Fitness for Work and Return to Work

Question 1

What was the of sickness absence to the UK economy in 2010?

Answer 1

£17 billion

Question 2

What was the cost of sickness absence to the NHS in 2009?

Answer 2

£1.7 billion

Question 3

List 5 advantages of reemployment (Waddell and Burton 2006).

Answer 3

1 - Improves mental health.

2 - Reduces psychological distress and minor psychiatric morbidity.

3 - Reduces the risk of long-term sickness.

4 - Minimises the harmful physical, mental and social effects of long-term sickness.

5 - Improves quality of life.

Question 4

What proportion of cases of work-related ill health are reported?

Answer 4

0.3%.

Question 5

What is the aim of a fitness for work assessment?

Answer 5

To ensure that the individual is fit to perform the tasks required for their job effectively and without a risk to their own or to others’ health and safety.

Question 6

List 5 reasons for why fitness for work assessments are necessary.

Answer 6

1 - The patient’s condition may limit them from performing their job effectively.

2 - The patient’s condition may be made worse by their job.

3 - The patient’s condition may make their job unsafe to them.

4 - The patient’s condition may make their job unsafe to others.

5 - The patient’s condition may make their job unsafe to the community.

Question 7

Who can refer an employee for a fitness to work assessment?

Answer 7

1 - Self-referral.

2 - Management.

3 - Human resources.

Question 8

Who is responsible for assessing fitness to start work?

Who is responsible for assessing fitness to return to work?

Answer 8

• The employer is responsible for assessing fitness to start work.
• A GP is involved in assessing fitness to return to work.

Question 9

List 3 questions a GP should ask to determine fitness to return to work.

Answer 9

1 - Does the patient want to return to work?

2 - Does the patient need to be symptom free before returning to work?

3 - Is work feasible?

Question 10

List 3 factors to consider for a patient returning to work.

Answer 10

1 - Identify and monitor ongoing risks.

2 - Consider whether the employee makes effective use of rehabilitation and health facilities.

3 - Consider management commitment to the employee’s rehabilitation.

Question 11

List 4 aims of an occupational health assessment.

Answer 11

1 - To determine the effects of work on health.

2 - To determine the effects of health on work.

3 - To recommend workplace adjustments required for employees to work safely.

4 - To ensure that work complies with the Equality Act of 2010.

Question 12

List 6 questions an employer may ask a GP regarding an employee who is unfit to work.

Answer 12

1 - When is the likely date of return to work?

2 - WIll there be any residual disability upon return to work?

3 - Will disability be permanent or temporary?

4 - Will the employee be able to provide regular efficient service?

5 - What duties would you recommend that the employee does not do, and for how long?

6 - WIll the employee require continued treatment upon return to work?

Question 13

Give an example of a tool used to monitor the severity of depression and response to treatment.

Answer 13

PHQ-9 (patient health questionnaire 9).

Question 14

Give an example of a self-administered patient questionnaire that is used as a measure for generalised anxiety disorder.

Answer 14

GAD7 (general anxiety disorder assessment 7).

Question 15

Give an example of a test designed for the detection of mild cognitive impairment and Alzheimer’s disease.

Answer 15

Montreal cognitive assessment (MoCA).

Question 16

What type of vehicles are included in group 1 of the UK medical standards for driver licencing applications?

Do these applications require medical assessments?

Answer 16

• Cars and motorcycles.

- These applications don’t require medical assessments.

Question 17

What type of vehicles are included in group 2 of the UK medical standards for driver licencing applications?

Do these applications require medical assessments?

Answer 17

• Large lorries and buses.

- These applications do require medical assessments.

Question 18

List 3 roles of doctors concerning fitness to drive.

Answer 18

1 - Advise the individual on the impact of their medical condition for safe driving.

2 - Advise the individual on their legal requirements to notify the DVLA of any relevant conditions.

3 - Notify the DVLA when the individual cannot or will not notify the DVLA about any relevant conditions themselves (although doctors are not legally obliged to alert the DVLA; this is the driver’s responsibility).

Question 19

List 6 factors that should be taken into consideration for a fitness for work assessment regarding the effects of work on health.

Answer 19

DETTOL:

1 - Demands of the job (physical, intellectual etc.).

2 - Environment (dusts, chemicals, etc.).

3 - Temporal (shifts, early starts etc.).

4 - Travel.

5 - Organisational (lone-working, presence of customers etc.).

6 - Layout (ergonomic aspects, workstation, equipment etc.).

Question 20

List 8 factors that should be taken into consideration for a fitness for work assessment regarding the effects of health on work.

Answer 20

SMARTIES:

1 - Stamina (to work full time and to meet physical demands).

2 - Mobility (walking, bending etc.).

3 - Agility (dexterity, posture and coordination).

4 - Rational (mental state and mood).

5 - Treatment (side effects and duration).

6 - Intellectual (cognitive abilities).

7 - Essential for job.

8 - Sensory aspects.

Question 21

List 4 outcomes of a fitness for work assessment.

Answer 21

1 - Fit for work.

2 - Unfit for work.

3 - Fit for work with restrictions or adjustments.

4 - Cannot make assessment without further information.

Question 22

List 8 examples of workplace modifications.

Answer 22

1 - Encourage reduced hours.

2 - Change patterns of shifts.

3 - Change work content.

4 - Adapt the layout of the workplace.

5 - Reduce the pace of work, e.g. by having more frequent or longer breaks.

6 - Adapt equipment.

7 - Provide training.

8 - Provide facilities for mobility and transport.