New ‘fit note’ guidance

In April 2010, sick notes were replaced with ‘fit notes’ which contain the option for a GP to state that an employee ‘may be fit’ for work subject to ‘reasonable adjustments’ being made, which the GP can then go on to recommend.

Until recently, there had been little guidance on how to deal with situations such as this. Following a period of consultation, the Department for Work and Pensions published new guidance on fit notes in March 2013 (available on the DWP website).

The Guidance is aimed at employers, employees and GPs and its tone is positive; the underlying message seems to be that a return to work (whether a phased return etc) is always the desired outcome and GPs should always be looking to encourage the patient towards work where possible.

The key points to note from the Guidance are:

  • GPS are encouraged to focus on giving ‘functional’ information i.e. assessing what the patient can and cannot do, rather than giving information about symptoms etc.
  • After concerns raised in the consultation period about ‘medicalised’ workplace disputes (for example the link between workplace stress and disciplinary/ grievance procedures) the Guidance aimed at GPs suggests fitness for work should be considered in light of actual health conditions and if an employee does not suffer from a health condition (or in the case of work related stress a ‘mental illness’) preventing them from working then they should not be issued with a fit note.
  • It is acknowledged that GPs are not specialist occupational health advisors and so the recommendations in a fit note are not binding on an employer. The employer is free to evaluate whether they can accommodate any suggested adjustments (although they should be confident that they can justify the decision made if necessary). It is also useful to know that if after careful consideration an employer feels they cannot accommodate the suggested adjustment(s), the employee can be treated as though the fit note has stated that they are ‘not fit to work’.
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