Fit notes


The “Statement of Fitness for Work” or “Fit Note” was introduced in April 2010. The Fit Note is stored electronically by the GP with a hard copy handed to the employer by the worker and used to prove entitlement to sick pay. The Fit Note allows the GP, in collaboration with the patient, to suggest a return-to-work based on one of four possible options:


• a phased return-to-work;


• altered hours;


• amended duties; and


• workplace adaptations.


There is no “Fit for Work” option. This is because where a worker is fully fit for work, the GP will simply not issue a new certificate. A GP should only recommend a return-to-work for a person who is not fully recovered after discussing it with the patient and making sure s/he is fully aware of what is being suggested.


In many cases, employers need expert advice in order to implement suggestions made by the GP, 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 GP 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.”


In practice, problems are likely if the employer either fails to take the steps promised, or fails to carry them through adequately. An employee in this position should seek help from his or her union rep, and would normally use the grievance procedure.


The employer should carry out a revised risk assessment of any changes or adaptations needed to implement the recommendations on the Fit Note, to avoid introducing new risks. The Fit Note procedure does not change the employer’s overriding statutory duty to make reasonable adjustments for a disabled employee, regardless of what the GP recommends.