'Fit note' failing say employers

Britain’s manufacturers are calling on the government to convene a summit of employers and the medical profession to agree measures to tackle sickness absence on the back of a major survey showing that employers have lost faith that the government’s flagship ‘fit note’ programme is delivering on getting people back to work.

The 2013 EEF/Westfield Health Sickness Absence survey, the UK’s largest business survey of sickness absence, suggests improvements in sickness absence seen in recent years have now plateaued and, that further progress will only be made through concerted action to tackle longer-term absence from work. However, the survey also indicates that manufacturers are becoming increasingly negative about one of the key initiatives tasked with addressing this – the Fit Note - is now failing to help get people back to work.

According to the survey, sickness absence rates have plateaued at 2.2% and 2.3% for 2011 and 2012 respectively, having previously fallen from 3% in 2007. The average number of days lost to absence has shown a minor increase from a low of 5.1 days in 2011 to 5.3 days in 2012. It also showed that the proportion of employees with zero sickness absence rates has also remained static at 51% this year, having risen steadily from just over 40% over the past five years.

Progress in reducing sickness absence has stalled despite a growing number of companies taking action through return to work interviews, line manager training, setting stretching absence targets and providing their employees with occupational health.

This is because more manufacturers are reporting that longer-term sickness absence is increasing (40%) rather than decreasing (24%). The balance reporting increases rather than decreases in long-term sickness absence has risen from 3% in 2010 to 10% in 2011 and 16% in 2012. After surgery, the key causes of long-term absence remain back pain and other musculoskeletal disorders; and stress and other mental health problems.

In this context, EEF is becoming increasingly concerned that the ‘Fit Note’ is failing to deliver on its objectives and is calling for renewed government action to ensure that the advice provided by GPs helps facilitate more employees returning earlier to work. The survey found that:

· Only 26% of employers believe that the ‘Fit Note’ has resulted in employees returning to work earlier, compared to 40% who said that they are not.

· More companies disagree (49%) than agree (20%) that the advice given by GPs about employees’ fitness for work has improved. The gap between those who rate the advice positively and those who view it negatively has widened substantially over the past 12 months.

· After employees’ health conditions, GPs are now seen as the second biggest barrier to rehabilitating employees who have been off sick from work.

In addition to an urgent summit of employers and the medical profession, EEF is calling on the government to take the following action to get the ‘Fit Note’ back on track.

· Ensure that all medical professionals, including hospital doctors and GPs, are trained in using the ‘Fit Note’.

· DWP monitors the data generated by the ‘Fit Note’ to assess the quality of advice.

EEF is also calling for the government to widen its proposed tax relief on health-related interventions by employers that are recommended by the new Health and Work assessment and Advisory Service. It is looking for an increase from the current threshold of £500 per person, for the relief to be available on interventions within the first two weeks of absence rather than the recommended four weeks and for it not to be dependent on a referral from the HWAAS.

Commenting, Terry Woolmer, Head of Health and Safety Policy at EEF, the manufacturers’ organisation, said:

"Driving down absence rates and helping more employees to return earlier to work can play a key role in getting our economy growing. But, despite the increasing efforts of employers to manage sickness absence and, support employees who have been off work, the improvement in absence rates has hit a plateau.

"We are only going to make further progress on sickness absence if we do something differently. That means making the ‘Fit Note’ deliver the advice to help employers and employees work together to get more of them returning earlier to work. However, employers that were willing to give the ‘Fit Note’ a chance are now becoming increasingly dissatisfied with the quality of advice that it is providing.

"The government needs to sit down with employers and the medical profession to understand what is holding up progress and agree a way forward. This must include a step change in the number of GPs being trained to use the Fit Note.”

Paul Shires, Executive Director at Westfield Health said:

"The plateau shown in sickness absence levels reflects the clear need for government to invest more time and effort in helping employers manage the health and wellbeing of their staff.

"A robust healthcare infrastructure is vital in stimulating economic recovery and, as this survey shows, an increased focus on better evaluating and adapting the strategies already in place such as the ‘Fit Note’ is crucial.”

The survey is the tenth national survey of EEF members, looking at their experience of sickness absence and rehabilitation and the third to be undertaken with Westfield Health, a leading UK not-for-profit health insurance provider. Further findings from the survey include:

· Just under 30% of companies reported that they did not receive any ‘Fit Notes’ in 2012 that were signed ‘may be fit for work’

· A third of companies said that where they could not make work adjustments for individuals, it was because there was insufficient information in the ‘Fit Note’ to make a decision.

· Just under half of all employers (49%) said that they were able to make all the required workplace adjustments for employees whose ‘Fit Note’ was signed ‘may be fit for work’

· Stress-related conditions (32%), MSDs (23%), and post-surgery/medical interventions (17%) were the most difficult long-term sickness absence conditions to accommodate.

· Companies in Yorkshire, the North-East and Scotland had a higher percentage of employees with no sickness absence than other regions in the country.

· 23% of companies reported seeing a decrease in medium-term sickness absence, compared with 18% who experienced an increase

· This survey recorded the lowest percentage of firms without some form of Occupational Health support – just 23%.

· The three most popular health and well-being benefits offered by companies are health screening/health checks (56%),access to counselling or employee assistance programmes (EAPs) (54%) and subsidised private medical insurance (40%).