'Fit Notes', Not Sick Notes

posted: 29/05/2009

‘Fit Notes’ will replace Sick Notes from spring 2010. This follows Dame Carol Black’s recommendations on the health of people of working age last year, so the government have announced that GP’s will soon be issuing ‘fit notes’ instead of sick notes.

These new ‘fit notes’ will be given out to people from spring next year. In the words of the Department for Work and Pensions press release, they will:

“….enable people to get the best possible advice about staying in work, and if they can't work, what their employer can do to help them return to work sooner. For example, if the employee has a problem with mobility, suggesting a job where they can work sitting down rather than standing up.”

You can have your say - a 12 week consultation on the Fit Note’s design started yesterday and will end in mid August.

The consultation document is called Reforming the Medical Statement

Having Your Say

Comments on any aspect of the draft regulations to:
Shelley Fuller,  Medical Statement Consultation, Department for Work and Pensions,
Health, Work and Well-being Directorate
2nd Floor, Caxton House, Tothill Street, London, SW1H 9DA
020 7449 5586
Email

HIV impact?

The new 'fit notes' are intended to help more people stay in work, rather than drift into long term sickness. This could help people with HIV who are working, by giving people with HIV written medical backing to get the employer to make 'reasonable adjustments' to your working arrangements.

They propose that the doctor should tick boxes next to a short list of basic adjustments. These are

• a phased return to work
• altered hours
• amended duties
• workplace adaptations, and
• the consultation asks whether occupational health assesssments should be added
• we  ask whether there should be a box for the doctor to add any other suggestions.

GP telling employers about HIV is a risk

From a first look at the proposals we have a major concern. The rules (rule 6) and proposed Fit Note itself require doctors to name the condition as precisely as possible that  makes the person fit or unfit for work. This means naming HIV.

There is a special exception rule (rule 9) that allows the doctor to state less precisely the condition in cases where disclosure of the precise condition would influence the patient’s well-being or the patient’s position with their employer.

George House Trust thinks this needs to be made a requirement for GPs and it should spell this out and name HIV as an example in Guidance to GPs and on the Fit Note form itself.

 

Government comments on Fit Notes

Lord Bill McKenzie, Work and Pensions Minister, said:

"Employers tell us that managing sickness absence can be a challenge. This is compounded by a 'sick note' system that makes sickness absence a black and white issue - either you are unfit for work, or you are not. We recognise how important it is to help people who are sick to stay in work or get back to work quickly - the new fit note will help do just that."

Health Minister Ben Bradshaw said:

"We know that sickness absence is economically and socially damaging and makes people more likely to drift into social exclusion and poverty. Getting people back into work quicker is good for their health as well as the country's finances. The fit note will give GPs a new opportunity to benefit their patients and I look forward to it being used in surgeries everywhere."

Developed with the support of healthcare professionals, employer representatives and trade unions, the new 'fit notes' will roll-out across Great Britain in the Spring of 2010.

The new 'fit notes' will be computer-generated in GPs surgeries, replacing the neatly hand-written - or possibly illegibly scrawled - doctor's sick notes.

The full Government response to Dame Carol Black's report.

Employment lawyer's view

Morag Hutchison, at employment law firm Pinsent Masons, said that the new scheme is likely to benefit both employers and their staff. 

“The current system causes problems for employers because there is no consideration of whether the employee is fit to perform some duties of their role even if they are unable to perform all the duties of their role,” she said. “If GPs are asked to give an indication of what an employee can do, that will enable the employer to consider whether their role can be adapted so they can return to work sooner than might otherwise by the case.”

Hutchison said that employees who are signed-off work can become detached from the workplace, particularly in cases of stress, making it harder for them to return to work.

“If a GP gives an indication of the tasks the employee could perform, that would help the employer to get them back to work sooner and is more likely to result in a positive outcome for both the employer and the employee,” she said.

The current system can cause problems for employees too, according to Hutchison.

“The issue of redundancy selection criteria is of particular relevance in the current climate,” she said. “Employers often use absence records as a selection criteria for redundancy. Under the proposed system an employee's absence record is likely to be reduced as they may be able to attend for work albeit it to perform a reduced role.”

Many employees are not entitled to any sick pay over and above their statutory sick pay entitlement which can result in them losing a significant proportion of their income if they are off sick. “Again, under the new system, there may be occasions when they are able to attend for work to carry out a reduced role whereas under the current system they would just have been signed off,” said Hutchison.

GPs are expected to have to spend more time with individuals to establish what parts of their job they are fit to perform, but Hutchison expects employers and employees to welcome the plans.

“The introduction of ‘fit notes’ would, on the face of it, appear to be a positive move for both employers and employees,” she said.

Reforming the Medical Statement consultation

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