Fit for Work – NHS or Private?

Posted on Posted in Early intervention, HCB News, Sickness Absence

Over the many years that we have been delivering early intervention absence management, for Insurers and Corporate clients, we have learnt three very important things, all of which support our argument that a Fit for Work service is best delivered privately.

  1. Not all absence is sickness, indeed not all sickness is sickness. The biopsychosocial (BSP) model of sickness / absence demonstrates that there are far more social, psychological and “life events” that end up as barriers to returning to work than suffering from a biological or diagnosable medical condition. Barriers can be to do with the culture of the workplace, issues at home such as child care, spousal support and even the individual’s ability to cope. The NHS Fit for Work service only intervenes after four weeks, or if there is an indication that the absence will extend beyond four weeks, It doesn’t address the frequent short term absences that are more often caused by social and psychological barriers. The NHS / DWP service focuses only on the medical issues which, perversely, can have the effect of medicalising the absence.
  2. Aligning the employee, the employer, line manager and HR, the medical professions and when appropriate the benefit providers will provide the most cost effective and most efficient outcome. This requires a greater level of knowledge than can be gained in the time allocated to the Fit for Work case managers.
  3. There is nothing better than in depth knowledge of the employee, their motivations, their medical condition, their work environment and their domestic circumstances, This knowledge has to be complemented by an in depth knowledge of the working environment; the employer’s motivations, the duties of the job, the ability of the employer to offer flexibility on hours and roles, the knowledge of the employer of the worksite supports available.

HCB Nurse case managers typically continue to work within the NHS, so their knowledge of the resources available locally and generally within the NHS is current.  In addition they receive training in the BSP and how to conduct motivational analysis and training on the use of  recognised disability duration guidelines.  They are supported by Doctors who hold The Diploma in Disability Assessment Medicine and they are also supported by a Lawyer in the interpretation of the Equality Act 2010 and the legalities of severance. Lastly they have access to an experienced Employee Benefits Consultant to advise on how the ‘in situ’ benefit programmes can support a return to work.

  • Specialist medical disability data guidelines, training in skilled analysis of the BSP factors, motivational analysis and an in depth knowledge of the workplace and the employees role within that workplace, mean that Nurse Case Managers can conduct either telephonic or face to face interviews. Their reports deliver accurate, reasoned and practical return to work recommendations.
  • Their knowledge of the local medical resources available from within the NHS and the medical resources from the employer’s benefit and Insurance programmes, enable our case managers to make a reasoned and viable rationale for private intervention if appropriate;
  • Complete impartiality means that the case manager can assist all stakeholders with termination of the employment contract if that is deemed the only workable option. The reports and analysis provided by the case manager also provide support against any potential future litigation

So if it is accepted that the private Fit for Work service is vastly superior to the DWP model, the remaining argument is cost. Our data analysis has concluded that for every £1.00 spent on early intervention services,  a payback of £4.00 is delivered. Our service is transparent and efficient and we can intervene at day one.

Enough said?