One of the stated aims of the Labour government is to reform and improve the services provided by the National Health Service (NHS). Work towards this ambition began with Lord Darzi’s report last year, and this month the government has published some ambitious plans. The key focus is to move the NHS from combatting sickness to prevention of ill health.
The 10-year plan
On 3rd July the government published “Fit for the Future”. This document includes a 10-year plan for the NHS in England.
The need for such a plan is increasingly evident to anyone who has used NHS services in recent years. Indeed, the report highlights the legacy inherited by the current government:
- Many people cannot get a GP or dental appointment.
- Waiting lists for hospital and community care have ballooned.
- Staff are demoralised and demotivated.
- Serious illness outcomes lag behind comparable nations.
The plan to overcome these difficulties includes three key ambitions:
- Hospital to community.
- Analogue to digital.
- Sickness to prevention.
Arguably the easiest of the above fixes is technology. The extension of the NHS App to an increasingly tech-enabled population is likely to improve the accessibility and delivery of many NHS services. And embracing AI will also streamline some services.
The intended move from hospital treatment to local support is another major change. Some funding will be redirected from hospitals to GP practices, local pharmacies, and providers of home care to achieve this outcome.
Sickness to prevention
The final ambition is moving the NHS from combatting sickness to prevention of ill health.
Clearly the success of digital and community approaches will be central to this. Yet so too will the need to embrace new approaches to illness prevention. This will include:
- New legislation to tackle the use of vapes.
- Embracing weight-loss medication.
- Free school meals.
- Expanded mental health support for young people.
- Increasing vaccination take-up rates.
- Encouraging citizens towards better health.
Fit notes
The government is also looking beyond the above interventions. Fit notes replaced sick notes in 2010 yet are clearly not working as intended. The government’s website says that fit notes are:
“intended to support you stay in, or return to, work.”
The aim was to avoid ill or injured employees being signed off from all work. Instead, the fit note was to focus on what aspects of work could still be undertaken.
Yet of the 11 million “fit notes” issued last year, 93% declared the individual “not fit for work”. This is clearly one area ripe for improvement.
One problem is that a family doctor has limited time to make such a judgement. Other issues include the doctor-patient primary relationship and limited understanding of the employee’s specific working conditions and job requirements.
WorkWell
The government recognise this concern and have responded accordingly. The new WorkWell Primary Care Innovation Fund is backed by £1.5m of government funding.
Health and Social Care Secretary Wes Streeting said of WorkWell;
“It isn’t just about freeing up GPs to treat patients rather than fill in forms. It’s about fundamentally changing the conversation from “you can’t” to “how can we help you?” When someone walks into their doctor’s surgery worried about their job they should walk out with a plan not just a piece of paper that closes doors.”
The aim is to help people remain in – or return to – work. WorkWell will connect patients to specialists including health coaches, pharmacists and occupational therapists. The service will also promote the use of reasonable adjustments.
Initially the service will be piloted in 15 regions across England. The aim is to support 56,000 people with health conditions or disabilities into work by Spring 2026. This development is to be welcomed.
Lessons from history
Yet we have been here before.
In 2012 the government introduced “Fit for Work”. This scheme was intended to require family doctors to make a Fit for Work referral when relevant. Yet Fit for Work failed because:
- GPs had limited time, information, or incentive to make a referral.
- There were concerns around the doctor-patient relationship.
- Awareness and understanding of the scheme were very limited.
- Government funding was insufficient to provide the suggested services.
These challenges and others will have to be addressed if WorkWell is to succeed and expand beyond the initial pilot exercise.
Unlikely to replace occupational health assessments
So, what might WorkWell mean for employer-funded occupational health assessments?
WorkWell service will be largely targeted at the 2.8 million people currently out of work for health reasons. WorkWell is also likely to focus on generic solutions without necessarily considering the practicalities of any employment recommendations made.
Whereas employer-funded occupational health assessments provide a far more focussed service. Assessments are typically rapid, objective, in-depth and contain expert and informed analysis of the challenges and solutions required to retain an employee in his/her job role. For more information on such assessments and the expertise available within the Occupational Health Assessment Ltd expert team and services please see this link.
In practice the two services will likely happily coexist. Each serves a different audience and is essentially complimentary and not conflicting.
About Occupational Health Assessment Ltd
Occupational Health Assessment Ltd is an SEQOHS Accredited and Certified B-Corp nationwide occupational health provider.
We provide rapid access to expert occupational health support for businesses right across the United Kingdom. Appointments are available nationwide within two days.
With a unique occupational health assessment service, night worker health assessments, fitness certifications and access to clinics in Belfast, Birmingham, Bradford, Brighton, Bristol, Cardiff, Coventry, Derby, Edinburgh, Glasgow, Hull, Leeds, Leicester, Liverpool, London, Manchester, Newcastle, Northampton, Nottingham, Plymouth, Portsmouth, Reading, Sheffield, Southampton, Stoke, Surrey and more, the business provides high quality, expert medical advice.
Please contact us for further information or assistance.