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The fit note

Posted on from AXA ICAS

The fit note has replaced all previous medical certification from 6 April 2010, 18 months after the initial decision to change the sick note. Here are the need to know facts...

The transformation

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

This could mean employers would be able to get employers returning to work early with adjustments to the employees working conditions.

While doctors can continue to certify patients as unfit, there is also a second 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 adoptions to the workplace to accommodate the employee.

Employers should have already put new practices in place to deal with the changes, which may result in a high number of calls from line managers to their HR departments until the fit note is fully understood.

Employer preparations

New practices and 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 for the first few months after it is bought in.

• 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 has raised a number of potential issues in relation to sick pay and absence management. 

Examples include:

o Should sick pay be extended if the company cannot accommodate transitional working?
o Should reduced hours be paid pro rata and from what period?
o Will any part-time working be counted towards absence targets?
o 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

Healthy fit note

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.

Throughout the Government consultation and implementation process there has been a significant lack of publicity attached to the introduction of the fit note and little guidance for employers on the adoption for UK businesses. This has left both employers and employees confused about their rights and obligations with the new fit note. Over the next few months it is imperative that GPs are also able to give as much advice to employers when it comes to an employee returning to work.

The fit note is certainly 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 self-esteem.

Fit notes are good news for employers and employees alike; they are a big advance on the old situation where employees reluctant to return to work will waive their sick note often issued for longer than is really necessary.

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

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