Take-up for the Fit for Work pilot programme has been significantly lower than expected, according to a report by the Department of Work and Pensions on the progress of the scheme.

Following Dame Carol Black’s 2008 review of the health of Britain’s working age population, 11 Fit for Work Service (FFWS) pilots were launched throughout Great Britain with the intention of testing different approaches to supporting people in the early stages of sickness absence working in small and medium-sized enterprises to get back to work as quickly as possible.

However by the end of March 2011, 6,726 people had taken up the service offered by the pilots, which is about 40% of the number that the pilots expected when they formed their original plans.

The take-up of the pilots varied, and while some attracted numbers close to their original plans, most fell well short. Two of the smaller pilots had a significantly higher penetration rate (defined as number of cases divided by the employed population) than the other pilots.

According to the report, the main reasons for the lower than expected take-up were:

* the size of the core client population of long-term sickness absentees may have been overestimated; and
* difficulties in generating the expected level of referrals from General Practitioners (GPs) and employers.

The report also adds that “All services had difficulties securing the volume of referrals they had expected from GPs and small and medium-sized employers and had little success in pursuing general marketing exercises to reach clients in other ways.”

The report concludes that GPs remain the most likely route through which FFWS will attract clients from the target group. For that reason, all the remaining pilots are concentrating on increasing their referrals from GPs and taking a more systematic and professional approach to securing their involvement. Effective engagement strategies involved:

* initially engaging with practice managers but trying to meet GPs face-to-face to get the message across;
* establishing credibility by, for example, working with advocates and champions;
* being persistent and maintaining visibility by, for example, meeting clients in GP surgeries;
* providing additional value and ensuring GPs received client feedback; and
* demonstrating the value of the service to GPs generally as well as their patients.