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Fit for Work

In response to Dame Carol Black's report, 'Working for a Healthier Tomorrow', in 2010 the Government set up a number of local pilot services under the label of "Fit for Work". Heather Downey, Project Manager for the Nottinghamshire Fit for Work Service, explains how the service works, the benefits that the pilots are proving and how the services might develop in the futureThe interrelationship between health and work, or indeed a lack of work, is vital to the economic and social wellbeing of a local economy. Being out of work, or in some instances never having been in work, puts individuals at increased risk of ill health and premature death, with all of the associated costs to society that this involves. Supporting individuals back into work and assisting them to continue in work despite long term health issues, not only boosts the local economy but improves the life chances and health outcomes for individuals and their families.Dame Carol Black's report, Working for a Healthier Tomorrow (2008) explored these issues and pointed out the lack of pathways of rapid intervention to help people get back to their place of work. The Government response was to set up a number of local pilot services under the label of "Fit for Work" to demonstrate the viability and success of services providing such early intervention on a case managed basis.The focus on public health has been central in the development of one of these pilot projects, the Nottinghamshire Fit for Work Service which was established in 2010. A Health and Work Steering Group has been in place since 2009 and this structure, chaired by a senior public health manager, oversaw the initial pilot stages of the project and has ensured accountability and governance as well as the wider consideration of the issues around health, work and indeed lack of work and its impact on local residents.The service provides case managed support to those offwork sick with both mental and physical health issues and works on a bio-psycho-social model. It is therefore ideally positioned to help GP's and other referring health professionals facilitate a return to work, benefiting both the patient and in many instances his/her family. It is estimated that such early intervention can stop as much as 40% of long term sickness. Case managers liaise with GP's on individual patients and advise them on what information is most helpful to include on a patient's Fit Note to help that individual back to, and to be sustained, in work. …