About this role
Job summary
To provide occupational therapy assessment and intervention for working-age adults whose health is affecting their ability to stay in or return to work, as part of the Enable service. The post is home-based, with consultations delivered by telephone and video.
- Carry out functional and work-focused assessments with patients from pilot GP practices who request a fit note.
- Issue and sign fit notes as the certifying healthcare professional.
- Complete workability assessments and plans with eligible patients, setting practical, occupation-focused goals to support a sustainable return to work.
- Work as part of a multidisciplinary team with the Advanced Nurse Practitioner, Occupational Health Nurses and admin team.
- Record activity and outcomes accurately so the pilot can supply data and learning to the Department for Work and Pensions (DWP).
Main duties of the job
Key responsibilities
Fit note certification
- Assess patients' fitness for work and issue and sign fit notes in your own name, as permitted for HCPC-registered occupational therapists under the Social Security (Medical Evidence) and Statutory Sick Pay (Medical Evidence) (Amendment) Regulations 2022.
- Assess the patient by video or telephone consultation, or by reviewing a written report from another healthcare professional, before issuing a fit note.
- Certify only within your own scope of practice and competence. Refer to the ANP or Clinical Lead when the presenting condition, complexity or risk falls outside it.
- Issue fit notes through EMIS, including correct dates, condition wording and review periods.
- Meet the service turnaround standard for fit note requests (currently 3 working days).
- Take part in audit of your fit notes for quality and consistency, and act on feedback from the Clinical Lead.
About us
Enable is one of four national pilots funded by the Department for Work and Pensions (DWP) to test a better fit note process, and it is the most clinical of the four. MBPCC delivers it under an NHS contract across the Barrow and Mid Furness Primary Care Networks.
For participating practices, every fit note is issued by the multidisciplinary Enable service rather than the GP practice. There is no change to fit note legislation, so every patient still needs a valid, signed fit note. Working patients who agree to take part receive a workability assessment and a personalised workability plan that focuses on what they can do and how to stay in, or return to, work. Employers are contacted only with the patient's explicit agreement. The pilot generates data and learning for the DWP to shape future national policy.
The service uses EMIS, AccuRx, X-on Surgery Connect and Florey questionnaires. This post is home-based: consultations are delivered by telephone and video, and the post holder works with the Enable team through Microsoft Teams and the service's clinical systems.
The service expects to handle more than 20,000 fit note requests a year at full rollout.
Job description
Job responsibilities
Fit note certification
- Assess patients' fitness for work and issue and sign fit notes in your own name, as permitted for HCPC-registered occupational therapists under the Social Security (Medical Evidence) and Statutory Sick Pay (Medical Evidence) (Amendment) Regulations 2022.
- Assess the patient by video or telephone consultation, or by reviewing a written report from another healthcare professional, before issuing a fit note.
- Certify only within your own scope of practice and competence. Refer to the ANP or Clinical Lead when the presenting condition, complexity or risk falls outside it.
- Issue fit notes through EMIS, including correct dates, condition wording and review periods.
- Meet the service turnaround standard for fit note requests (currently 3 working days).
- Take part in audit of your fit notes for quality and consistency, and act on feedback from the Clinical Lead.
Clinical assessment and workability plans
- Manage a defined caseload of working-age adults referred through the fit note pathway.
- Complete workability assessments and plans with eligible patients, assessing physical, cognitive, psychological and environmental factors affecting work through remote assessment.
- Where an in-person functional assessment is clinically necessary, arrange this through agreed pathways and record the rationale.
- Advise on graded return to work, activity pacing, fatigue and symptom management, and practical workplace adjustments.
- With the patient's explicit agreement, liaise with employers by telephone, video or in writing about reasonable adjustments and return-to-work arrangements.
- Signpost and refer to other services and community resources.
- Identify and act on risk, including mental health risk, escalating promptly to the Clinical Lead and Advanced Nurse Practitioner. At the start of each remote consultation, confirm the patient's identity, location and a contact number.
- Undertake comprehensive assessments of occupational performance, functional capability and the impact of physical, mental health and social factors on work participation.
- Assess an individual's ability to undertake the functional demands of their role and identify opportunities for reasonable workplace adjustments and support.
- Identify and respond appropriately to safeguarding concerns, deterioration in mental or physical health and risks which may impact patient safety or ability to work.
- Escalate concerns in accordance with organisational policies and agreed clinical pathways.
Communication and teamwork
- Communicate complex and sometimes sensitive information about health and work, adapting to each patient's needs and overcoming barriers to understanding, including those that arise in telephone and video consultations.
