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Jill Miller

The Chartered Institute of Personnel and Development

Research Adviser

Read more about Jill Miller

Talking Point: Is the fit note fit-for-purpose?

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The fit note was introduced in April 2010 and replaced the ‘all or nothing’ classification of the traditional sick note, under which people were either ‘fit’ or ‘unfit’ for work.

Based on the premise that you don’t need to be totally ‘fit’ to do some kinds of activities, establishing a third option of ‘may be fit for work’ meant that it became possible for people to make a supported or phased return.
 
But recent research from our annual Absence Management survey, produced in partnership with private health insurer, Simplyhealth, indicated that the new system appeared to have generated benefits and challenges of its own.
 
On the positive side, 52% of employers believe that it is a good means of prompting managers to discuss absence and health issues with employees. On the downside, however, it appears that the fit note is yet to have a positive effect on absence levels.
 
But supporting employees back into work after they have been away has benefits for both employers and the individual concerned. Evidence shows that work is generally good for people’s heath and can help aid rehabilitation and recovery.
 
Helping employees to stay in work also lowers absence costs for employers and enables them to retain individuals’ key skills. But for this to take place, it is essential that good quality conversations take place between staff and managers in order to understand any adjustments that may be necessary in order to ease their return.
 
Phased return
 
The aim of the fit note, after all, is not to push people back into work before they are ready. It is instead about removing barriers in order to make the process a straightforward one.
 
As a result, HR and occupational health professionals have an important role to play throughout the process in terms of developing line managers’ capabilities and providing them with the tools and support required to effectively manage absence and promote employee wellbeing.
 
Another significant role is to demonstrate how a phased return to work can be positive for an individual’s health – as well as for the business –and to work with managers to make necessary workplace adjustments, if appropriate.
 
But the survey findings suggest that, to date, the full benefits of the fit note system have simply not been realised. For example, only just over one in 10 employers say that its introduction has reduced absence in their organisation.
 
This statistic is perhaps not surprising given the culture change required, however – a change that could result in it taking another five years or so before fit notes are employed effectively.
 
But one of the advantages of the system today is that, rather than simply provide a blunt choice between an individual either going back to work or not, it encourages GPs, employers and employees to consider whether a return is possible under certain conditions.
 
Such phased returns are, in turn, considered to be an integral part of an employee’s rehabilitation. Nonetheless, only just under a third of employers currently believe that fit notes have helped line managers to go down this route.
 
Making adjustments
 
In order to make the promise a reality, therefore, HR and occupational health professionals have to ensure that line managers make the most of their discussions with staff.
 
They also need to provide managers with appropriate guidance and support as many are simply unsure about what they are and are not allowed to do when managing absence, especially when dealing with complex issues such as stress and mental health.
 
Another consideration is ensuring that individuals with people management responsibilities have the skills and confidence required to manage the situation effectively and understand how staff can best be supported, where possible, in line with GP fit note guidance.
 
When considering whether it is time for individuals to return to work, employers should, for example, evaluate whether they need to make suitable workplace adjustments, when and if this is appropriate.
 
Such adjustments could include reduced hours, travelling outside of rush hour times or role amendments. For instance, an employee who has been off sick due to stress may be able to return if some aspects of their role are tweaked.
 
Making adjustments to the work environment itself may also be helpful and could include actions such as assigning a parking space directly outside the building to someone who has recently had surgery and requires time off for check-ups and further treatment.
 
Prevention better than cure
 
To ensure that everything runs smoothly, however, line managers will need to be well-informed about the organisation’s absence management and wellbeing policies. They should also be made aware of the support available to employees and what resources can be accessed by them too.
 
Good absence management is the same as good people management and, as the ‘eyes and ears’ of the organisation, line managers are well-placed to spot early warning signs of any problems among their team members.
 
This means that they should be encouraged to hold regular conversations with staff to put them in a better position to take early action if required rather than try to start a dialogue when a problem has made itself felt. Equally significant, however, is creating an open and supportive culture to ensure that people feel comfortable enough to raise any concerns that they might have.
 
Our research shows that employers can still do more to manage absence in a more effective manner, however. Taking targeted action in ‘hotspots’ across the organisation means that timely initiatives can be introduced in order to address any problem areas early on, for example.
 
But strong, attendance-focused leadership is also essential to send a clear message that employees with health problems will be supported so that they can remain in or return to work.
 
Because prevention is better than cure, however, it makes sense to focus on promoting well-being – an investment that our research amply demonstrates will be worthwhile. In fact, those organisations that took the time to evaluate the impact of their well-being expenditure last year were twice as likely to increase it this year, in effect, creating a virtuous circle for everyone concerned.
 
 
Jill Miller is a research adviser at professional HR association, the Chartered Institute of Personnel and Development.
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Jill Miller

Research Adviser

Read more from Jill Miller
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