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Fit notes
Fit Notes
Employers are all familiar with the “Sick Note” that employees produce after visiting their General Practitioner (GP). This form – more correctly known as the MED3 - provides an employee with medical evidence that they are unfit for work.
But from April 2010 there will be a change in process and procedure. A new Statement of Fitness for Work form, being called the Fit Note, will be introduced.
Background
The Government has a wide ranging agenda that seeks, amongst other things, to:
Reduce the number of people on long term sickness and other forms of State benefit
Secure a joined up approach between healthcare professionals, employers and occupational health practitioners
Secure the proven benefits that flow from getting sick or injured people back to work as quickly as possible
Assist employers, businesses and the economy in general by reducing the amount of sick pay that is paid to sick and injured employees
The Department of Work and Pensions briefing includes the following text:
“The new guidance has been created by the Department for Work and Pensions with the Royal College of General Practitioners, British Medical Association, CBI, ACAS, Federation of Small Businesses, Chartered Institute of Personnel and Development, Association of British Insurers, British Retail Consortium and EEF, the manufacturers’ organisation. The fit note reflects medical evidence that work is generally good for health and well-being and can aid recovery for many health conditions.”
The new Fit Note will apply to any person’s ability/inability to work whatever the cause. It will be equally applicable if a person has:
A medical condition that affects their ability to work e.g. arthritis
Is recovering from surgery or other significant treatment e.g. chemotherapy for cancer
Has suffered an injury e.g. as the result of a road accident or from taking part in sporting activities
Has been injured as the result of a workplace accident
What will the new Fit Note say?
The main changes are:
The removal of the fit for work option
A new option for a GP to advise if an employee may be fit for work with some support
The Fit Note will have space for GPs to provide information on how the employee’s condition will affect what they do
There will be tick boxes for GPs to use to suggest common ways to help an employee return to work
What remains unchanged?
There are some things that remain substantially the same as at present.
The Fit Note can only be completed by a GP
The Fit Note remains as evidence of a person’s fitness for work
The information supplied by the GP is still advisory and is not binding on the employee or employer
The situation regarding Statutory Sick Pay remains unchanged
An employer’s obligations under the Disability Discrimination Act remain unchanged
What will the GP have to do?
GPs will need to both assess the fitness of their patient and understand the working environment in order to determine what the patient is capable of doing and what action is required on the part of the employer in order for there to be a safe and healthy return to work.
The GP can make their assessment on the basis of
A face to face consultation
A telephone consultation
A report from another doctor or healthcare professional
The basis on which the decisions have been made must be shown on the Fit Note. The GP will state that their patient:
Is “Not fit for work” or
Is fit for work “subject to” alterations and amendments
and will then make a suggestion as to how a return to work can be achieved.
What will Employers have to do?
Since "sick notes" contain confidential information they have traditionally been received and retained in the Personnel Department. However, Fit Notes may require changes to the workplace and work processes. This will require those in charge of the operation of the business to have an understanding of what has been suggested by the GP.
Employers will need to establish a system for
Retaining information about the employees condition confidential whilst
Ensuring that the necessary information is acted on
This best approach may be along the following lines:
1. Consider: the suggestions on the Fit Note and decide what can be done
2. Discuss: the proposed changes with the employee
3. Agree: what changes will be made and when the employee will return to work
4. Monitor and Review: the success of what has been implemented or introduced
Note: If agreement has not been reached at Step 3 then it is best to set a review date at some point in the future. This will ensure that any improvements made by the employee can be factored into a new “Consideration” stage. It may also be necessary for the GP to re-assess the employee.
Employers will need to make changes and typical examples include:
Phased return to work: Someone who is recovering from an operation may be able to work shorter hours, gradually increasing to full time working
Alteration in the hours of work: Someone who is unable to use their car to drive may have to travel on public transport – their working day could be adjusted to avoid rush hour travel
Amendment of duties: Someone with a back injury may need to avoid heavy lifting or someone with a stressful job may be moved to a less demanding position until they have developed suitable coping strategies
Adaptations or alterations to the workplace: Someone who is suffering from arthritis or mobility problems may need to work on the ground floor and may need to be given a reserved parking space adjacent to the main door
Note: The Fit Note is advisory and the employee may decide not to follow the GP’s advice.
Securing Advice
Employers may well need to secure advice from trained and competent persons such as occupational health nurses, ergonomists or occupational hygienists. Such advice may need to be obtained from consultants although there is a free government advice service – see References below.
Key Action Points (for employers)
Employers must:
Set up a system for managing the new Fit Notes
Ensure that shop floor management knows what has been suggested by the GP
Carry out assessments of the employee and the suggested changes
Ensure risk assessments are reviewed and amended as necessary
Encourage employees to report back on whether the changes are proving satisfactory
References
Department for Work and Pensions:
The “Fit Note” site – which contains specific guidance for employers
http://www.dwp.gov.uk/fitnote/
