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Employers’ Guide to “Fit Notes” and Sickness Absence

05 May 2010

A new ‘fit note’ was introduced in April. It replaces the traditional sick note and aims to introduce a new ‘can do’ attitude towards medical statements.

The forms are designed to be completed electronically and ask the GP to tick one of two boxes:

(a) You are not fit for work (b) You may be fit to work taking account of the following advice

The second option allows the GP to suggest changes that might enable the employee to return to work. This might mean discussing:

  •                    a phased return to work
  •                    altered hours
  •                    amended duties
  •                    workplace adaptations

The GP will also provide general details of the functional effect of the individual’s condition.

While you don’t have to act on the GP’s advice in a ‘may be fit for work’ statement, it may help you make simple and practical adjustments to help your employee return to work and reduce unnecessary sickness absence.

This means that, for example, employees who suffer with a bad back – one of the biggest causes of sickness absence – may still be able to work so long as they avoid bending and lifting while they recover.

If the fit note says that the employee ‘may be fit for work’ but you and the employee both agree that he or she should remain off work, then Statutory Sick Pay remains payable.

It had been proposed that doctors would be able to state that an employee was ‘fit for work’, but this was abandoned in acknowledgement that it is not the doctor but the employer, in consultation with the employee, who is best placed to decide whether changes can be made. An employer can assume therefore that if an employee does not produce a ‘fit note’, they are fit to work, unless the employee tells you otherwise.

The new fit note system aims to reduce the number of working days lost to sickness, which currently stands at a staggering 172 million days a year. It could also be used to help those with long-term illnesses enter into employment, and to help reduce the number of people who claim incapacity benefit.

But, there is widespread concern that the new system will lead to a fundamental shift in GPs’ responsibilities, as they will be expected to take on the role of occupational health adviser, rather than to act as the patient’s advocate. It remains to be seen whether doctors will tend to use the new fit note as intended, or stick with the ‘not fit for work’ option that they are used to.

Some believe that the change will lead to disputes based on how the employer responds to the advice given by the GP in the fit note, particularly where the suggested changes might be costly or difficult to manage. Where an employee is disabled, there may also be disputes about whether the employer has complied with its duty to make reasonable adjustments under the current Disability Discrimination laws when implementing the GP’s fit note advice.

Our advice to employers is to seek advice early on how to deal with these changes, to check whether employment contracts and policies will need updating, and to consult with staff who may be affected immediately by the new note. We would advise any employer to consider obtaining a full medical report from a GP or specialist and to carry out a risk assessment when an employee returns to work from long-term sickness.


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