The purpose of the Fit Note

The Fit Note allows the GP, following discussions with the patient, to suggest a return to work based on one of four possible options:

• a phased return;

• altered hours;

• amended duties; and

• workplace adaptations.

There is space on the Fit Note for the doctor to provide more information on the condition and its effect on the member’s work. There is no “Fit for Work” option on the Fit Note. This is because where a worker is fully fit for work the GP will simply not issue a new certificate.

Sometimes, an employee’s GP agrees that they are fit to return but the employer insists on more medical checks. The employee is entitled to normal wages while these extra checks are being carried out, unless a clear written term in the contract says something different. This is because there is an implied term in every employment contract that an employee who is ready, willing and able to work should be paid their normal wages (Beveridge v KLM UK [2000] IRLR 765). Withholding wages without a clear written term would be an unlawful deduction of wages (see page 91) as well as a breach of contract (see Chapter 3).

The Fit Note guidance for employers says that once a GP has confirmed a worker’s fitness to return, any extra medical evidence of fitness must be organised and paid for by the employer, either through a private arrangement with a GP or by engaging an occupational health specialist. “Once your employee’s doctor has assessed them as fit for work, they cannot issue any further fit notes to cover a period while they are waiting for additional health checks required by your organisation”, the guidance states.

The guidance lists examples of possible changes to discuss with the employee. The employer is not obliged to accept the advice on a Fit Note but if an employer decides not to follow GP advice or follows it inadequately, the Fit Note should be treated as if the GP has advised that the employee is not fit for work. The DWP guidance is clear: “if you can’t agree to any changes, you should treat the Fit Note as if it says that your employee is not fit for work”.

The employer should carry out a revised health and safety risk assessment of any changes or adaptations needed to implement the recommendations on the Fit Note, to ensure new risks are not introduced.

The Fit Note procedure does not affect an employer’s statutory duty under the Equality Act 2010 to make reasonable adjustments for a disabled employee (see Chapter 6).