Author Topic: "‘biopsychosocial holistic assessment’ " rears its ugly head again.  (Read 3106 times)

lankou

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From: Benefits and Work, Three sets of guidelines no mention of "‘biopsychosocial holistic assessment’ in the employees guide,
but several mentions in the employers and GP guides. (Now I wonder why  >whistle<
 )

http://www.benefitsandwork.co.uk/news/2975-employees-cannot-be-forced-onto-fit-for-work-scheme

Employees cannot be forced onto Fit For Work scheme
Category: Latest news   Created: Tuesday, 06 January 2015 14:41


Guidance issued by the DWP last week on the new Fit for Work scheme makes it clear that referrals can only be made to the scheme with the consent of the employee. It also makes it clear that most health assessments will be carried out over the telephone.

Fit for Work is the new DWP scheme intended to cut sickness absence and ESA claims by getting sick employees back to work more quickly. In England and Wales the scheme has been outsourced to a branch of Maximus, the company also talking over the work capability assessment contract from Atos later this year. In Scotland fit for work is being delivered by the Scottish government.

GPs and employers can refer employees for an occupational health assessment via the Fit for Work service once they have been off sick for a month, provided that there is a reasonable prospect of the employee retuning to work. The employee must consent before a referral can be made.

Fit for work will carry out a ‘biopsychosocial holistic assessment’ of the employee over the telephone and draw up a return to work plan on the basis of that call. In a small number of cases a face-to-face assessment will be carried out.

For GPs, the attraction of a referral is that once a return to work plan has been drawn up by Fit for Work the GP will no longer be responsible for providing sick notes.

Employers receive a tax exemption of up to £500 per year, per employee on medical treatments recommended by Fit for Work to help their employees return to work.


https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/389283/fit-for-work-employees-guide.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/389278/fit-for-work-employers-guide.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/389273/fit-for-work-gps-guide.pdf

DarthVector

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Quote
GPs and employers can refer employees for an occupational health assessment via the Fit for Work service once they have been off sick for a month, provided that there is a reasonable prospect of the employee retuning to work. The employee must consent before a referral can be made.
...
Employers receive a tax exemption of up to £500 per year, per employee on medical treatments recommended by Fit for Work to help their employees return to work.

That sounds like a financial incentive for employers to improperly pressure their sick employees into the Fit for Work system, at the very time said employees will be most vulnerable and least able to defend their own interests.

auntieCtheM

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I wish that they did proper checks for grammar and spelling rather than just relying on a spell-checker.  It just annoys me that a government department cannot get it right.

KizzyKazaer

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Quote
GPs and employers can refer employees for an occupational health assessment via the Fit for Work service once they have been off sick for a month, provided that there is a reasonable prospect of the employee retuning to work. The employee must consent before a referral can be made.
...
Employers receive a tax exemption of up to £500 per year, per employee on medical treatments recommended by Fit for Work to help their employees return to work.

That sounds like a financial incentive for employers to improperly pressure their sick employees into the Fit for Work system, at the very time said employees will be most vulnerable and least able to defend their own interests.

Worryingly so, I would say.

And I do wish that the assessment could have been given a less clunky name as well - 'biopsychosocial holistic', my a**e.  What wiseguy dreamed up that tongue-tangling nonsense?

DarthVector

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Auntie, if I hadn't already seen what this Government was capable of, I would wonder what that kind of sloppiness implied for the rest of their work. I'm now thinking of a top-notch teacher I had at school who was ex-Civil Service - by that, I mean the real Civil Service this country used to have - and he would probably be driven to drink by this sort of thing.

Mind you, I must admit that the prospect of "retuning to work" sent me off on a strangely persistent sidetrack.

Behold: RoboDarth!

Or was it MotoDarth? GuitarDarth? I get confused...

Don't worry, though. Radio Darth will be retuned to work as soon as possible.

seegee

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No, you can't retune to work Darth, Maximus are talking over the WCA contract from Atos... ;-) >lol<

« Last Edit: 06 Jan 2015 10:26PM by seegee »

DarthVector

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Ergh. I walked right into that. Nicely done :)

seegee

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The misspellings were there just waiting to be played with. :-)

Sunny Clouds

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I think I'm feeling very malicious right now.

