Business as usual

Do your patients want to return to work, despite an injury or health condition? Lynn Eaton reports on a CSP scheme that could help

The CSP has been at the forefront of an initiative aimed at helping employees back to work after an injury or illness, due to be launched on 5 March at the Health and Wellbeing at Work conference in Birmingham.

Employers and GPs are set to benefit from the new assessment tool, which enables physiotherapists and other allied health professionals to play their part in getting people who are ill or injured back to work at an early stage.

The tool could even help employees to avoid going off sick in the first place.

In 2011, 131 million working days were lost in the UK to sickness absence, according to the Office for National Statistics.

The evidence shows that rapid access to physiotherapy reduces the risk of going off sick and speeds up return to work. (See CSP’s Physiotherapy Works

‘There is still a belief that people need to be 100 per cent fit before they can go to work,’ said CSP professional adviser, Léonie Dawson, who led the project on behalf of the society. ‘We are providing the advice to support early return, so that the work can be part of the recovery process.

For many, staying off work can mean reduced activity and de-conditioning, making an eventual return to work activities far more challenging.’

The Allied Health Professionals (AHP) Advisory Fitness for Work Report (‘AHP Fitness Report’, for short) complements the existing Statement of Fitness for Work, or ‘fit note’. GPs use this to determine whether patients can remain in work, or need to be signed off.

‘The idea was to provide a busy physiotherapist with a straightforward form that may help an individual to resume work,’ Ms Dawson explains.

’Returning to work should be an outcome measure for all AHPs and asking about the work situation an established part of assessment.

If the patient states they are off sick or that they are struggling at work, use of the Fitness Report should be triggered.’

The Fitness Report is a downloadable A4 form that the AHP can fill in during a consultation.

It is available for all competent AHPs to use, but members of the CSP, the College of Occupational Therapy (COT) and the Society of Chiropodists and Podiatrists (SCP) are expected to be the main users.

It shows what sorts of issues the patient has as a result of their condition, what adjustments need to be made, what time period the report covers and whether a review is necessary.

‘The form has been designed to be straightforward for practitioners to complete and for the employer receiving it to read and understand,’ said Ms Dawson.

‘It is deliberately non-medical and focuses on perceived work-relevant problems and how to address them.’

Once the patient has received the completed form they can use it to have a discussion with their line manager, employer or human resources manager.

For example, a worker with back pain who regularly carries a load may receive advice to carry a lighter one.

The comments section can then advise on the timeframe for progressing the weight back to normal loads as the worker recovers.

Professional development

‘It’s an ideal opportunity for all physiotherapists and other AHPs with expertise in occupational health to support people in using work as part of the patient’s rehabilitation,’ said Ms Dawson

However, Ms Dawson points out, although the research supporting changes to the GP Statement of Fitness for Work (Med3) was government funded, the Fitness Report initiative has been entirely funded by the CSP, COT and the SCP.

After an initial pilot in the autumn of 2011 followed by redesign, a second pilot of the project was launched late in 2012.

More than 350 members of the CSP responded to a Survey Monkey questionnaire to iron out any problems they encountered when using it.

Responses were conclusively positive, says Ms Dawson. Most physiotherapists felt the form was clear, simple to use and well received by the patients.

Employee response also indicated that the advice on the form was influential in agreeing a successful return-to-work plan between employer and employee.

The AHP Fitness Report will be used in addition to the established ‘fit note’. Patients will still require a Statement of Fitness for Work from a doctor to claim ill health benefits.

As at present, this is needed for anyone who is off sick for more than seven days.

People normally want to go back to work, Ms Dawson states. ‘Although some people might think people like being off sick, we know that’s often not the case.

There is good evidence that not only is work good for you, but that returning to work early can have a positive impact on recovery.

‘Someone may be struggling to sit for long periods after a back complaint, or have difficulty travelling in the height of the rush hour after breaking a limb,’ said Ms Dawson.

‘Practitioners can help support a sustainable return to work in these situations, but must be aware of their role in supporting people to remain in work.

Advice on, for example, changing a piece of equipment like an office chair is not part of this tool.’

If such a change were considered necessary, the physio would need to recommend a work-station assessment so that an accurate on-site assessment could be made.

Meanwhile the Department for Work and Pensions (DWP) is keen to encourage allied health professionals to use the report to help people return to , or stay at, work.

‘We’ve had good support from the DWP during the life of the project,’ said Ms Dawson.

‘Our hope now is that, following the launch, the tool will be given the high profile it deserves with employers’ organisations, from small businesses through to large organisations.’ fl

What is the AHP Advisory Fitness for Work Report?


  • It is an A4 form, available online, which can be printed out, filled in for a patient to give to their employer
  • It provides an employee, their employer and GP with information which may be used to help keep that employee in work if possible or be signed off
  • It can help employers to understand practical modifications which may help an individual remain engaged with or return to work
  • It can be used for a physical or mental health, work-related issue
  • It does not replace the GP’s Statement of Fitness for Work (fit note)
  • It can be used to claim sick pay from employers

For more information see:

Lynn Eaton

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