In July the UK government released a new consultation called ‘Occupational Health: Working Better’, inviting views on a number of questions aimed at improving access to occupational health (OH) services. The consultation was largely unexpected but there are very good reasons for this to be an area of focus for the government. A recent Labour Force Survey carried out by the Office for National Statistics (ONS) found that 36% of all working-age people report at least one long-term health condition representing a drop of two million reporting themselves as fully fit in only four years.
The data behind the consultation is stark. Long-term sickness is now the most common reason given by working-age people for economic inactivity. The latest figures show that the proportion of people who are economically inactive mainly due to long term sickness has now increased to 2.55 million. The pathway to economic inactivity often begins with sickness absence from work with the consultation citing record high figures of 186 million working days lost to sickness or injury in 2022 alone. The consultation also reported that only 45% of workers had access to OH services through their current job.
The two biggest drivers of economic inactivity are musculoskeletal and mental health conditions. This is perhaps unsurprising, given that these conditions are often chronic, long term and difficult to manage.
When analysing OH coverage (which we understand to mean the capacity of existing providers to cover the current working population) in the UK, the consultation estimated this to be 51%. This contrasts with countries that have legal requirements for employers to provide OH services which have over 75% coverage.
The government aims to increase employer take-up of OH services, as well as improving availability, to prevent ill health turning into job loss and economic inactivity statistics.
The consultation covers three main ideas:
The government is also consulting on the possibility of tax incentives to help employers to provide OH services to their workforce.
One of the more interesting ideas is a system which mirrors the pension automatic enrolment scheme by introducing a new legal duty on employers to provide OH access for their employees after a certain event: a period of sickness absence, for example. The government would need to introduce a new regulatory body to oversee this new legal duty with employers required to complete a declaration of compliance.
The consultation also asks for views on whether the ability to certify fit notes should be extended to other healthcare professionals. As of July 2022, registered nurses, occupational therapists, physiotherapists and pharmacists, as well as doctors, can certify fit notes. It is unclear which other healthcare professionals the government has in mind, but any extension to professionals who are not strictly regulated could undermine employer confidence in fit note certification.
Whilst we will need to await the outcome of the consultation for any confirmed changes, some employers will be heartened that the government is looking at providing additional tax incentives which may help them afford to use OH services, or use them more widely.
The many employers who have received unsatisfactory OH reports that either raise more questions than they answer or lack specific, workable recommendations will also welcome a baseline for quality OH provision. Often due to poor experiences with OH, some employers see the service as a tick-box exercise in managing long term sickness absence that is no more than a procedural step. A quality OH offering may help employers see that there can be real benefits to engaging with the process.
However, OH is often only a small player in healthcare. OH, of course, cannot medically treat employees who are at the mercy of lengthy NHS waiting lists. Particularly for mental health issues, OH recommendations often include that employees seek psychiatric support, which may only be available privately. This is something that many employees cannot afford and that employers are often unable or unwilling to fund.
The consultation will close on 12 October 2023, and may be viewed here.
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