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 has the support of their GP that they are fit to return but the employer insists on further medical checks. The employee is entitled to their normal wages while these extra checks are being carried out, unless an express 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).

The Fit Note guidance for employers says that once the GP has confirmed the employee’s fitness to return, any extra medical evidence of fitness must be arranged through a private arrangement with a GP or 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 new guidance lists a variety of examples of possible changes to discuss with the employee. The employer is not obliged to accept the advice on a Fit Note, but if the 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 2013 guidance to employers confirms that “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 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 change the employer’s statutory duty to make reasonable adjustments for a disabled employee (see Chapter 6).