GPs will be asked to stop sick notes that sign people off work and instead refer them to job coaches or the gym, under a new government pilot scheme.
The scheme, being trialled in 15 regions, will see GP surgeries given funding to provide specialist support to patients alongside sick notes, rather than simply signing them off.
Last year, the NHS issued more than 11 million “fit notes” – up from 5.3 million in 2015 – with the vast majority not providing any alternative route to keep them active or prepare patients for work.
The pilot will arrange for doctors to work with employment coaches who can help patients with writing CVs and cover letters. Gym memberships and gardening classes may also be “prescribed”. Patients will also be connected with charities helping with issues such as debt management and housing.
Health secretary Wes Streeting said: “Some 2.8 million people are out of work due to health conditions – this is bad for patients, bad for the NHS, and bad for the economy. The sick society we inherited costs taxpayers eye-watering sums – we simply can’t afford to keep writing people off.”
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Issuing 11 million fit notes a year was not healthcare, it was a “bureaucratic dead end”.
Streeting said occupational therapists, work coaches and “social prescribers” would be brought in to “actually help people navigate back into employment while managing their health conditions.”
The most common reasons for long-term sickness absence were mental health conditions such as anxiety and depression, and musculoskeletal disorders such as back pain and injuries.
The pilot – which ministers hope to expand nationally – also aims to free up GP time by allowing other NHS staff, such as physios and occupational therapists, to issue fit notes and provide more work and health advice. It will operate under the WorkWell scheme that originated in the final year of the Conservative government and dovetail with the Restart scheme launched in 2020. It will run in 15 regions of England with high levels of unemployment and sickness, including Birmingham, Manchester, Lancashire and Leicester.
Employees can self-certify absence due to illness for seven days, but if their illness means they need to be absent for longer, they need a fit note to continue to receive sick pay.
NHS leaders have warned that the crisis of inactivity is “perpetuating” mental health problems, and that helping people find work should be a vital “part of the treatment plan”.
Claire Murdoch, the NHS national mental health director, recently told The Times: “As the NHS, we want to help people find work or keep work. The NHS can, should and does think of itself as a contributor to economic growth.”
Nearly 11 million working-age adults in the UK are not employed. This includes a record 2.8 million signed off with long-term sickness, half of whom have depression or anxiety.
The figures include 923,000 young people not in education, employment or training (Neet) in the UK, a number that showed a slight decline from the 930,000 recorded at the equivalent time last year.
Legal comment
Owen Dear, partner, Crossland Employment Solicitors, said the idea was good in theory but it may run in to practical problems when it came to implementing it.
He said: “Any proposal to promote engagement between employees who are unable to work due to ill health and their employer should be welcomed, and the Government’s proposals are a good step in that direction. In theory, at least, with the assistance of trained professionals facilitating that engagement and the employees to take pro-active steps to help their return to work, it could help to reduce the amount of time that any employee is off sick, receiving sick pay, and unable to do the work that their employers need them to do.
“But the system will work best if it still recognises that employers are the ones best placed to evaluate what steps they can and cannot take to help an employee back to work. Health coaches and occupational therapists might not know the full detail of the business where the employee works and may make a recommendation to help the employee in good faith. However, if an employer genuinely cannot facilitate those recommendations, it should not create a situation where the employee refuses to engage or return to work until the employer has put in place whatever the fit note recommends, even if that is not possible for the employer.”
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