- Work as an active member of the Enable multidisciplinary team and attend virtual team meetings, case discussions and huddles.
- Build good working relationships with pilot GP practices, PCN teams and partner organisations.
- Contribute an occupational therapy perspective to the development of pathways, templates and patient information.
Records, data and evaluation
- Keep accurate, contemporaneous clinical records in EMIS to professional and MBPCC standards.
- Record activity and outcome data accurately and on time, as needed for DWP evaluation.
- Contribute to service evaluation, audit and quality improvement, including sharing learning from the pilot.
Professional development
- Take part in annual appraisal and agree a personal development plan.
- Maintain a CPD portfolio that meets HCPC requirements.
- Develop knowledge of vocational rehabilitation, occupational health and work and health policy.
Working arrangements
Contract and hours
- This is a fixed-term post funded through the national pilot. Continuation beyond the pilot period cannot be guaranteed and is subject to national decisions on the future of the model.
- Some flexibility over working hours may be needed to accommodate patients who are in work and employers who are only available outside core hours, such as Saturday working.
- The post holder will be expected to work in a rapidly evolving service where processes, systems and documentation change during the pilot period, and to lead others through that change.
This is a home-based post. MBPCC's Homeworking, Hybrid Working and Remote Learning Guidance applies in full, and the post holder remains subject to the same professional, contractual, governance and performance expectations as staff working from MBPCC premises.
Location and in-person attendance
- Live in the UK and carry out all work from a UK address for the duration of employment. Working from outside the UK is not permitted.
- Deliver patient consultations remotely by telephone and video, using MBPCC-approved systems only.
- Travel to MBPCC head office at the start of employment to collect MBPCC equipment and to attend a face-to-face induction.
- Attend MBPCC head office when equipment needs to be collected, exchanged or returned, including at the end of employment.
Suitable home working environment
- Have a suitable, dedicated workspace that supports concentration, minimises distractions and enables professional communication.
- Ensure consultations and confidential conversations cannot be overheard, and that screens cannot be seen by family members, visitors or anyone else not authorised to view them.
- Have a suitable desk or workstation, appropriate seating, adequate lighting, ventilation and heating, and reliable internet access sufficient for video consultations and clinical systems.
- Use a headset whenever patient or confidential information is being discussed, and use the MBPCC background on video calls.
- Complete the MBPCC Homeworking Self-Assessment (including display screen equipment) and sign the Employee Homeworking Agreement before starting, and tell your manager of any significant change to your home working arrangements.
- Home working is not a replacement for childcare or dependant care arrangements. Where caring responsibilities affect your ability to work, discuss this with your manager.
Information governance and cyber security
- Use only MBPCC-issued devices, organisational accounts and approved systems and video conferencing platforms. Do not store confidential information on personal or unapproved systems.
- Lock screens when away from the workstation, keep passwords, smartcards and fingerprint access to yourself, and do not allow anyone else to use MBPCC devices or systems.
- Verify who is present before discussing confidential information, share only the minimum necessary, and keep patient-identifiable information out of chat functions unless clinically necessary and authorised.
- Do not record, screenshot or photograph consultations, meetings or training unless this has been authorised. Do not join patient-related calls from public places.
- Secure and dispose of any paper records using approved methods, and report any information governance or cyber security incident immediately.
Audit and monitoring
Because this post involves remote access to patient-identifiable clinical information, enhanced governance controls apply. The post holder will be subject to audit and monitoring, including:
- Periodic information governance audits and an annual information governance review.
- Verification that the home working environment is, and remains, secure and suitable.
- Asset and equipment audits, at least annually. MBPCC equipment remains organisational property and must be cared for, faults reported promptly and items returned when requested.
- Compliance monitoring of mandatory training, information governance and cyber security training.
- Monitoring of availability, activity and performance against service standards, through one-to-ones, work plans, activity schedules, supervision and clinical audit.
- Quarterly one-to-one and wellbeing reviews, and an annual review of the home working arrangement.
Failure to meet these requirements may be managed under MBPCC's disciplinary, information governance and data protection procedures.
Availability, communication and wellbeing
- Work contracted hours, be visible and contactable during agreed working times, keep your electronic calendar up to date and respond to communications promptly.
- Attend virtual team meetings, huddles, multidisciplinary discussions, supervision and training punctually and in full. Training during working hours is working time and must not be combined with caring or domestic tasks.
- Follow the MBPCC Lone Working Guidance and use agreed routes (Teams or telephone) to escalate clinical risk to the Clinical Lead or Advanced Nurse Practitioner without delay.
