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November 21, 2011

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“Compelling case” to refer long-term sick for independent assessment

A new independent assessment service should be set up to help individuals with health problems, and those at risk of extended sickness absence, return to work.

This is one of the headline proposals put forward by the authors of a new report tasked with reviewing the sickness-absence regime in Britain. The report, by national director for health at work Dame Carol Black (pictured), and former director-general of the British Chambers of Commerce David Frost, identifies serious flaws in the current system.

Too often, says the report, people with common health conditions are advised by health-care professionals to refrain from work entirely. But the report points out that this runs contrary to extensive evidence that, for many people, work is good for health and can aid recovery.

To give employers more confidence in the medical evidence they receive and to help doctors who lack expertise in return-to-work issues, the authors suggest independent assessment, funded by the government, is the way forward. This service should not replace the assessments the State makes in determining an individual’s entitlement to health-related benefits, but could be used as evidence for subsequent claims made by people who fall out of work subsequently.

The report explains: “The Independent Assessment Service would provide an in-depth assessment of an individual’s physical and/or mental function. It would also provide advice about how an individual taking sickness absence could be supported to return to work. It should be provided by approved health professionals, and be appropriately quality-controlled. The service should usually be accessed when an individual’s absence spell has lasted around four weeks.”

The authors also call on the Government to offer a job-brokering service for anyone who is off work for a period of 20 weeks, or more, and to consider the implications of allowing earlier access to the service, and who should pay for it.

IOSH has long held the view that tax rules should be changed so that employers who spend money on vocational rehabilitation to help keep employees in work are not penalised for doing so. Endorsing tax relief for such treatments aimed at basic-rate tax-payers, the report estimates that the net gain to employers of such a measure would be in the region of £100m a year.

The Institution’s head of policy and public affairs, Richard Jones, said: “Good, well-managed work is good for health and well-being, and those wanting to return to work after illness should be given all the help and support they need. After all, prolonged periods of absence can lead to deterioration of mental and physical health.
“We’d welcome support for family doctors, employers and workers in overcoming any barriers in returning to work. And we’re pleased to see that our call has been heard over the need for tax breaks for employers wanting to provide therapy, or rehabilitation. We’d urge the Government to support this, along with the proposal for access to independent expert panels.”

Highlighting the gap between sickness-absence rates in the public and private sectors, the report calls on the former to improve its performance, and urges the Government to take action to bring the poorest performers in the public sector up to scratch. It estimates that halving the gap in sickness-absence levels between the public sector and large private-sector employers could save the tax-payer up to £800m a year.

Commenting on the review findings, Dame Carol Black said: “Sickness absence from work can be unavoidable, but when unduly prolonged it is wasteful and damaging. We believe we have presented an urgent and compelling case to change the current system so that it unashamedly promotes work for those that can.

“If implemented, these recommendations will ensure many more people with health conditions are able to enjoy the benefit of work. Far fewer will needlessly lose work and fall into long-term benefit dependency.”

The report estimates that the reforms, if implemented in full, could save employers £400m a year and the state £300m a year. The reforms could potentially boost economic output by up to £1.4bn a year.

Minister for Welfare Reform Lord Freud added: “The economy loses £15bn in lost economic output each year due to sickness absence and we cannot continue to foot this bill. But, even more important, is the impact of needless inactivity on people’s lives, the damage to their aspirations and their health, and the damage to their families and communities.

“The Government will undertake a comprehensive assessment of the review’s findings and recommendations, with the view to publishing a response during 2012.”

EEF, the manufacturers’ organisation described the proposals as “a welcome step forward for both employers and employees”, adding that smaller companies with no access to occupational-health support stand to benefit the most from the new Independent Assessment Service.

However, Professor Sayeed Khan, the body’s chief medical advisor, also raised some concerns about how the recommendations might work in practice. “In making changes to a system that has not had that long to bed down, we must continue training GPs in occupational-health issues,” he remarked. “We still need to establish a relationship between GPs and local employers, especially for those with long-term conditions who are not off sick.
“Early assessment of individuals is also a small part of sickness-absence management, which is a complex issue. It does not tackle wider sickness-absence issues, which impact on an individual’s ability to get back to, or stay in, work, such as early access to high-quality health-care services.”

The report, ‘Health at work – an independent review of sickness absence’, can be downloaded at

What makes us susceptible to burnout?

In this episode  of the Safety & Health Podcast, ‘Burnout, stress and being human’, Heather Beach is joined by Stacy Thomson to discuss burnout, perfectionism and how to deal with burnout as an individual, as management and as an organisation.

We provide an insight on how to tackle burnout and why mental health is such a taboo subject, particularly in the workplace.


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12 years ago

As someone who was off work for 12 months once with no sick pay after 6 weeks, begging the doctor to let me go back after month 4, but wasn’t allowed to drive until month 11. Sickness management – properly done is a very good thing.

However, if the same criteria that the government uses is employed then it is Very Very Bad.

Adequate sick pay, far from being a burden on small businesses can help them get their experienced workers back on the job. Please, please, EEF. Get this right