Every employer will no doubt have had first-hand experience of the impact that high levels of sickness absence can have on their business. This single issue – long term sickness in the workplace – remains possibly one of the most challenging areas in HR. Designed to help working people who face lengthy sickness absence return to work, Fit for Work provides the services of occupational health professionals to employed people if they have been, or are likely to be, off work for four weeks or more, helping employers get their valued staff back sooner.
Our vision for Fit for Work has always been to ensure it is as effective and efficient as possible in helping employees to successfully get back to work after a long period of sickness absence. At Fit for Work, we employ tried-and-tested occupational health processes to help us deliver the best service we can, for example, we conduct a lot of our assessments by telephone, which is now widely accepted as being a very effective method for contacting employees on sick leave.
However, whilst we wanted to ensure that our case managers were properly trained in motivational interviewing and using a biopsychosocial approach for these telephone assessments, we were also keen to recruit people with a range of different healthcare backgrounds, and this has become a key element of our approach. You would of course expect to see occupational health advisors among our team of case managers, but we also have general nurses, mental health nurses, occupational therapists and physiotherapists, amongst others.
The logic is pretty simple – we often match case managers to individual referrals, depending on the case manager’s background. This approach has significant benefits for the employee who has been referred to Fit for Work, because the case manager is able to make their assessment based on their understanding and knowledge of particular health conditions. For example, a case manager with a mental health background will be well equipped to assess employees struggling with moderate depression, approaching the assessment process with knowledge and understanding of depression and its treatment. Similarly, a case manager with a physiotherapy background can provide valuable input when assessing an employee suffering from back pain or more complex musculoskeletal issues.
While our case managers do all have their own specialisms, they are all still more than adept at taking on any referrals that come in. By building a multi-disciplinary team with a rich skill and background mix, this facilitates collaboration, discussion and shared learning within the team to ensure the referred employee receives the best advice. Sometimes this can be by discussion only, where a case manager seeks advice and support from a physiotherapist, mental health nurse or occupational health adviser. In other instances, case managers can also opt to ask a colleague to provide direct input to support the employee, and we then ‘step up’ the case to a colleague with the most ideal experience or skills. The original case manager still retains the case, however, to ensure that the employee has continuity and a single point of contact.
Our case managers are all trained in using a biopsychosocial approach with referred employees, meaning that their assessments cover all the aspects of why someone may be off work. The ‘bio’ part refers to physical and mental health, the ‘psycho’ to their attitudes and beliefs to work, and the ‘social’ to things like their relationships and financial issues. This holistic approach means that employees referred to Fit for Work can discuss any obstacles that may be preventing their return to work, and work with their case manager to resolve these.
We are finding that the combination of a multi-disciplinary team and the biopsychosocial approach is working very well for us, for both employees and for employers. Referred employees respond well to case managers who have practical knowledge and understanding of their particular health condition. Case managers will use their motivational interviewing technique to ask the right questions, gaining the confidence of the employee more quickly and creating the rapport that is so important for people discussing symptoms and personal matters. It benefits the employer too because the case manager’s experience means that the assessment will be well-informed and comprehensive.
The combination of motivational interviewing and a specialised health care background is particularly powerful for working with employees who may be finding the process uncomfortable. While a referral is always based on consent, it’s understandable that there can sometimes be a reluctance to share relevant information that employees may feel is sensitive. However, Fit for Work is an entirely impartial, confidential service, and our case managers are trained to ensure that employees feel as comfortable and confident as possible. They are also trained to encourage employees to share their Return to Work Plan with their employers and discuss their return to work with line managers, as we know from experience that this will help make a successful return to work much easier. Case managers also often make direct contact with employers when consent is given by the employee, as this can help to resolve any issues much more quickly and help facilitate a smoother and sustainable return to work.
Overall, employers have responded really well to Fit for Work, even those with their own occupational health services. A tax exemption of up to £500 a year per employee is also available on medical treatments recommended by Fit for Work or an employer-arranged occupational health service to help with positive steps towards a return to work. As we grow Fit for Work we are encouraging employers to consider integrating the programme into their HR policies too, to make the referral process as seamless as possible.
Chris has spent over 20 years delivering and managing occupational services across a wide client base that includes the gas industry, rail, construction, NHS services and media. She developed a keen interest in tropical disease working with the BBC and their Natural History Unit.
Prior to working in the occupational health sector, Chris spent time working in the Falkland Islands as a ward sister in trauma and general medicine, as well as working as a UK-based practice nurse. She has worked with Fit for Work, assembling and managing a large multi-disciplinary team of health professionals to deliver the Fit for Work service, since October 2014.