Rehabilitation following stress-related sickness absence — the “Fit Note”

The Statement of Fitness for Work or “Fit Note” was introduced in April 2010. Properly administered, and with the support of effective occupational health provision (either internal or external), the Fit Note should help to encourage a more proactive, collaborative approach to the rehabilitation of employees back to the workplace following a stress-related absence.

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.

Revised Department for Work and Pensions (DWP) guidance advises doctors on how they can give the most useful advice about what patients can do at work and how they can return to the workplace as soon as possible. This could include exploring a period of home working or different ways of working. It says they should look at what a person can do, rather than what they can’t. Employers and patients can then use the Fit Note to look at what can be done to help an individual back into work.

The guidance clarifies that the Fit Note is about someone’s general fitness for work and is not tied to their most recent job, allowing flexibility to discuss what changes could help someone do some work.

The revised guidance can be found at: www.dwp.gov.uk/fitnote

In addition, by late 2014, the government has said it will launch a health and work assessment and advisory service to make occupational health available to employers and employees. The service is to include:

• state-funded assessment by occupational health professionals for employees off sick for four weeks or more;

• “signposting” to “appropriate interventions” including universal job match, an online job search service, for employees who are able to work but unlikely to return to their current employer; and

• “case management” for employees with complex needs who need on-going support for their return to work.

The government had not yet announced who will run the service as this booklet went to press.