Fit for Work: final report of a process evaluation

This report presents the fndings from the process evaluation of Fit for Work. Fit for Work was an occupational health assessment and advice service looking to address long-term sickness absence. The assessment service was for employees who were on (or at risk of entering) long-term sickness absence, defned as four weeks or more, via a referral through their General Practitioner (GP) or their employer. Participation was entirely voluntary. Employees giving their consent took part in a biopsychosocial assessment, which were primarily conducted by telephone. After assessment, a Return to Work Plan (RtWP) would be produced, with recommendations for self-care, workplace adjustments, and/or signposting to further specialist support and therapy services to assist the employee’s return to work. With the employee’s consent, the RtWP could be shared with their employer and/or GP. The service was funded by the Government and was delivered in England and Wales by Health Management Limited (HML) and in Scotland via an agency agreement with the Scottish Government. The process evaluation aimed to determine whether the Fit for Work service had been implemented as designed, and whether the design met the policy intent to provide support for those on long-term sickness absence to stay in employment. The research programme was conducted between September 2015 and May 2017 and consisted of: an analysis of management information; 72 in-depth qualitative interviews with employees, employers and GPs; a telephone survey of 504 employers that had had contact with the service; a telephone survey of 1,045 employees that had been discharged from the service and a follow-up survey of 492 of them (only those who received an assessment and who gave permission to be re-contacted for further research). Management information was analysed for employees referred to and discharged from the Fit for Work service between October 2015 and December 2016 inclusive. As this analysis did not cover the whole period of the service, fndings could differ from the overall management information. In some instances, due to small sample sizes, apparent differences between groups (e.g. between countries) may not be statistically signifcant and therefore should be viewed with caution. Following very low referrals, it was announced that the Fit for Work assessment service would come to an end in England and Wales on 31 March 2018 and 31 May 2018 in Scotland. However, employers, employees and GPs will continue to have access to the same Fit for Work helpline, website and web chat, which offer general health and work advice as well as support on sickness absence. This process evaluation was undertaken before the decision was taken to close the service.