The government is set to overhaul the 'fit note' system, which currently sees a vast majority of patients signed off work. Pilots will be launched to move away from a 'tick box exercise' and provide personalised support to help people stay in or return to employment.
Current System
Under existing rules, healthcare staff issue official medical statements, enabling access to sick pay and benefits. Around 11 million fit notes are issued annually in England, with over 90% confirming the person is unfit for work.
New Pilots
Four pilots covering up to 100,000 appointments will run for up to a year. Patients may be referred to community health workers after an initial fit note, or supported by a separate service without a note. The support includes dialogue between patients, employers, and health professionals on reasonable adjustments and workplace connections.
Government View
Work and Pensions Secretary Pat McFadden said: 'Fit notes are too often a dead end – a piece of paper that tells people they can’t work but does nothing to help them get better. We’re changing that.' He added that bringing employers, the NHS, and patients together can help people recover faster and stay connected to their jobs.
Background
A government review found 8.7 million people in the UK have a work-limiting health condition, up 2.5 million in a decade. The pilots will be in Birmingham and Solihull, Coventry and Warwickshire, Cornwall and the Isles of Scilly, and Lancashire and South Cumbria.
Expert Opinion
Gill McAteer, Director of Employment Law at Citation, said: 'Although the trials are expected to last for a year, there are clear indications that this is the direction of travel.' She noted that over 50% of work-related sickness absences relate to stress, depression, and anxiety. 'Poor employee wellbeing impacts sickness absence rates, retention, engagement, productivity, and performance levels.'
McAteer added that small businesses often struggle to access occupational health services, so this new direction could be beneficial. However, some employers may be concerned about unrealistic expectations from non-clinical support.
