Employers and GPs advised on Fit Note

Feb 24, 2010

The Government has published guidance for employers and doctors outlining how the new fit note system will work.

From 6 April, GPs will be required to issue patients with statements advising that they are either ‘not fit for work’ or ‘may be fit for some work’. Doctors will also have the option to suggest that the patient would be able to work if, subject to the employer’s agreement, temporary changes to their work conditions could be made.

The advice for employers explains the options and the new form line by line. It includes a flow chart describing what to do with a ‘may be fit for work’ statement, and contains case studies, an FAQ section, and a comprehensive list of where more information and support can be obtained.

GPs will be able to include comments on how the employee’s condition will affect what they do, and they can suggest common ways to facilitate a return to work. These include a phased return to work, altered hours, amended duties, and/or workplace adaptations, all of which are explained in the guidance.

The guidance for GPs states that they do not need specialist expertise in occupational health, or a detailed understanding of the patient’s job, to complete the form. They are also encouraged to discuss the health benefits of work with the patient, as well as the adverse effects of not working on health, and how to overcome obstacles to returning to work. Based on their discussion with the patient, they can recommend on the form that an OH assessment be considered.

The DWP guidance is clear that if it is not possible for the employer to provide the support suggested, she/he and the employee should use the statement as if the doctor had advised ‘not fit for work’. Similarly, if the doctor advises that the employee may be fit for work but he or she remains off because the employer cannot provide the necessary support, or make the recommended adaptations, the advice should be considered the same as ‘not fit for work’.

Employers who feel that someone is fit for work even though a GP says they only ‘may be’, or those who simply want to be sure that their employee is fully ready to return to the workplace, can enter into a private arrangement with a GP or occupational-health specialist for a ‘second opinion’. The same advice applies if the employer offers support, or adaptations that the employee does not feel are adequate.

The DWP is also reminding small and medium-sized businesses that the occupational health advice line will be providing help on the new system and will be rolled out nationwide from 1 April.