Preparing for the new ‘fit note’

From 6 April 2010 Medical Statements issued by doctors to people when they are ill or injured are changing. Under the existing sick note system, doctors can only advise their patient on whether their health condition means that they should or should not work.

The new scheme aims to achieve an earlier return to work for those who could benefit from support whilst in work by giving employers the opportunity to consider how they could help them.

Under the new fit note system doctors will be able to advise that a person is either:

• Not fit for work - the equivalent of to “refrain from work” on the sick note, or
• May be fit for work taking account of the following advice…

The doctor can then indicate one or more of four common ways to support a return to work:

• A phased return to work
• Altered hours
• Amended duties
• Workplace adaptations

The Statement also has space for the doctor to provide more information on the condition and how it may affect what the patient can do and to state a period or specific dates that the advice covers.

The doctor must also state if they need to assess their patient’s fitness for work again at the end of the Statement period. Where the doctor does not need to see the patient again, in most cases employers should expect an employee to return to work or their usual duties at the end of the Statement period.
 
If the doctor sees the patient again and decides he/she is able to return to work without any functional limitations, the doctor will not issue the employee with a new Statement.

Consideration of the advice on the fit note is likely to be helped by discussion by the employer with the employee and consideration of whether a revised workplace risk assessment is required. However it is important to note that an employer does not have to accept the advice on the medical statement, but if they do not do so then the statement is treated as though the doctor has advised “not fit for work”.

The TUC has commented that:

'If employers use the additional information on the revised medical certificate to work with individuals who want to get back to work, and give them the support they need, this could help reduce sickness absence. But if employers see the changes as a green light to force workers back to work before they are well enough to return, in the long run, it will only lead to increased sickness absence and unnecessary conflict.'

Some other points to note are:

• GPs will complete and store fit notes electronically, although they will still be given directly to the worker to send to the employer.
• If the employee is disabled and covered by the DDA then the new procedures do not alter the duty on the employer to make adequate adjustments regardless of what a GP recommends.
• Responsibilities to pay SSP have not changed.

Links

The guide produced by the Department for Work and Pensions in partnership with the CIPD, the CBI, the FSB, Acas, the Association of British Insurers and EEF.
http://www.dwp.gov.uk/docs/fitnote-employer-guide.pdfe

The DWP guide includes a sample of the new form and one can also be found at:
http://www.dwp.gov.uk/docs/med3-fitnote-sample.pdf

The TUC has produced guidance for union representatives
http://www.tuc.org.uk/extras/fitnote.pdf