Fit notes are just not working for anyone. That is why we are launching pilots in four NHS areas – in order to fix a broken system and keep people connected to their careers from day one of sickness, says Pat McFadden.
The Problem with Fit Notes
None of us know what is around the corner. Whether we will fall ill, how serious it might be, or how long recovery might take. That uncertainty is one of life's constants, but what should be certain is the support you receive when the worst happens. Right now, that support simply is not good enough. More than 11 million fit notes are issued every year in England, and 93 per cent of them say the same thing – unfit for work. No guidance, no plan, no route back to employment. Just a form that writes people off and leaves them unsure of their next steps and often disconnected from their workplace.
Of the fit notes with a recorded condition, just over a third are for mental and behavioural disorders, and under a fifth for musculoskeletal conditions. But where there should be treatment and a plan, for too many, fit notes are a dead end.
GP Perspectives
We have heard GPs say they feel under pressure to issue them, and have little time to go into detail of what the patient needs. It is taking their valuable clinical time – and it is not helping anyone: employers, patients or doctors. As Sir Charlie Mayfield, who carried out the government’s review into economic inactivity, said: fit notes are not working as intended.
A New Approach
This is a huge problem and we have to face up to it. I want to try a different approach, and that is why we are launching pilots in four NHS areas, which we will test continuously to work out the best way forward. Covering up to 100,000 appointments, one tick box form will be replaced with personalised “stay in work” and “return to work” plans, shaped by patients, employers, and healthcare professionals. These will focus on practical solutions and treatment, reasonable adjustments and keeping people connected to their workplace from day one of absence.
Some will have the GP issue the first fit note and refer the patient onto our expanded Workwell service. Others will see the whole process moved out of the doctors’ surgery. The evidence from these pilots will shape future legislation, to radically reform this broken system and get the economy firing on all cylinders.
