The new GP's ‘Fit Note’

From 6th April 2010 there will be a number of changes to the sick note, or medical statement, that employees get from their GP to certify sickness absence.

Previously a sick note simply stated whether a doctor believed that a person should or should not be in work. The new medical statement will either indicate that a person is not fit for work, or that they might be fit for work under certain circumstances. The doctor will also be able to suggest changes that would assist a return to work. There is no requirement for the GP to write anything apart from that the person is not fit for work and how long the person is “signed off” for, and in most cases the patient and employer will see no change in the information that the medical statement gives.

In addition, in the future, the note will be completed and stored electronically by the GP rather than handwritten, although it will still be given directly to the worker to send to the employer.

There will be no change to the basic purpose of the medical statement and it will still be used by employees as confirmation of illness if claiming sick pay.

The new process

The new medical statement will still be evidence that an employee cannot work due to injury or illness, and normally will not be required until after the 7th calendar day of sickness.

The present arrangements for Statutory Sick Pay (SSP) and any occupational sick pay scheme that you may have will not be changed. As at present, the form is advice that is given to the worker to use to give to the employer as evidence of illness for the purposes of sick pay and is not binding.

The changes will be:
The form will now have two options:

1. That the patient is “not fit for work” in which case the medical statement will then be given to the patient, as at present. The patient should then send it to the employer.

OR

2. That the patient “may be fit for work taking account of the following advice.”

There will be four types of alterations listed which the GP can tick.

These are:
- A phased return to work
The doctor is likely to propose a phased return to work where someone is suffering from an illness that has left them fatigued, or has been away for a long period of time and is not confident about returning full-time. It may also be used if a person has an injury where the doctor believes that their strength has to be built up gradually. Often a phased return to work may be proposed along with other changes such as amended duties.

- Altered hours
Here the doctor will recommend that the pattern of working hours is changed. This may be recommended if the GP feels that the person may not be able to travel in rush hour public transport, or if shift working should be avoided.

- Amended duties
Amended duties; the GP should recommend amended duties where they believe that an employee cannot fully do their former work but may be able to do their job if some duties are avoided or changed. This could include not doing any kind of lifting if recovering from a back injury, or avoiding any work with the public if a person is recovering from workplace stress.

- Workplace adaptations
Workplace adaptations may be recommended if the GP believes that some physical adaptations are needed to help the person return to work. An example of this could be moving someone’s desk to the ground floor of a building if they have trouble with stairs.

There will be space for the doctor to provide more information on the condition and how it may affect what you do.

The GP should base the recommendations on what the patient has told them about their workplace and should discuss the proposals and the implications fully with the patient.

In a lot of cases there will be nothing to recommend and, as at present, the worker will go back to work once the GP feels they are ready to. There will not be an option for the GP to say that a person is “fit for work”. The doctor will simply not issue a new medical certificate.

If in doubt contact the Branch for advice and support on 0845-600 1546.