Guest blog by Dr Lara Shemtob
The Keep Britain Working Review Final Report has been published. The report outlines the direction of travel the government will be asking the country to take, in order to stop and reverse the rising rates of economic inactivity due to ill health in working age adults.
The report highlights that public spending cannot be a standalone solution. Rather, employers and individuals have responsibilities in achieving good work and good health. The report recognises that currently effective, and consistent, advice and support at the work-health interface is lacking, leading to people falling through the cracks. Existing infrastructure, including the fit note, does not adequately bridge this gap.
Accessible Workplace Health Provision (WHP) has been put forward as a solution. This Provision aims to support an organisation’s people operations at the work-health interface from recruitment to exit. Retention and return to work are highlighted as areas for initial focus.
Workplace Health Provision is outlined as a non-clinical case management service to support employees and line managers including:
- Longitudinal support
- Retention and return to work advice
- Rapid access to management for certain common conditions
The report sets out WHP as building out, via a multi-provider marketplace, from infrastructure that currently exists in the work and health ecosystem, including occupational health. Over time, WHP is likely to absorb at least some of the function of the fit note. The vision is that this is to be funded by employers - at an estimated cost of £5-£15/ employee/ month with pooled funding models to be explored in upcoming Vanguard pilots. The Provision would become certified and held to standards. Employers that are certified adopters may receive tax relief and sick pay rebates where they invest in evidence-based workplace health programs and practices.
Occupational health is essential to Keeping Britain Working
The Keep Britain Working Report demonstrates that the government acknowledges the fundamental role of professional support at the work-health interface has in reversing current trends in rising levels of economic inactivity due to ill health in the UK. This is a huge endorsement of the function of occupational health, and allied professional services, and is to be welcomed.
The plans for the WHP appropriately recognise the power of early intervention, continuity of care and longitudinal follow up when supporting people and organisations navigating challenges at the work-health interface. What’s more, building on the current evidence-base and learning from similar models of care and support elsewhere in healthcare, the WHP innovatively leverages the scale of de-medicalised personalised support that can be achieved through delivery via non-clinical work and health professionals that are appropriately trained and supervised.
The role of SOM and occupational health professionals in the WHP
Stewardship in governance:
Clinical stewardship will be essential to establishing, and unifying, safe practices and governance in a non-clinical service which focuses on the interplay between health and work. The report acknowledges the challenge that treating clinicians, such as GPs, have in providing occupationally focused clinical advice. It is wholly understandable that GPs, in a position of advocating for their patients, without workplace context or occupational health training, cannot be the independent person assessing the needs of both employer and employee. Occupational health professionals are work and health experts and are ideally placed to support the WHP build out.
Training and accreditation:
Occupational health professionals are uniquely qualified to curate and deliver the training and accreditation of non clinical WHP professionals, and provide the ongoing supervision and support that will be necessary to enable non-clinical WHP professionals to make safe and effective decisions around health and work.
Support in delivery:
Safe triage, escalation pathways and clinical support must be embedded into the WHP offering for certification. Occupational health professionals are experienced, qualified and well positioned to deal with the clinically complex and high risk presentations that inevitably arise when managing cases at the work-health interface.
The Society of Occupational Medicine (SOM) has been working closely with the Department for Work and Pensions to develop suitable training and certification on work and health for non-clinical WHP professionals. Together with the Faculty of Occupational Medicine, the Centre for Work and Health and other stakeholders from across the UK, SOM has been preparing to support upskilling and supervising non-clinical professionals at the scale that would be required to facilitate a certified programme for access to work and health advice at national level.
SOM welcomes the Keep Britain Working Report and would be delighted to be the professional home for non-clinical WHP professionals.