Working for a healthier tomorrow -

Dame Carol Black's review of the

health of Britain's working age

population


Taken from NRAS magazine, Autumn 2008


NRAS was pleased to be able to submit evidence for this review which looks at the health of working age people and “a concern to remedy the human, social and economic costs of impaired health and well-being in relation to working life in Britain”. The review was undertaken by Dame Carol Black who is the government’s National Director for Health and Work.

The report states that around 175 million working days were lost to illness in 2006 and it is estimated that the overall costs of sickness absence and health-related worklessness among those of working age is in excess of £100 billion per year (around the cost of the NHS budget!).

The report has 3 principal objectives:

  • Prevention of illness and promotion of health and well-being
  • Early intervention for those who develop a health condition
  • An improvement in the health of those out of work – so that everyone with the potential to work has the support they need to do so

It looks at wide ranging challenges for change and makes key recommendations in the following areas:

  • the role of the workplace in health and well-being
  • changing perceptions of fitness for work
  • developing a new model for early intervention
  • helping workless people
  • developing professional expertise for working age health

The full report sets out a new vision for health and work in Britain and shows that wide ranging reforms are needed.

NRAS Members may be particularly interested in the section of the report which looks at developing a new model for ‘early intervention’ for those who have long periods of sickness which can sometimes ultimately progress to losing employment.

‘A Fit to Work’ service is proposed which would be case managed and provide an individualised plan for achieving recovery. This kind of service would ensure that those with more serious conditions would be referred onwards at the earliest opportunity.

The report proposes that a GP would be able to refer a patient, through an electronic fit note system, to a multidisciplinary ‘Fit for Work’ service. Then a case manager would be able to guide the patient through a personally tailored programme of support. This would not be restricted to medical treatment and may also include:

  • exercise and physical training
  • cognitive behavioural therapy and counselling
  • physical and occupational therapy and other clinical interventions
  • occupational health interventions including assessment of appropriateness of returning to work
  • advice and support for social concerns e.g. financial, housing, family and childcare issues.

The GP would be updated by the case manager. The service would also contact the employer to facilitate a return to work when appropriate. This might include discussing adaptations in the workplace, phased return to work, flexible working, restricting duties or changing job role and responsibilities.

This article covers only a small part of the review. The full report, including more information on the importance of keeping people healthy at work together with lots of useful case studies, can be found at http://www.workingforhealth.gov.uk

The recommendations are now being considered by a cross government team from the Department of Health and Department of Work and Pensions.

NRAS welcomes the proposals for improving support for people with long term illness and hopes that the government will support the recommendations in this review at the earliest opportunity.