Unlock the Editor’s Digest for free
Roula Khalaf, Editor of the FT, selects her favourite stories in this weekly newsletter.
The UK government plans to reform the “fit note” system that employers see as a key driver of economic inactivity as it strives to keep more people with health conditions and disabilities in work.
Pat McFadden, minister for work and pensions, said that in place of the current system, where doctors sign patients off sick, there was a case to shift to a system of assessments by non-medical practitioners.
“We are going to try some different ways,” he told reporters on Tuesday. “You could have different practitioners doing it, as long as it is someone trusted by the patient who can . . . see how ill they are and how long they need to be off or whether they could in fact be better off in work.”
McFadden was speaking at the launch of an initiative to improve the way employers manage health issues and disability in the workplace — the outcome of a review led by the former John Lewis boss, Sir Charlie Mayfield, as part of the government’s drive to tackle economic inactivity.
The programme involves a “vanguard” of 60 major companies and scores of smaller businesses partnering with government to test new forms of support, at an estimated cost of around £60 to £180 per employee annually.
Its aim is to stem the rising number of UK employees falling out of work due to ill health, at an estimated cost to employers of £85bn a year in sick pay, lost output, conflict resolution and new recruitment.
“Ill health has become one of the biggest brakes on growth and opportunity. But this is not inevitable,” Mayfield said, adding that the end goal is a “general adoption” of workplace health provision at a certified standard. This would cost between £2bn to £6bn at current prices.
At present, however, participation is voluntary — reflecting the sensitivity of imposing any new costs on business ahead of this month’s Budget.
“With the cost of employing people already a barrier to creating jobs, it’s right that the focus is on how to help firms make the most of their considerable investment in health and wellbeing,” said John Foster, chief policy and campaigns officer at the CBI business lobby.
Many of the big employers in the initial “vanguard” — ranging from British Airways, to the retailers Currys and Tesco, professional services firms and manufacturers such as Ford and JLR — already have well-developed in-house occupational health provision.
The idea is to develop new, certified standards to guide the way employers handle health issues, such as helping employees to discuss their needs more openly from the outset and managers to intervene earlier when problems arise and support people to stay in work.
The “vanguards” will also fund and build a new Workplace Health Provision (WHP) service, offering independent, third party case management, agreed plans to help employees stay in or return to work, and access to commonly needed help such as physiotherapy or counselling.
The aim is to trial pooled funding models and seek economies of scale that could lower the cost of WHP, especially for smaller businesses.
The review calls for the government to set up a new unit to gather data and establish the evidence base for a later expansion of the scheme, while also testing financial incentives that could drive take-up by employers.
Ministers must “rewire the incentive system in time for the next spending review”, Mayfield said, suggesting that sweeteners for employers could include tax breaks or sick pay rebates, while employees could receive better occupational sick pay if they engaged with the support on offer.
Mayfield also called for the government to pursue wider reforms, including to the fit note system that many employers see as problematic.
Fit notes, used as evidence to support sick pay requests and benefits claims, replaced “sick notes” in 2010 and are supposed to help patients return to work with appropriate support.
In practice, overworked GPs sign 93 per cent of patients off sick, often with repeated extensions, Mayfield said, and the fit note could “act as a firewall”, preventing open discussion between an employee and their manager.
In revisiting fit notes, the Labour-led government would be reviving a reform previously envisaged by the former Conservative prime minister Rishi Sunak, who promised a crackdown on Britain’s “sick note culture” in the run-up to last year’s election.