Just back from my seminar travels, and one of the first items to grab my attention is this rather interesting article from Workplace Savings and Benefits Magazine: GP’s incentivised for HWS referrals
Those that have followed the saga of HWS will be aware that the original intention was that GP’s would be mandated to make referrals for any patient who had been off work for 4 weeks or more.
This was subsequently watered-down, and the service became strictly voluntary, with referrals after the qualifying period possible via GP, employer, or employee.
If you have heard me speak on this topic recently, you will be aware that I am more than a little concerned about this revised approach. Employees are unlikely to make referrals in large numbers, as in the early years they will be unaware of the service, or confuse the HWS with other Government-led assessments regarding state benefits.
Employers are more likely to make use of this – and early evidence from the Jelf Employment Seminars suggests that some 58%* of employers intend to use the service. Such employers will (hopefully) be taking steps towards including HWS referrals within their standard absence management policies. Whilst this is clearly a positive sign, a concern on how employee consent will be managed still clouds this particular horizon.
Which takes us back to GP’s. Will they make recommendations to the HWS, even with the encouragement of an incentive?
Evidence from another recent initiative in this space, The Fit-Note, suggests not (or at least not for some years to come). Last Autumn I heard Dame Carol Black say that only 10% of GP’s had been trained in the correct use of Fit-Notes, several years after their introduction. And given that Fit-Notes were a requirement rather than an option, this surprised and concerned me not a little.
So unless the incentive is significant, I can’t really see it changing GPs attitudes or actions in the short-term.
Alternatively, if the incentive is so large that it becomes compelling for the local Health Centre to engage in such referrals, then this would raise something of a red flag as to why so much additional public money is being spent on a service that was originally intended to require GP referrals without additional cost.
All in all, I think the question of incentives could be something of a red-herring. In the absence of a mandate on GP’s, I remain of the opinion that employers, rather than the family Doctor, are likely to be the primary referral point in the early years of the service.
We shall see.
* Jelf Employment Seminar, London 18/02/14