Fit notes will not allow doctors to declare a patient ‘fit for work’

The new fit note will not give doctors the option to deem a patient “fit for work”, only whether they may be fit for some work, it has emerged.

Under the new system, due to come into force this April, GPs will replace the hand-written sick note with a computer-generated medical fit note explaining what a patient is able to do. But the government’s response to the Reforming Medical Statement consultation, published today, ruled out allowing GPs to determine whether a worker is 100% fit to return to work.

Employers will only receive doctors’ notes presenting one of two options – either that the employee is “unfit for work”, or “may be fit for some work”.

The consultation was published in May by the Department for Work and Pensions, setting out proposals to replace the ‘sick-note culture’ and help more people stay in work rather than drift into long-term sickness – about 172 million working days were lost in 2007 due to sickness absence.

The response paper said: “While we understand that some stakeholders believe that there may be some practical benefits from retaining ‘fit for work’ statements, especially for those involved in safety-critical roles, doctors completing the medical statements do not have the knowledge or expertise about an individual’s job role and the risks involved. The doctor will have to indicate on the new revised statement whether or not they need to assess their patient’s fitness for work again, making the need for a ‘fit for work’ option unnecessary.”

It added the two options would “empower individuals” to make their own decisions to return to work and would also potentially reduce unnecessary appointments for doctors, which can then be used for those patients who require medical attention.

The paper added the ‘fit for work’ statement was not needed for employer liability insurance reasons, and it was the employer’s responsibility to carry out a risk assessment when an employee returned to work to ensure there was minimal risk to the employee and others in the workplace.

Rachel Dineley, head of the diversity and discrimination unit at law firm Beachcroft, said: “In its response the government has recognised that it is not the doctor, but the employer, in consultation with the employee, who is best placed to make the decision as to whether they can accommodate any changes to facilitate a return to work.

“It encourages employers to initiate discussions with their employees. If an employer is not able to facilitate a change or adjustment, the GP’s advice on the statement will be evidence that an individual has a condition which prevents them carrying out their current role.”

However, she added: “Employers that work with occupational health practitioners may disagree with the GP’s advice. If the employee’s condition constitutes a disability under the Disability Discrimination Act – to be replaced with provisions in the Equality Bill, currently going through Parliament – the employer will have a duty to make reasonable adjustments in any event.”

Simon Rice-Birchall, employment partner at law firm Eversheds, added: “Whether the new approach succeeds will depend, to a large extent, on how well GPs adapt to using the form. The DWP says it will be issuing guidance for doctors on the new medical statement, and there will also be specific guidance for employers, although no publication date has been given.”

Other changes in the government’s response to the consultation include a reduction in the maximum length of time the doctor can issue the fit note for – from six months to three months.

The new fit note system, which forms part of the government’s response to Dame Carol Black’s report into the health of Britain’s working-age population, will come into effect on 6 April 2010.




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