In many cases, employers need expert advice to implement suggestions made by the health professional, and union reps have a role in making sure that the employer seeks appropriate professional support before introducing any adaptations. An employer is not obliged to accept the advice on a fit note, but if the employer decides not to follow the advice, the fit note must be treated as if the health professional has advised that the employee is “not fit for work”. Government advice states clearly that “unless the employer implements the advice on the medical certificate, the worker is not fit to return and should continue to be paid his or her sick pay entitlement”.