the right time aids recovery. It is important that ‘may be fit for work’ is used as an opportunity to encourage employers to make suitable adjustments, not just within the workplace environment, but within the work itself, to enable an employee to transition back in a successful way.
Employers also rely on fit notes to identify those cases where an employee has a health condition which limits function, but could work if given sufficient support.’ So a Fit Note written by the clinician who knows the patient does help, and an early conversation can reduce the risk of long term absence, or the individual falling out of work, and be detrimental to their health and wellbeing.