Fit Notes

The new 'sick notes': fit for purpose?

26th March 2010

FAQ's

My employer has recently mentioned that 'sick notes' are being abolished and that they are going to be replaced by 'fit notes’. What are fit notes and how will they affect the way people take sick leave?

From 6 April, fit notes will replace the current medical statement that is used by GPs to sign people off work. The fit note will give a doctor three options, the third of which is new. Those options will indicate if a patient is:

• fit for work;

• not fit for work;

• may be fit for some work.

If the doctor indicates that the patient may be fit for some work, they can then elaborate by indicating that employees may, with their employer's agreement, benefit from:

• a phased return to work;

• altered hours;

• amended duties;

• workplace adaptations.

Why are the changes being introduced?

There are a number of reasons behind the changes. Inevitably there has been some influence from employers' groups which are eager to drive down sickness absence rates without much concern for the welfare of workers.

However, there has also been genuine concern for some time that workers who are signed off work for long periods actually prolong their illness or injury because they feel unable to do any work.

In that respect, these reforms could have a positive impact for some workers, but only if the new form is responsibly implemented.

The regulations introducing the fit note make clear that the criteria for the assessment should be the medical outcome for the individual patient – not getting the person back to work. It is only through vigilance at branch level that abuse of the system can be avoided.

What should members and branches do to prepare for the introduction of fit notes?

Branches should make sure that members are informed about the changes being introduced. And it's important to support members coming back to work as a result of the new system.

What are the potential problems with fit notes that we should be looking out for?

Doctors will not always have the knowledge required to make an informed decision about how much work their patient is able to do. The physical and emotional demands of a job vary widely between different workplaces and different roles.

Unless there is significant consultation between the GP, the patient and their employer, there is a danger that patients will be forced to carry out work that inhibits their recovery. This is particularly true of cases where the work itself is the source of the illness, injury or physical strain.

It is also crucial to check that irresponsible employers do not use the introduction of the new system to discriminate against disabled workers or those with long-term health conditions. To guard against this, employers should have policies and procedures in place that promote access to work and explicitly prohibit discrimination.

The requirements of the fit note system should also be used as a reminder to employers of their responsibilities under the Disability Discrimination Act to make reasonable adjustments that provide access to work for disabled people.

If you need any further information, please e-mail mailto:bsg@unison.co.uk