The Impact of the Fit Note

The Fit Note in practice 

Despite changes coming into effect 6 years ago, many employers still struggle to understand the implication of the changes and what they can or can’t do when an employee sends in a ‘fit note’. The fit note is the informal name for the ‘statement of fitness to work’, which replaced what was commonly known as the ‘sick note’ (medical statement) on 6 April 2010.

The main change is that a GP can advise you, the employer to help the employee to return to work (though the fit note is issued to the employee and not you). The fit note allows GPs to identify one of two options and specify a time period (i.e. a week/month, or until a specific date):

• Not fit for work.
• May be fit for work.

It also includes space for a GP to give some general advice about the impact of the employee’s illness or injury, and tick boxes for a GP to suggest, where appropriate, more common ways in which an employer could support or help their employee return to work. If an employee is off work due to ill health or injury for more than seven calendar days (i.e. including weekends, bank holidays and normal days off) you will normally ask them for a fit note from their GP as evidence that they are actually unwell. This enables appropriate sick pay (company sick pay or Statutory Sick Pay (SSP) to be arranged and enables you to arrange appropriate cover for the period of absence that has been indicated by the doctor. Should the employee recover from their illness or injury more quickly than expected, they can return to work and resume their normal duties before the end date on the fit note so long as you are in agreement with their decision to return to work. If the employee is not yet fully fit but they feel they could resume some level of work, they can return so long as you are able to support them with an alternative/reduced role. When an employee’s GP indicates that they ‘may be fit for work’, the GP can give general advice on the fit note about how you could support the employee to enable them to return, for example:

• returning to work gradually by starting with part-time hours;
• working different hours on a temporary basis;
• performing different duties and tasks; 
• avoiding certain tasks that may aggravate a health condition.

Employers must discuss these options with their employee to establish what might be possible, and the employee should be completely up-front with you about what they can realistically manage in order that appropriate support can be offered. 

What are you/your employee’s responsibilities? 

The fit note gives the employer the ability to discuss with their employee, whether they can return to work despite their illness or injury. Aspects to consider include: 

• temporary changes to working hours;
• temporary changes to tasks;
• exclusion from specific tasks for a period of time.

Any adjustments to the employee’s job role, working hours, etc. need to be agreed before they can return to work. If the employee’s GP has suggested that they ‘may be fit for work’ but you cannot make the necessary adjustments, you should explain the reasons for this to the employee as clearly as possible. Whilst a GP may make this assumption, they may have little or no understanding of the employee’s role or their working environment.

If you are unable to accommodate the required adjustments, the employee will not need to see their GP again for another statement. The employee will remain on sick leave until they either feel able to return without the adjustments, or until the date they were able to return without adjustments arrives, or something happens to change the fact that you were previously unable to accommodate their required adjustments. The employee will not need to be ‘signed back to work’ by their GP. The employee can return to work at the end of the statement (or before the end of it) although there may be specific procedures to follow in some cases to ensure that they are fit to carry out particular job roles safely. 

Backdated Fit notes

It is not uncommon for an employee to tell you that they have an appointment to see their GP in a few days’ time, after which the employer receives a fit note which covers the period of absence prior to the date when you know the employee saw the GP. This is not an indication of anything untoward, the GP issuing the fit note will know that it can often take an employee in certain areas of the country and at certain busy times of year 3 or 4 days to get an appointment.

Sending an employee back to the GP for a note to say they are fit to return

The fit note does not provide the space or any requirement for a GP to sign an employee back to work as fit. If the GP feels they need to assess the employee again, at the end of their current certified period of absence the GP will indicate this on the fit note. If there is nothing on the note to suggest a reassessment, the employer can be confident that the GP is satisfied that the employee will be able to return on that date, or maybe earlier.

If an employee contacts their GP to say that they need a fit-for-work note the practise will turn them away, explaining that this is not a service the NHS offers and that they will not be able to arrange this. The fit note form ‘statement of fitness to work’ only allows for two options, the employee is fit to return with adjustment or that the employee is unfit to return. 

In summary, employers need only to follow the orders and information on fit-note forms prepared by an employee’s GP. Employers do not need (and are not able to request) a ‘fit-for-work note’ and only need to follow the information on the fit note, or the employees own opinion on whether they are well enough to return to work and perform their duties. If an employee has a concern that an employee that has returned to work is still not well or able enough to perform their duties, and poses a risk to health and safety in the workplace, the employer is still obliged to take reasonable action and intervene.