Why the change?
The Fit Note has been introduced so that the Doctor can provide simple, clear and practical advice about an employees' fitness to work. They are designed to encourage those off sick to return to work sooner. The Fit Note will provide, where possible, the opportunity for employees and their employers to work together to find an arrangement that works for them both to support their return to work.
However the change will bring difficulties both from GP’s management of the new system and employer/employee interpretation of GP’s advice.
What's different about the new fit note?
In the past Doctors have either said that 'you should refrain from work' or 'you need not refrain from work'. The fit note offers a new option of 'may be fit for work taking account of the following advice'.
If the Doctor decides the person is fit for some work, the form provides tick boxes for either a phased return to work, altered hours, amended duties or workplace adaptations. There is a large space for the Doctor’s comments, including a more detailed explanation of the effect of the patient’s condition on their ability to perform functions. This information could be included on the old forms, but now the layout encourages it.
The form makes it clear that phased return-to-work options are subject to the employer’s agreement. The “may be fit for work” option still requires the employer to make a decision. - It’s the Employers’ choice/discretion, after discussing the statement with their employee, how to act on the Doctor’s advice.
The employer can discuss with the employee appropriate adjustments such as:
-
a phased, gradual return to work,
-
altered hours,
-
flexible hours,
-
time off for treatment,
-
amended duties, and/or workplace adaptations.
Possible Problems
There will inevitably be some problems with fit notes while employers, employees and GPs adapt to it. Predicted difficulties include:
-
difficulty for GPs making the judgments between 'unfit for work' and 'may be fit for some work' as they may not know enough about the nature of the work,
-
disagreements between employees and employers concerning the nature of adjustments which are appropriate,
-
employees refusing to return to work once adjustments have been made, leaving the employer to decide whether to invoke disciplinary or capability processes, or stop paying statutory sick pay,
-
other employees may feel disadvantaged if another employee achieves a variation to their working schedule on what the other employees see as spurious health grounds,
-
DDA claims may be generated as a result of refusals to carry out adjustments in appropriate cases,
-
possible increased risk of personal injury claims from members of staff who injure themselves while back at work following a fit note saying they may be fit to return.
To try and minimise the risk of the above problems occurring employers should review their absence, return to work and flexible working policies to ensure they are compatible with the fit note system.
Concerns
Trying to get people back to work more quickly sends out the right message however there are concerns with the new approach including the ability of Doctors’ to deal with occupational health, the danger that managers will misinterpret fit notes or be unable to make adjustments for people and fears that there will be more work for employers. The traditional role of the Doctor is to be a patient advocate and look after the patient and maintain confidentiality. The new fit note is asking the Doctor to play a role more akin to occupational health. Also, the information on the fit note is only as good as that given to the Doctor by the employee about their work – they may not see it in the same way as the employer. Lastly, the focus is on long‑term sickness absence, whereas persistent short-term absence is the bigger problem for most employers.
Fit notes and statutory sick pay (SSP)
SSP has not changed and remains payable for any sickness absence of four days or more provided that the employee meets the qualifying conditions. Difficulties may arise where a GP has advised that an employee may be fit for work, but the employee remains off work because the employer cannot provide the necessary support. In such cases employers should treat the note as a ‘not fit for work’ note and pay SSP in the same way.
The Government emphasise in their guide for employers that SSP is only a minimum provision and that if an employer is considering a return to work which involves reduced hours, it may be cost effective for the employer to consider paying voluntary sick pay for the hours not worked due to illness or injury, even when SSP does not apply.
Comment
Only time will tell if the new ‘Fit Notes’ will reduce the cost of sickness absence and help employees too.
From 'Sick Note' to 'Fit Note' - A new Approach from April 2010
The new “fit note” launched in April, replaced the sick note provided by Doctors. Under new government regulations, Doctor’s will be required to state whether someone is fit for some work or unable to work at all.
Why the change?
The Fit Note has been introduced so that the Doctor can provide simple, clear and practical advice about an employees' fitness to work. They are designed to encourage those off sick to return to work sooner. The Fit Note will provide, where possible, the opportunity for employees and their employers to work together to find an arrangement that works for them both to support their return to work.
However the change will bring difficulties both from GP’s management of the new system and employer/employee interpretation of GP’s advice……………. Read more
What's different about the new fit note?
In the past Doctors have either said that 'you should refrain from work' or 'you need not refrain from work'. The fit note offers a new option of 'may be fit for work taking account of the following advice'.
If the Doctor decides the person is fit for some work, the form provides tick boxes for either a phased return to work, altered hours, amended duties or workplace adaptations. There is a large space for the Doctor’s comments, including a more detailed explanation of the effect of the patient’s condition on their ability to perform functions. This information could be included on the old forms, but now the layout encourages it.
The form makes it clear that phased return-to-work options are subject to the employer’s agreement. The “may be fit for work” option still requires the employer to make a decision. - It’s the Employers’ choice/discretion, after discussing the statement with their employee, how to act on the Doctor’s advice.
The employer can discuss with the employee appropriate adjustments such as:
· a phased, gradual return to work,
· altered hours,
· flexible hours,
· time off for treatment,
· amended duties, and/or
· workplace adaptations.
Possible Problems
There will inevitably be some problems with fit notes while employers, employees and GPs adapt to it. Predicted difficulties include:
· difficulty for GPs making the judgments between 'unfit for work' and 'may be fit for some work' as they may not know enough about the nature of the work,
· disagreements between employees and employers concerning the nature of adjustments which are appropriate,
· employees refusing to return to work once adjustments have been made, leaving the employer to decide whether to invoke disciplinary or capability processes, or stop paying statutory sick pay,
· other employees may feel disadvantaged if another employee achieves a variation to their working schedule on what the other employees see as spurious health grounds,
· DDA claims may be generated as a result of refusals to carry out adjustments in appropriate cases,
· possible increased risk of personal injury claims from members of staff who injure themselves while back at work following a fit note saying they may be fit to return.
To try and minimise the risk of the above problems occurring employers should review their absence, return to work and flexible working policies to ensure they are compatible with the fit note system.
Concerns
Trying to get people back to work more quickly sends out the right message however there are concerns with the new approach including the ability of Doctors’ to deal with occupational health, the danger that managers will misinterpret fit notes or be unable to make adjustments for people and fears that there will be more work for employers. The traditional role of the Doctor is to be a patient advocate and look after the patient and maintain confidentiality. The new fit note is asking the Doctor to play a role more akin to occupational health. Also, the information on the fit note is only as good as that given to the Doctor by the employee about their work – they may not see it in the same way as the employer. Lastly, the focus is on long‑term sickness absence, whereas persistent short-term absence is the bigger problem for most employers.
Fit notes and statutory sick pay (SSP)
SSP has not changed and remains payable for any sickness absence of four days or more provided that the employee meets the qualifying conditions. Difficulties may arise where a GP has advised that an employee may be fit for work, but the employee remains off work because the employer cannot provide the necessary support. In such cases employers should treat the note as a ‘not fit for work’ note and pay SSP in the same way.
The Government emphasise in their guide for employers that SSP is only a minimum provision and that if an employer is considering a return to work which involves reduced hours, it may be cost effective for the employer to consider paying voluntary sick pay for the hours not worked due to illness or injury, even when SSP does not apply.
Comment
Only time will tell if the new ‘Fit Notes’ will reduce the cost of sickness absence and help employees too.