The Assessment of Fitness to Work

Physiotherapists should be at the forefront of sick absence management.

This new Assessment of Fitness for Work tool offers the profession the way to prove its worth.

Using the tool should offer practical help to patients and employers in keeping them working effectively through recovery.

The real cost of sickness absence

With evidence that long periods away from work can be detrimental to an individual’s health, the CSP has lobbied for more employers to recognise the importance of supporting employees to remain in work, even when they are unable to conduct their normal duties.

Statistics in the recent sickness absence review show that every year over 300,000 people move out of employment and onto health-related state benefits.

140 million working days are lost to sickness absence, costing employers £9 billion a year in sick pay, associated costs, plus maintaining their business while people are off sick.

How does the assessment tool work?

The introduction of the AHP assessment tool is an ideal opportunity for the profession to support people in using work as part of their rehabilitation" Léonie Dawson, CSP professional adviser

The AHP Assessment of Fitness for Work is an A4 document providing a tick-box for 'can work with adaptations'/'can't work' and a space for advice on how to retain an employee in work whilst recovering from illness or injury.

The tool complements the GPs' Statement of Fitness for Work (DWP 2010) by providing a consistent and easy to read form for AHPs to advise em­ployees on their fitness for work and how they might be able to return to work as part of their recovery.

The employee is given the form to share with their employer to help plan how their recovery may continue whilst working.

If the employer cannot implement the recommendations, the employee can then give the form to their GP for use in completion of the Fit Note.

The Assessment of Fitness to Work form can therefore help GPs, employees and employers to focus on what a person can do whilst using work as part of their rehabilitation rather than sign a person off to recover at home.

Preventing the slide into incapacity

Many employees find that being unable to work or contribute fully to their job role can have a devastating impact on their social interaction and psychological health.

They may be able to continue working whilst recovering from illness or injury, but may require modified work, as part of the rehabilitation process.

By helping people to remain engaged with work, employees continue within the work environment and therefore returning to their previous form, preventing deconditioning, isolation and loss of self-esteem.

Background

In 2010 the DH introduced the GP Statement of Fitness for Work (the Fit Note), an A5 document which replaces the Med 3 (Sick Note).

Many physiotherapists had negotiated a local arrangement whereby they were able to sign Med 3s and the change to doctor-only Statements was a retrograde step.

The focus of the Statement of Fitness for Work allows GPs to consider an individual’s capability to work and approve modified working, if the employer can accommodate the adjustments.

However, the Fit Note has only managed to sign 15% of people back to work with recommendations for work adjustments.

It is recognised that AHPs can make a real difference in reducing sickness absence and facilitating a return to work.

Many workers spend time with AHPs, either undergoing physical treatment or receiving advice on ergonomic adaptations to help them recover and keep working.

The AHP Assessment of Fitness for Work provides an easily recognisable and useful tool for employers to receive recommendations on modifications which may help the individual employee, and for GPs to access for completion of the Statement of Fitness for Work.

How does it help GPs, employees and employers?

The Assesment of Fitness to Work has been created in paper and electronic format to provide space for detailed recommendations from AHPs. It can be used:

• by AHPs to provide advice to employees on fitness for work and how a return to work could be facilitated
• by employees to provide evidence to their employer for sick pay purposes
• by employers, to agree appropriate modifications to an employee’s environment to enable them to work
• by employees to give to their employer as part of a return to work discussion
• by a doctor as a report on which to base the provision of a Statement of Fitness for Work to the employee

The pilot process

The AHP Assessment of Fitness for Work was piloted by the members of CSP, COT and SCP in 2011. Results were fed back to the stakeholder group.

An electronic format was created by the CSP and welcomed by practitioners who use e-records.

The majority of responses from practitioners and users of the tool was favourable. The launch of the AHP Assessment of Fitness for Work is due in the Spring.

The AHP Assessment of Fitness for Work has been developed by officers and members of the Chartered Society of Physiotherapy (CSP), the College of Occupational Therapy (COT) and Society of Chiropody and Podiatry (SCP) professional bodies in consultation with the Department for Work and Pensions (DWP), Department of Health (DH) and Allied Health Professions Federation (AHPf).