Occupational health providers to be polled by government on reform plans

Occupational health providers will be directly contacted by the government over the next three months to feed into its twin consultations on expanding access to workplace-based health support announced earlier this week.

Ministers yesterday (July 20) announced a Department for Work and Pensions (DWP) consultation between now and October on the development of a new national “health at work” standard to provide a baseline for quality occupational health provision.

At the same time, the Treasury and HM Revenue & Customs are running a concurrent consultation on how changing tax incentives could help to boost incentives to invest in OH.

OHW+ will examine the Treasury/HMRC consultation in a separate article but, as part of the DWP consultation, the government has commissioned a research company called IFF Research to conduct additional research with OH providers to understand more about the OH market.

This will include a telephone survey of OH providers that will run from July to September. “We strongly recommend OH providers to engage in both the survey and the wider consultation to help create a picture of current provision in the UK and to shape the UK government sector,” the government said.

Providers wanting to find out more or wishing directly to take part, can also contact [email protected]

Possible legal duty to provide OH

The DWP consultation also provides some valuable insights into the government’s possible thinking around the expansion of OH provision.

For example, and perhaps most intriguingly for practitioners, the consultation makes it clear the government is keen to gauge views on whether making access to OH a compulsory, legal requirement for employers might be a viable option.

This could perhaps work through some form of automatic enrolment model, similar to what is now in place for pensions.

As the consultation outlines: “Employers could be legally required to provide minimum access to OH, as a default for their eligible employees. Employees could however opt-out of their entitlement to access OH and the onus would be on the employer to send a declaration of compliance.”

A body would be required to oversee this scale of change, perhaps equivalent to how The Pensions Regulator supports the delivery of automatic enrolment, it points out.

“Careful consideration would need to be given to SME requirements, allowing them to prepare for the changes, and support services would need to be in place to meet their needs,” it adds, with SMEs potentially being brought into any compulsory system on a longer timeframe,” the consultation states.

To do this, however, would require primary legislation to legally require employers to provide a minimum level of OH in specified circumstances, as there is no existing legislation to enable this, the DWP points out.

There would also need to be agreement on what services, circumstances, and employee eligibility criteria should apply. “For example, OH assessment following sickness absence; identification or creation of a regulatory body and processes to support administration, compliance, and penalties; and sufficient OH capacity to ensure all employers could access when required,” the consultation states.

“The government is therefore considering the development of a UK-based employer model encompassing systems change elements that could drive increased OH take-up amongst employers in the longer term and is keen to seek views to help build the evidence base on impact,” it adds.

Learning lessons from other countries

As part of the development of the health at work standard, the consultation emphasises the government is keen to draw on, and learn from, how other countries have expanded access to OH, including in France, Finland, the Netherlands, and Japan.

The health at work standard will ideally embed “a simple and clear baseline for quality OH provision by employers”, the consultation states. However, it recognises that OH provision can mean different things for different employers, based on their size, available resources, circumstances and needs.

“It does not necessarily translate into a need for an employer to offer the full range of interventions that OH covers, which might be more challenging and unnecessary for SMEs. The government will explore a range of researched views on OH interventions to understand their efficacy and approach for a national OH standard,” the consultation highlights.

This could include following the OH model in Denmark, where there is a tiered approach to minimum levels of occupational health based on employer size. “Another example is a work ability plan, which offers to map out individualised support for an employee with health conditions to help return to work from sickness absence,” the consultation states.

This could include a guided self-assessment of an employee’s work ability as a starting point, from which a case management approach is taken.

Baselining high-quality could involve commissioning an expert advisory group to develop evidence-based options to help define “a simple and clear baseline” of quality OH provision, the consultation suggests.

New guidance could be developed to consolidate best practice examples to develop a framework and guiding principles on workplace OH provision for employers. This could, in turn, be promoted via government-funded marketing and communications campaigns.

As the consultation outlines: “The government would like to explore the value of consolidating existing best practice and introducing new guidance to develop a government-endorsed, evidence-based accreditation scheme on workplace health and disability which employers could adopt. This could include a national health at work standard for employers, embedding a baseline for quality OH provision, and how to achieve it.”

The consultation recognises the existing value of SEQOHS, which it emphasises it wouldn’t look to replace. The new accreditation scheme could set in place a national tiered (likely based on business size) set of provisions that an employer could implement in regards to OH.

Employers could then advertise that they had committed to maintaining a certain standard on workplace health and disability, including OH. “This would increase their [employees] psychological safety and wellbeing at work as well as their ability to seek support when required and therefore potentially stay in work when they might otherwise fall out of it,” it points out.

Drawbacks, however, potentially include duplicating existing frameworks and standards, confusing employers, a lack of employer capacity, and a lack of credibility if the standard is not developed in an appropriately robust way.

“For example, if the evidence base is inadequate or the standard does not contain measures to assure employer compliance such as spot checks and the standard not being attractive enough for employers to take it up, leading to poor value for public money,” the consultation outlines.

Additional funded support could be put in place for those seeking to accredit themselves to the proposed national health at work standard, including for providing baselined quality OH, the government has emphasised.

A possible model for this could be the approach taken in its Mental Health and Productivity Pilot (MHPP) in the Midlands. This is a pilot primarily focused on mental health but could be expanded to tackle both mental and physical ill health, it says.

The pilot offers employers access to outreach workers to work to tailor the package to their needs and facilitating peer-to-peer learning, access to evidence-based resources for managing health and disability in the workplace, opportunities for businesses to network and to mentor each other and share ideas on best practice, and bespoke support options tailored to different employer sizes.

Both consultations are due to run until 12 October. The DWP consultation ‘Occupational Health: Working Better’, can be accessed here.