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Bill McCulloch

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Is your business ‘fit’ for Fit Notes?


With the introduction of the new “fit note” medical statement system on April 6 2010, both employers and employees have a range of a new considerations for all the stages of workplace absence, and it’s far better to proactively prepare to work with the new process than to learn solely by experience.


One of the most fundamental differences is that Doctors will no longer need to see the patient before issuing a note, and in addition, the system no longer merely signs off a person from work. The new note has two categories: “Not fit for work” and “May be fit for work with the following limitations”, and there is then a tick box section for the recommendation of either reduced hours, modified work, workplace adaptations or a phased return or combinations of these adjustments. The general practitioner can then elaborate on their proposed modifications.

The emphasis then falls on the employer, who is duty bound to try to seek work for the individual within the restrictions of the note. If this is not possible, then the individual will remain off sick.  But already there is scope for potential problems as some GPs who are not fully trained or experienced in occupational medicine will be unfamiliar with workplaces and work tasks, so that the advice given has to be interpreted correctly by the patient and the employer. Proper communication is therefore vital.

For instance, there remain some common misconceptions such as patients do not need to be signed back to work (even with the old system they never did, but many employers and patients believed this), so the employer and the individual need to agree a suitable return date and any modification. If no agreement can be reached on modifications then the individual will continue on sickness absence until suitable arrangements to accommodate the condition can be devised or until they no longer need the modifications. They would then return to the doctor (or merely phone the doctor) when the term covered by the note is over to seek renewal. Clearly this has real potential for a case to drift, with an adverse effect on the business, so employers need to be prepared to handle this kind of challenge.

To help with this, many businesses are likely to turn to specialist occupational health advisers or occupational physicians, who will have knowledge of that business or sector. They can be working either in house or as contractors, and will ensure that the return to work plan, such as adjustments, modification and whether a phased return is appropriate, is carefully considered. There are a wide range of potential avenues all parties can consider, including a temporary or permanent redeployment, but the objective is that this kind of considered intervention can allow people to return and contribute to the business at the earliest possible stage, and liability risk for employers can be considerably reduced.

The introduction of this new system also presents an opportunity for businesses to address their strategic approach to dealing with absence for mutual benefit and protection. Ideally, every business should develop a policy on the way they should now handle sickness absence and redeployment in the light of the new ‘fit note’ process to ensure consistency and safe practice, while gaining maximum benefits for themselves and employees. In addition they should also have advice available on medical issues as it is likely they will be asked to modify work more frequently than at present.

It’s tempting to view these changes as an administrative overhead, but the new fit note system not only provides a new framework for dealing with workplace absence, but will also incentivise many organisations to adopt a better approach to the subject as a whole.


Dr Bill McCulloch FRCP FFOM MRCGP Kensington OH Specialists

For further information, visit the relevant section of the DWP website at:, or for help on policies and practices feel free to contact [email protected]


One Response

  1. fit note

     Not sure this. i had 3 months off sick with   Depression. Also i have a problem with my left hand due to an injury i suffered and have worked with for 15 years.My employer refused to have me back to work in March.I am not on the sick nor am i suspended i am sat at home doing nothing but worry  which has done nothing to improve my mental health. My employer a local authority whom i have worked for for 26 years slapped me on the redeployment list (informally in their words) and gave me 12 weeks notice. Occupational health informed me last week i have 2 dissabilitys covered by the DDA that my employer is aware of.They said go and get a fit note you can return to work my reply being how i am not of sick!!!!!


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