I looked it and thought whoopee, money!

Why?

Well, can't you imagine the number of people trying to return to work with rubbish assessments who'll try to use the assessments to claim reasonable adjustments and find the employers don't think they're reasonable?

Or the case managers say they're fit to go back to work and they're not and something goes wrong?

I'd absolutely love it if instead of the usual phone calls "have you had an accident in the last 3 years" I got "did your employer refuse to comply with a fit to work plan".

Yup, horrible of me, but I really do believe this scheme is unfair on employers and unfair on employees and goodness only knows where the doctors come in the middle of all this.

But then I'm one of those really horrid people who, when I read of some poor victim of IDS & co.  who's killed themselves, I wish they'd done it in an assessment centre or a WRAG centre.  Yes, nasty of me, but it's the reality of what this means.

The thing that really gets to me is this: when I read about benefits assessments, more and more what I think of is something slightly different and now this is triggering the same thoughts.  It's about petty meanness not only of money but of attitude.

I guess I'm not alone in having heard the stories from an older generation of the depression, of the twenties and thirties.  In those days, of course, there wasn't the welfare system there is now, and if you fell on hard times, you turned to the parish for help.

You had to sell almost everything to get help.  To me what has always symbolised the cruelty of the system was women having to sell their wedding rings before they'd be given money to feed their children. 

I've a suspicion a lot of the women visiting foodbanks these days don't have wedding rings (which I don't judge them for) but they do have other things that matter, mementos of people they love etc.  We might look at that big telly and think of it as a luxury but it might actually represent money carefully put aside every week to pay to Bright House or wherever for that luxury that made up for so much horridness in life.

But whether it's a wedding ring or labelling what is, these days, a basic item, a luxury, it's the same meanness of attitude. 

I read through the guidance.  There's nothing in it about adaptations, referrals for equipment etc.  There are some references to help with costs of treatment - eh?  Why should the employer provide treatment and claim a grant?  That's not just a matter of principle (I believe in the NHS) it's a matter of perception - a sick patient becomes a paperwork burden, a finance trail burden.

Last year, I renewed my ESA and asked my GP for a letter.  I told him I'd hesitated to ask because I know that various LMCs, including our local one, had told their member GPs not to give such letters.  He looked at me kindly and asked "If a GP doesn't advocate for his patients, who will?"

Who will actually advocate for the patients stuck in this expletive system supposedly to get them back to work?
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

Dic Penderyn

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I remember one story told to me many moons ago about when my Great Aunt was a girl for long periods she would be trapped in the family home because she could not go out side to play and that was because her father had had to pawn her one set of clothes to get money for food and to pay the rent. Oh the good old days.
Be careful in what you wish for, God has a sense of humour

Sunny Clouds

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On a tangent, I get a bit hacked off over a different aspect of the biopsychosocial word.

You see, I think the original concept and development of it were very useful for analysing healthcare and what to do about it.  Not necessarily right, hence the debate on it, but useful.

In particular, let's take conditions like schizophrenia and bipolar disorder.  The BPS model would say there's a genetic base (bio), there's a base relating to upbringing or life-events affecting brain development or triggering genetic susceptibility (psycho) and current cirumstances (social).

It doesn't always work and there are ongoing 'feuds' over how far conditions are based on what, but the model does seem to have influenced the concept of the multidisciplinary care team (even if for an awful lot of us, it was a dysfunctional model with all sorts of problems over internal politics, budgets etc.)  It acknowledged in the 'social' element issues like the higher rates of schizophrenia amongst second-generation immigrants, about issues like diagnosis being biased by factors like the ethnicity and social status of the patient, about the importance of helping people with things like income, shelter, advocacy etc.

All that has effectively been stymied as a useful basis for research and debate by being hijacked by certain big insurance companies and politicians/political movements, in particular, I think, in anglophone countries.

Or, to put it a bit more briefly, my ability to project to the world around me that how I'm treated (psycho and social) is a big factor in my condition has been turned around into my still being ill is about my attitude (psycho and social).

 >angry<
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

DarthVector

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Or, to put it a bit more briefly, my ability to project to the world around me that how I'm treated (psycho and social) is a big factor in my condition has been turned around into my still being ill is about my attitude (psycho and social).

That's a very good point.