Employment Issues: Fit Note needs more time

It is now over three months since the fit note was launched on a wave of publicity, writes Dr Mark Simpson, medical director at AXA ICAS, the International EAP specialists.

 
Although it is still early days, has it had an impact in helping employees to return to work earlier?  This is probably an unfair question.  Whilst doctors undoubtedly sign sick notes, it is a common myth that they actually adjudicate on fitness for work.  So who does? 

Actually, it is the employee, or ‘patient’ in the parlance of the General Medical Council. Therefore, with such deeply ingrained behaviours, it was highly unlikely that the introduction of the fit note would lead to an immediate shift in sickness absence behaviours and attendance certification. Also, the previous process of getting a sick note has been around since 1923, and therefore change is not going to happen overnight.

So what has happened in the past three months following the fit note’s introduction? It is probably fair but disappointing to say that the experience has been somewhat underwhelming. Those organisations that had geared up for it have had little to do to maximise the opportunities offered by this fundamental change in viewing fitness for work.

Feedback from employers

The Royal Mail has recently published early feedback on its experience.  As a large, public sector employer, the Royal Mail prepared its managers to work effectively with the new certification process. 
In the first month of the fit note, 3962 certificates were issued to Royal Mail employees.  However, only 35 (less than 1%) were completed as “may be fit” by doctors.

 In 15 of these no work modifications were required to achieve an early return to work.  In 19, changes to work options facilitated an early return and only one employee of the 35 remained on sickness absence.  Therefore, where the “may be fit” option is used, the chances of a successful return to work are very good.  However, it appears that GPs – and/or their patients – are reluctant to exercise this option.

Feedback from our own customers has echoed this experience. Whilst there has been an encouraging volume of traffic through our fit note portal, there have been few calls to our fit note advice line.  However, the positives from this are an increase in overall awareness of managing sickness absence and the critical impact of the line manager’s role in this. 

Employer flexibility

The introduction of the fit note has raised a number of potential issues in relation to sick pay and absence management.  But how flexible do employers need to be to accommodate staged returns to work?

Accommodating the fit note needn’t be costly or overly time consuming, although some firms such as the Royal Mail have strived to make the transition as smooth as possible, small businesses do not need to go to such lengths.
Employers should look at what suggestions have been made on the fit note on individual cases. In some instances it may not be viable to make the changes but in others it may simply mean introducing new working practices or flexible working for a certain employee.

The new way of dealing with staff absence and sickness may be alien to us now but adapting working practices to accommodate staff back into the workplace sooner will become the norm.

The future of the fit note

So what is the longer-term future of the fit note?  In view of the historic trends and behaviours influencing sickness absence it should come as no surprise that the Fit Note’s impact has been low-key to date. There is a positive aspect of it beginning to help both the GPs’ awareness of fitness for work and opening a dialogue with their patients about their jobs.  It is likely that further training for GPs will be needed to continue this process.  A further positive is that both employers and employees have started to move away from the mindset that you are either wholly fit or totally unfit for work.  This has been a long overdue overhaul of an antiquated certification system and resultant change should be reviewed in years rather than months.  It will be interesting to see if the government adopts a strategy of carrots and sticks for stakeholders to help accelerate this change.

Article featured in the September issue of Professional Manager

AXA ICAS has offices throughout the UK and Europe – www.axa.icas.com 0800 17 0800

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