| The new "Fit Note" - information for employers |
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On 06 April 2010 new regulations come into force in the UK. The “sick note” which is issued by GPs will change to a “fit note”. This replaces the existing Med 3 form. Under the old system the doctor issuing the sick note could only advise the patient that they should or should not work. There was no facility to indicate that the patient could do some aspects of their work if given support.
The aim of this change is to try and get people back to work sooner if at all possible. This is beneficial to both employers and employees.
The new “fit note” system gives the doctor 2 options.
The patient is either
The “may be fit for work” option can be used if the doctor thinks that their patient’s health condition could allow them to work in some capacity.
The “unfit for work” option will be used if the doctor thinks their patient is too ill to work.
There is also a section where the doctor is able to advise on modifications to work which might be beneficial such as
and to expand on this advice if they wish To see the new Fit Note (in pdf file format) click here. Frequently asked questions What do I do if the statement says my employee “may be fit for work”? You might discuss the advice given with your employee to see if it is possible to implement any recommendations. If you have an occupational health provider you may want to discuss it with them as well, particularly if you feel the advice given is unrealistic. Most GPs have a limited knowledge of occupational health and their understanding of the job is likely to be restricted and based on information provided by their patient. They may also be unaware of any industry specific guidelines which might apply or safety aspects of the job. Do I have to follow the advice on the fit note? No. The fit note or new Med 3 is a statement issued for Social Security Purposes, like the old Med 3. It is accepted practice for employers to use the system as evidence of fitness for work but there is no legal obligation for you to do so. If you are unable to make the adaptations to allow your employee to return to work you should explain this to the employee and use the statement as if the “unfit for work “ option had been advised. There is no need for the employee to return to their GP for another certificate. How long do any amended duties have to last for? The GP will indicate on the fit note how long the modified duties should last. When discussing return to work plans with your employee it is advisable to have a clear idea and agreement on the length of time this is going to take. If you feel the suggested timescale is unrealistic you should discuss this with the employee and either come to an agreement or consider referring to your OH provider for further advice. Can I ask for a certificate stating my employee is fit for work? Unlike the old sick note there is no option to include a statement that the employee is fully fit. Employees do not need to be “signed back” to work by their GPs. If you require confirmation of fitness from a doctor you can either refer to your OH provider or the GP may be prepared to issue a private note for a fee. How does this affect offshore workers? The current system where offshore employees are assessed by an OGUK approved doctor for a “fitness to return” certificate remains unchanged. It is rarely possible to modify duties offshore although the possibility of finding onshore based temporary work might be considered. Most offshore workers will need to remain off work until they are fully recovered. What do I do if an employee wants to return to work before the end of a “not fit for work” statement? Employees are sometimes ready to return before the date stated if they have recovered more quickly than expected. If you are in agreement they do not need to wait until the end of the statement period. They do not need “signed back”. What do I do if I offer support to an employee and they disagree that they are able to return to work? If your employee does not accept your proposals for adaptations you should discuss the reasons for their views with them in the first instance. If the situation cannot be resolved you may wish to consider obtaining an independent opinion from your OH provider. Do employees still self certify for the first 7 days? Yes. There have been no changes to this. Does this affect SSP? SSP is still payable under the current rules for any absence of 4 days or more. If an employee is unable to return to work because it is not feasible to make modifications you should treat them the same as if they were unfit for work. If you have your own occupational sick pay scheme you will need to consider reviewing it to make provision for employees who may be back at work but on alternative duties or part time. How does this affect DDA? Your responsibilities under DDA remain unchanged. How will GPs be able to assess the patient’s job? GPs will generally have to rely on their patient’s description of the job, and the patient’s views of what modifications might be possible. Your OH provider is much more likely to have a better understanding of the nature of work in your organisation, the hazards, and any industry specific guidance which might be relevant. They are better placed to give you an objective, informed and unbiased opinion and advice. Will there be conflict between the GP and OH doctor? There may be situations where differing opinions are expressed by the GP and OH doctor. This happens already, for example, when advising on whether an employee is fit to attend a disciplinary hearing. GPs are not OH experts and have been advised by the Medical Defence Societies to avoid giving opinions on fit notes which are outwith their clinical competence. It is generally accepted that the OH physician’s opinion overrides that of the GP, because of their greater understanding of the job. It can also be hard for GPs to give purely objective advice because of their “doctor-patient relationship” Where can I get further advice? There is an excellent Guide for Employers published by DWP. This can be found on www.dwp.gov.uk/fitnote
Dr Elizabeth Wright Medical Director |
