The process of getting signed off sick may be about get easier for employees

Jamie Baker, Senior Partnerships Marketing Manager, WorkNest

Under new legislation introduced on 1 July, a wider range of healthcare professionals (HCPs) – including nurses, occupational therapists, pharmacists and physiotherapists – now have the power to certify fit notes (aka sick notes).

The intention is that where the fit note is certified, such as a hospital or GP surgery, will remain the same – but who can do this will be expanded to relieve the administrative burden on doctors and GPs, as they aim to tackle the COVID backlog and deliver an extra 50 million appointments by 2024.

The changes – which apply across England, Scotland and Wales – follow the rollout of digital fit notes back in April and are intended to further simplify the process of certifying sickness-related absences.

What are fit notes and how do they work?

Employees can usually self-certify for the first seven days of illness. Beyond that, they will normally need what’s known as a fit note.
The fit note is a healthcare professional’s assessment of a patient’s fitness for work. It may say one of two things: either the employee is not fit to work, or they may be fit to work subject to certain adjustments. It is not open to GPs or other medical professionals to confirm that the employee is fit for the job they do. Employers seeking such confirmation would have to involve the services of Occupational Health to get further guidance. If following assessment, the patient is considered fit for work, they don’t need a fit note, even if it is asked for.

Once a fit note runs out, if no further fit note is sought/provided, the employer can take it as read that the employee is fit to return. At this stage, a return to work meeting should help the employer uncover if there are any risks of allowing the employee back to work or if temporary measures are required. Of note, the advice in the fit note pertains to an employee’s fitness for work in general, and not specifically their current job role. This gives employers maximum flexibility to discuss possible changes to help the employee return to work, which may include changing their duties for a while. Using the fit note to its full potential helps employers to reduce sickness absence costs – for example, in relation to sick pay, staff cover and lost productivity – and minimises the disruption caused by employees being off sick unnecessarily.

How might the new rules impact employers?

For employers, there are concerns that easier access to fit notes could lead to more people being signed off sick, resulting in higher levels of absence. Indeed, employees who may have previously put off going to their GP for a fit note due to difficulties in getting an appointment may now be inclined to take the easier route of going to a pharmacist or other healthcare professional, increasing the likelihood that they will take time off work. That said, it won’t be as simple as walking into your nearest pharmacy to get a fit note. The idea is that the HCP certifying the fit note can only do so if they are integral to the patient’s health management. They may be doing this in combination with other HCPs and it might be that there is a combined approach to the individual’s care, whereby they see multiple HCPs.

The government guidance is clear that fit notes should only be certified following a full assessment of an individual’s fitness for work, and therefore should be provided by a clinician with a holistic oversight of the individual’s condition. This will hopefully lessen any disruption to employers. The Minister for Disabled People, Health and Work, Chloe Smith MP, suggests the changes will be positive for both employees and their employers.
“The extension of fit note certification is fantastic news for patients, making it easier for them to get the support and advice they need from the right place, ensuring where possible that they can remain in work”, she said.

Another potential positive for employers is that by alleviating the practical difficulties in getting a fit note, employees should have less of a reason not to submit them. Sometimes, employees will use the excuse that they can’t provide a fit note because they are unable to get an appointment with their GP to get a fit note, and/or they don’t realise that fit notes are needed once SSP has stopped.

If an employee is past the stage of SSP, i.e. has been off work for longer than 28 weeks, employers will generally be in the realms of a capability process, but this does not mitigate the need for a fit note to evidence the genuineness of the employee’s continued sickness absence. The changes are a timely reminder that employers must continue to actively manage sickness absence, and gathering appropriate evidence plays a key part in that.

Ultimately, at this early stage, we can only speculate as to the impact of relaxed fit note rules. However, given ongoing staffing shortages and the numerous challenges businesses are currently experiencing around unexpected absences – due to factors such as COVID-19, flight delays, fuel costs and transport strikes – understandably employers may be concerned.

What should employers do now?

Going forward, the changes mean employers need to be aware that fit notes authorised by other healthcare professionals, not just doctors and GPs, will be accepted as evidence of incapacity. Organisations will need to update their absence policies to reflect this.
Additionally, employers must be aware that fit notes no longer need to be physically signed. They must, however, contain the name of the healthcare professional who has made the certification and their professional title, otherwise, they won’t be legally valid.

6 things to do when provided with a fit note: 

  1. Check whether your employee’s healthcare professional has assessed that they are not fit for work or maybe fit for work.
  2. Check how long your employee’s fit note applies for, and whether they are expected to be fit for work when their fit note expires.
  3. If your employee may be fit for work, discuss their fit note with them and see if you can agree on any changes to help them come back to work while it lasts.
  4. If your employee is not fit for work, or if they may be fit for work but you can’t agree on any changes, use the fit note as evidence for your sick pay procedures.
  5. Consider taking a copy of the fit note for your records (the employee should keep the original).
  6. Take further advice from a workplace Occupational Health professional or your HR Team.

For advice on managing workplace sickness contact WorkNest at