Health and Work Service

Dr Bill GunnyeonChief Medical Adviser

DWP Health and Wellbeing

2Department for Work & Pensions

Fitness for Work: the Government response to “Health at Work – an independent review of sickness absence”

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• Cost of sickness absence:– Economy - £15bn– Employers - £9bn– Individuals - £4bn– Government - £2bn

• A state-funded health and work assessment and advisory service from 2014 [now Health and Work Service]

• Funded through abolition of the Percentage Threshold Scheme

• Access to Universal Jobmatch for those requiring job change

• Retention of tax relief on Employee Assistance Programmes

• Budget and Autumn Statement 2013: tax exemption on medical treatments recommended by the Health and Work Service or employer-arranged occupational health services

Department for Work & Pensions

Source: Annual Population Survey (APS) – Office for National Statistics February 2014

Department for Work & Pensions

Sickness absence in Scotland

• 49% of long term absentees in Scotland (4 weeks+) are over-50 compared with 28% of employee population overall

• 51% of long term absentees in Scotland are disabled

• £9 billion annual cost of sickness absence to employers UK-wide

Source: DWP analysis of Labour Force Survey Oct 2010-Sept 2013 and data relating to Young V. and Bhaumik, C (2011), Health and Well-being at Work: a survey of employees. DWP Research Report No. 751; Black, C. and Frost, D (2011). Healtha t work – an independent review of sickness absence. DWP.

Estimated annual long-term sickness absences by GB country 2010-2013

Scotland 95,000

Great Britain 960,000

Share of long-term sickness absentees accounted for by different employer sizes 

  Scotland Great Britain

Micro (1-10 employees) 16% 15%

Small (11-49 employees) 33% 27%

Medium (50-249 employees) 24% 27%

Large (250+ employees) 26% 31%

Department for Work & Pensions 5

What is the Health and Work Service?

PurposeMake independent expert health and work advice more widely available to employees, employers and GPs

Help employees to return to work, support employers to better manage sickness absence and give GPs access to work-related health support for their patients

Complement and work with existing in-house occupational health provision

Advice: •Health and Work advice to enable return to, or retention of, work•Website and telephone line•Occupational health advisers or other appropriate professionals

Assessment•Referral through GP and employer•Occupational health assessment•Identifies issues preventing a return to work, culminating in a Return to Work Plan•Signpost to appropriate interventions•Telephone or face to face where appropriate

Health and Work Service

All employers, employees and GPs in GB

Employees on, or expected to reach, four weeks’ sickness absence

6Department for Work & Pensions

Health and Work Service – Critical Success Factors

• Early intervention that is prompt and rapid

• Independent and objective advice

• Quality of advice, assessment and return to work plan

• Ease of use

• Nationally available with consistent standards

• Innovative and flexible

7Department for Work & Pensions

Health and Work Service – assessment model

Fo

llow

Up

Biopsychosocial

Assessment

Outcomes

Return to work

OR

Continue on

sickness absence

RtWP/revised RtWP

Delivery of a more intensive service

including additional assessment(s) and

specialist advice

Return to work

plan

Recommended work-focused interventions are progressed

Customer Contact

Case managercontact

Case managercontact

Case management

Employer contact as necessary

Disch

arg

e

8Department for Work & Pensions

Stylised sickness absence journey for an employee receiving SSP and/or contractual sick pay (For illustrative purposes only)

7 day self-certification

period

4 weeks absence

GP fit note

Employee on sickness absence

Referral by GP

Return to Work Plan

Return to Work

Employer contacted as necessary

Employer OH contacted as necessary

6 weeks absence

Employer/ Employer OH oversees recommended interventions

Tax exemption on medical treatments up to £500

Evidence of sickness absence

HWSaction

Case Management

Employeraction/ involvement

HWSAssessment

Discharge Follow up

Referral by employer

9Department for Work & Pensions

Delivery of the Health and Work Service

• England and Wales

– External procurement

– Invitation to tender issued 13 February 2014

• Scotland

– Agency agreement with Scottish Government to be put in place to deliver on behalf of DWP

• Overall

– Same service and outputs across Great Britain

– Implementation late 2014

– Phased introduction

10Department for Work & Pensions

Benefits of the Health and Work Service

• A new approach to and focus on sickness absence

• A further step change in culture, perceptions and behaviour

• For individuals earlier return to work and reduced risk of job loss and benefit dependency

• Financial savings (GB):

– £65m - £80m for employers

– £105m - £225m for Government

– £450m - £900m for the economy

11Department for Work & Pensions

• “The new (Health and Work) Service has the potential and provides opportunities to render a holistic approach by bringing GPs, employers, employees and occupational health professionals together to limit the number of people drifting into labour market exclusion and improve individuals’ health so they can lead healthy and productive lives.”

• “Mental Health and Work – United Kingdom”

• OECD – February 2014

Department for Work & Pensions

Questions?