Thumbs Down for Fit for Work Scheme

What is the Fit for Work Scheme?

The Fit for Work scheme aimed to spring-clean our overburdened benefits system by providing a service to cut down on sickness absence.  There were loads of reports linking long term benefits with being off sick for ages.  We were now going to have extra options on the fit note other than the too simplistic ‘sick’ or ‘fit.’  And a telephone advice service.

The aim was to give GP’s other options.  The problem was that GP’s and patients, were quite happy with the yes or no decision and both find it difficult to a) argue with the other about the matter and b) have any idea of what other jobs might be available in their workplaces.

So things basically went on in the same way with GP’s fudging the matter; blaming their reluctance on taking full advantage of the new fit note, on lack of time and knowledge. So then, the government offered full training for GP’s to get over that one.

Testing Programmes

I had insider knowledge of the pilot programmes of the helpline, one was at my local hospital occupational health service where I worked and still had close friends.  I understood the statistics from the pilot schemes showed it worked but hardly anyone called. However, these figures were never published and, from the inside, the justification for the service seemed a foregone conclusion.

After the analysis and business case, a close colleague’s medical company won the contract for the Fit For Work Service to go alongside the new initiative. I was sure it would take off.

As an aside, it was rather strange that the English Fit for Work Helpline ceased after some time, presumably because no one called?

Next Steps

The training for GP’s made little impact, so the next step was to start a national service for absence. Remove the patient/doctor relationship and so make more difficult decisions easier.  Now sick workers could see a professional who understood about health at work and had resources to work directly with the workplaces. Problems quickly emerged:

  • The referral to the FfW service was NOT automatic
  • The employee had to consent to the process
  • Large companies and some SME’s had their own OH services
  • Alienation of current OH services in companies
  • Employers could not refer directly to the Ffw scheme (referrals did not come about til later)
  • Anecdotal evidence of untrained assessors calling patients
  • Many patients did not understand the process
  • Mainly a telephone service (patients do not enjoy talking about personal issues to a stranger on the end of the phone)


My Impression of Usage

I’m a member of a number of forums that discuss latest developments in occupational health and safety and the reports back from these groups regarding the fit for work service as a whole, have been at best neutral and at worse, negative.

You could say we would say that, wouldn’t we? The fit for work service challenged our work, many believing that the new initiative would take away a large part of our remit. However we are a professional forum and like to consider things from most angles; but in this case, I can honestly say, with hand on heart, I haven’t heard of any real positive case studies via the forums or, through the work I do, as an OH specialist.

But, knowing the industry and SMEs as I do, I can’t say I’m surprised with the latest analysis of the fit for work service – the only thing I am surprised by is that people are surprised!

What Next?

So where does that leave us? We still have the fit note and we still have sick people who would benefit from staggered returns and workplace adjustment. We still have overworked and poorly resourced GP’s who, by the look of things, are under tremendous pressure in the ever-changing NHS service.

But the fit for work service is not fitting the bill and surely just adding to it?


I’m not sure what the answer is.  The three fit for work web sites are all excellent and I think it’s the way to go in terms of information giving and help for employers.

Check out each of the services here:

England and Wales:

Welsh Language Line:

  • Ffit I Weithio (
  • 0800 032 6233


  • Fit for Work Scotland (
  • 0800 019 2211

I’m glad to see that the English fit for work service now has a telephone help line and it’s fast catching up to the excellent Scottish fit for work service website.

Interestingly I wrote a lot of the knowledge base for the English fit for work service, way back when it started, and see many of my documents are refreshed and updated, and, improved by the editorial staff, so that’s good news anyway.

Read the Reports

If you want to see the reports on the numbers using the fit for work service please go to the article in People Management which also includes EEF comments too, pointing out that, although three-quarters (77 per cent) of the 264 companies it surveyed had heard of the Fit for Work scheme, just a quarter of those that were aware of it would use it.

Of those 14 respondents that had used the scheme, only three agreed it had helped their staff return to work earlier.

Negative Feedback

It’s taken a long time for the numbers to come in.  It has been pretty obvious to me and my colleagues that the scheme or service is not working – yet at the back of my mind, I really wanted it to.

I know people get sick notes (the term fit note has not really caught on either) relatively easily from their GP’s and that GP’s are under tremendous pressure.  Yet I also know that work is basically good for you and the longer someone is away from work the harder it becomes to return.  The Fit for Work service, in an ideal world without the NHS, might have worked, but it doesn’t and isn’t likely to.

This is not the answer.

Unfit for Work or Maybe Fit for Work?

So is it totally unfit for work or can we make some adjustments? For a start, let’s amalgamate the country specific Fit for Work services to save a lot of money. See what I did there?

Seriously though, we have to accept the Fit for Work service is failing and someone needs to do something to make it more effective or put it out of its misery because, with all the pressures on other parts of the NHS, this really is a luxury we cannot afford.

Further Reading and Resources

Do you have a cunning plan to rescue the ailing Fit for Work services?

Leave your comments in the reply box below.

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