Employment issues: Fit note designed to encourage absent employees back to work

Dr Mark Simpson, Medical Director at AXA ICAS (International EAP specialists with offices throughout the UK and Europe – www.axa-icas.com 0800 17 0800) reports on the fit note coming into force in April

 The system of doctors giving workers a sick note if they are ill has not changed since the NHS was created in 1948. Reform is therefore long overdue. The present system is open to abuse and more importantly tends to medicalise quasi health issues and perpetuate disability.

In November 2008 the government confirmed, after a raft of consultations, that there should be a shift from the sick note to the fit note. The fit note will therefore replace all previous medical certification as from 6 April 2010.

The new fit note has one simple aim – to align the thinking of GPs and employers so that both parties can encourage an absent employee’s early return to work even when the employee is not ‘fully fit’. The note will encourage doctors to offer simple, practical advice to employers about basic workplace adjustments that could help patients make an earlier return to work.

Whilst doctors can continue to certificate patients as fit or unfit, there is now a third category “you may be fit for some work”.  This gives the option for doctors to advise employers on the level of work an employee can undertake, whether this is altered working hours, amended duties or adaptations to the workplace to accommodate the employee.

Employers must start preparing for these changes if they are going to be ready for the transformation in April, which may result in a high number of calls from line managers to their HR departments until the fit note is fully understood.

Preparations should include:

• Giving line managers and HR departments a full brief on the introduction of the fit note and the opportunity to ask questions before the event
• Provide training for staff for accommodating employees who are returning to work
• Review company sick pay and attendance management policy: The introduction of the fit note raises a number of potential issues in relation to sick pay and absence management.Examples include: •Should sick pay be extended if the company cannot accommodate transitional working?
  • Should reduced hours be paid pro rata and from what period?
  • Will any part-time working be counted towards absence targets?
  • What will happen if the transitional working leads to any deterioration in the  condition?  Who will bear responsibility and potentially liability – the employer or the GP or both?

* Plan any additional support services that may be needed in order to accommodate the new fit note. This may be via an external company that can provide telephone advice to line managers and employees about the fit note and employees

* Improve return to work (RTW) interviewing: Effective RTW interviews achieve two main aims – improving the chances of successful RTW and reducing the risks of recurrence.  If they are handled sympathetically and objectively, they will increase employee engagement and reduce absence.

There has been a significant lack of publicity attached to the introduction of the fit note and therefore there is a danger that employers and employees will not be prepared for the introduction in April.

The fit note is a positive step for the UK to move away from the outdated concept that an employee is fully fit or completely unfit for work, and instead there are other options for employees either to have staged return or to amend their duties in the workplace. In the face of a demographic time bomb it is simply unaffordable for the UK to allow 350,000 people a year to transition to long-term sickness absence with virtually no prospect of a return to useful employment and associated potential loss of self esteem.

Fit notes will be good news for employers and employees alike: They are a big advance on the current situation where employees reluctant to return to work might use the full recovery period included in the sick note even if they are well enough to return to work.

So goodbye and good riddance to the sick note and a hearty welcome to its successor, even if it does come as a big surprise to many employers. 

Are you ready for the fit note? Do you agree with Dr Simpson that it is long overdue?

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