Fit note to launch in April 2010

The ‘fit note’ is set to replace the existing Med 3 ‘sick note’ on 6 April, and the government issued advice to GPs on how to implement it in February.

The fit note differs from its predecessor the Med 3 as it allows GPs to suggest a return to work with adjustments through the introduction of a new option: “May be fit for work taking account of the following advice”.

Formally known as the Statement of Fitness for Work, it is designed to encourage GPs to advise on the functional limitations of the patient’s condition and suggest simple things that might help them return to work.

Early feedback from occupational health (OH) and HR practitioners shows confusion about the legality, practicality and aims of the document.

The government’s response to a consultation on the fit note, published in January, clarifies that employers will be responsible for deciding whether it is possible to make the adjustments needed to allow an absent employee to return to work.

However, some OH nurse advisers are sceptical about the willingness of GPs to change their practice. Catherine Keyes, OH manager (safety, health and environment) at BAE Systems, writes in this issue: “The [government’s] response states that “doctors completing the medical statements do not have the knowledge or expertise about an individual’s job role and the risks involved’ to enable them to make this judgement. So how can GPs make the judgements ‘unfit for work’ or ‘may be fit for some work’?”

But Dr Mark Simpson, medical director of Axa Icas Wellbeing is confident that GPs will embrace the new approach. “By and large absence certification is more the employee’s view of their fitness to return for work than the GP’s view, and very rarely will a GP say to an employee who wants to go back to work that you shouldn’t do so,” he said.

OH practitioners are disappointed that the government decided against including a tick box allowing GPs to refer patients to an OH specialist.

Dr Paul Nicholson, associate medical director of Procter & Gamble UK, said the decision against the OH referral option is a “potential missed opportunity”.

“It would have raised awareness of that lack of access and might have made important changes in the future in terms of improving access to OH,” he added.

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