Job summary
Lancashire and South Cumbria Integrated Care Board (ICB) has been selected to take part in one of four national Fit Note Reform Pilots commissioned by the Department for Work and Pensions, testing a new approach that aims to improve support for people whose health affects their ability to work. The pilot addresses a recognised challenge in the current system, where fit notes often focus on certifying sickness absence rather than providing practical support to help people remain in work or return to work safely.

The Occupational Health Nurse is one of the senior clinical assessment resources within the Enable team. Working from home, the post holder will undertake work and health assessments by telephone and video for patients referred into the pilot, form an occupational health judgement about functional capacity and fitness for work, and produce Workability Plans that are clinically defensible, practical for employers and genuinely useful to the patient.

This is a test-and-learn service. The post holder is expected not only to deliver assessments, but to help shape the clinical model itself contributing to protocol development, escalation criteria, triage rules and the evaluation evidence that will inform national policy.

Main duties of the job

• Undertake structured work and health assessments with patients referred into the pilot by telephone or video, according to patient need and clinical appropriateness. Where a face-to-face assessment is clinically necessary, arrange this through agreed pathways.
• At the start of each remote consultation, confirm the patient's identity, location and a contact number.
• Assess the interaction between a person's health condition, their functional ability and the demands of their role, taking account of all appropriate physical, psychological, social and workplace factors.
• Formulate and co-produce personalised Workability Plans focused on functional capability, phased return, adjustments and the practical support required to sustain work.
• Exercise autonomous professional judgement in determining whether a period away from work is clinically appropriate, and articulate that judgement clearly, proportionately and defensibly.
• Provide specialist advice on reasonable adjustments, graduated return to work, workplace modification and phased hours, informed by an understanding of the Equality Act 2010 and relevant health and safety legislation.
• Review and update Workability Plans at agreed intervals, adjusting recommendations as recovery, circumstances or employer response change.
• Recognise the limits of the pilot service and of personal professional competence, and escalate promptly and appropriately.

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.

Details
Pay scheme: Other
Salary: £41,590 a year
Contract: Fixed term, 12 months
Working pattern: Full-time
Reference number: B0160-26-0032
Closing date: 18 November 2026

Job responsibilities
Main duties include clinical assessment and workability planning, triage, caseload and pathway management, employer and stakeholder liaison, clinical governance, safety and record keeping, service design, data and evaluation, and education and professional development, as set out in the full advert.

Working arrangements
This is a fixed-term post funded through the national pilot. Continuation beyond the pilot period cannot be guaranteed. This is a home-based post subject to MBPCC's Homeworking, Hybrid Working and Remote Learning Guidance. The post holder must live in the UK and work from a UK address for the duration of employment, travel to MBPCC head office at the start of employment and for equipment returns, and maintain a suitable, private home working environment with reliable internet access.

Person specification
Essential: Registered Nurse on the NMC register (Part 1 Adult, Mental Health or Learning Disability) or Registered Midwife with current unrestricted registration; significant post-registration experience as an autonomous practitioner; experience of structured clinical assessment and managing a personal caseload; ability to assess functional capacity and relate health conditions to work; excellent verbal and written communication; confident delivering telephone and video consultations; competent use of clinical record systems and Microsoft 365 including Teams; satisfactory DBS check; able to commit to the full 12-month pilot period.
Desirable: Specialist Community Public Health Nurse (Occupational Health) registration or occupational health qualification; knowledge of the Equality Act 2010 and health and safety legislation; familiarity with EMIS; experience in occupational health, fit notes, sickness absence management or primary care; experience of contributing to service design, pilots or audit.

Disclosure and Barring Service check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and requires a submission for Disclosure to the Disclosure and Barring Service to check for any previous criminal convictions.

UK registration
Applicants must have current UK professional registration. For further information please see the NHS Careers website.

For questions about the job, contact: HR Manager, Pam Compston, pamela.compston@nhs.net

Apply through our website.