1. © Su Allen HR 2011
The new Fit Note: Fit for Purpose?
From April 6th
2010 the GP‟s sick note became a „Fit Note‟ or, to give it its proper name, a
Statement of Fitness for Work, Its aim is to encourage those off sick to return to work sooner,
with the GP being able to advise whether a patient is „unfit for work‟ or „may be fit for work‟
where they believe the patient can return providing they receive suitable support from their
employer.
Whilst there were high hopes of the new Fit Note reducing sickness absence and thus
benefitting both employees and businesses alike, three months in, how it is working in practice?
Some early feedback reveals confusion about the practicality of the process and predictions of
possible workplace conflict. For example, if an employee refuses to return to work even after
adjustments are made, the employer must decide whether or not to agree to them continuing on
sickness absence, stop paying statutory sick pay or dismiss. To retain an employee‟s
cooperation once they are beginning to make a recovery and thus prevent such conflict, it is
critical for employers to reassure them that appropriate support will be given during the
transitional period.
The ongoing challenge for employers is that the Fit Note will only ever be as good as the
information it provides. A potential barrier to its overall effectiveness could be the conflicting
advice being given to GPs. Guidance issued by The Medical and Dental Defence Union of
Scotland advised GPs to exercise a degree of caution, to not give opinions and only work within
the limits of their clinical competence. The Department for Works and Pensions (DWP)
however, advises that whilst GPs are not experts in occupational health, they are experts in
their patient‟s health. Their advice should therefore help employers to work with employees to
support them back to work. Indeed, even Dame Carol Black, the creator of the Fit Note, warned
that the initiative would amount to little more than a sick note if GPs failed to volunteer
information about the activities workers could carry out.

2. © Su Allen HR 2011
With this degree of pressure, GPs have the added burden that they are largely reliant on the
subjective reporting of the employee about what their actual job entails. The obvious risk to this
is the GP recommending a course of action that is costly or not feasible from the employer‟s
perspective.
Another drawback of the new system, as highlighted by Dr. Bill Gunnyeon, DWP‟s chief medical
adviser, is the “eligibility of doctors‟ handwriting”. He added that whilst he wanted the new Fit
Note to become computerised by the end of 2010, thus eliminating the potential for confusing
doctors‟ scribbles, this timescale was now unlikely.
It may also be a while before the actual effectiveness of the new Fit Note can be quantified. Its
introduction coincided with a recession and a recent sickness absence survey shows that
workers are already taking fewer sick days. This suggests that the drop in sickness absence
could be because employees are scared of losing their jobs in the current economic climate
thus camouflaging actual statistics regarding the Fit Note.
Fit Note supporters acknowledge that while it may take years to bring about the cultural shift in
attitudes required for it to achieve its overall aims, with more people returning to work than
under the previous system, employers should at least see positive trends. Further time -
particularly outside of a recession - will provide a more robust indication as to the long term
effectiveness of the Fit Note.
Lorraine Swain – Su Allen HR