- Take regular screen breaks, raise wellbeing or workload concerns early, and report any accident that happens during work activities.
- If you become unwell while working, tell your manager at the earliest opportunity, stop work if you are unfit to continue and follow normal sickness reporting procedures.
Remote working, confidentiality and information governance
The successful candidate will be required to work remotely whilst maintaining the highest standards of confidentiality, information security and professional conduct. These essential requirements are also assessed through the person specification.
Essential requirements
- Ability to maintain a secure, private and professional remote working environment suitable for the handling of confidential and sensitive information.
- Ability to conduct telephone, video and online meetings in a location where conversations cannot be overheard by unauthorised individuals.
- Demonstrable understanding of confidentiality, information governance, cyber security and data protection responsibilities.
- Commitment to complying with all organisational policies relating to information governance, confidentiality, records management, acceptable use of IT systems and remote working.
- Ability to process, access, store, share and dispose of information securely and only for authorised business purposes.
Person Specification
Registration
Essential
- Current HCPC registration as an Occupational Therapist, with no conditions affecting practice
Desirable
- Membership of the Royal College of Occupational Therapists
Qualifications
Essential
- Degree or diploma in Occupational Therapy
Desirable
- Vocational rehabilitation or occupational health qualification or module
Knowledge & Skills
Essential
- Understanding of how health conditions affect function and the ability to work
- Understanding of clinical risk assessment, safeguarding and when to escalate
- Understanding of confidentiality, consent and information governance
- Knowledge of workplace adjustments, graded return-to-work approaches and vocational rehabilitation interventions.
- Knowledge of the fit note, Statutory Sick Pay, Access to Work and understanding of the Equality Act 2010 and the principles of reasonable workplace adjustments.
- Clear, professional decision-making on fitness for work within own scope of practice
- Effective verbal and written communication, including sensitive conversations about health and work
- Good IT skills, including using clinical systems, Microsoft 365 and Teams to record consultations and data
- Able to manage own time and prioritise a caseload to meet turnaround standards
- Ability to undertake effective occupational therapy assessment and intervention through telephone and video consultation.
- Ability to formulate practical workplace recommendations based on functional assessment findings.
Desirable
- Awareness of the DWP Fit Note Reform Pilot and national work and health policy
- Knowledge of standardised work-related assessments, such as the Worker Role Interview or Work Environment Impact Scale
- Experience of quality improvement or service evaluation
- Motivational interviewing or health coaching skills
- Experience of EMIS, AccuRx or another GP clinical system
Experience
Essential
- At least 12 months' post-registration OT experience, including preceptorship, with working-age adults in physical or mental health
- Experience of assessing and managing an individual caseload
- Experience of vocational rehabilitation, workability assessments, return-to-work planning or employment-focused occupational therapy interventions.
- Ability to contribute to pathway design, quality improvement, audit and service evaluation within a test-and-learn environment.
Desirable
- Experience in primary care, occupational health, vocational rehabilitation, musculoskeletal or community mental health services
- Experience of telephone or video consultations
Personal Qualities
Essential
- Commitment to person-centred, enabling practice that supports people to stay in or return to work
- Able to work autonomously and as part of a new multidisciplinary team, using supervision well
- Flexible and comfortable working in a pilot where processes are still being developed
- Self-motivated and well organised, able to stay connected to the team while working from home
- Ability to build rapport and assess risk within a remote working environment.
Other
Essential
- Lives in the UK and able to work from a UK address for the duration of employment
- Willing and able to travel to MBPCC head office to collect equipment and attend a face-to-face induction
- Accepts audit and monitoring of home working arrangements, clinical records and information governance compliance
- Satisfactory enhanced DBS check and occupational health clearance
Remote working, Confidentiality and IG
Essential
- Ability to maintain a secure, private and professional remote working environment suitable for the handling of confidential and sensitive information, with reliable broadband and meeting the MBPCC Homeworking Self-Assessment
- Ability to conduct telephone, video and online meetings in a location where conversations cannot be overheard by unauthorised individuals
- Demonstrable understanding of confidentiality, information governance, cyber security and data protection responsibilities
- Commitment to complying with all organisational policies relating to information governance, confidentiality, records management, acceptable use of IT systems and remote working
- Ability to process, access, store, share and dispose of information securely and only for authorised business purposes
- Ability to work independently, manage workload effectively and maintain accurate records in line with organisational requirements
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).
Employer details
Employer name
Morecambe Bay Primary Care Collaborative
Address
Remote/Home Working
Remote
LA14 2HG
United Kingdom
Employer's website
https://mbpcc.co.uk/ (Opens in a new tab)