Government “Fit Note” fails to deliver

Posted on 21 Jul 2015 by Victoria Fitzgerald

The government’s flagship “fit note” scheme aimed at getting people back to work has failed to deliver five years on from implementation, according to an EEF survey in conjunction with Jelf Employee Benefits.

The initiative’s flop could seriously hamper the UK’s attempts to improve sickness absence performance and reduce unnecessary sickness absence.

The “fit note” initiative, aimed at helping individuals back into work after sickness absence, allows employees to share their GP notes explaining their capability to work.

Industry calls for increased training for GPs in Health & Work:

  • 43% of employers say “fit note” not aiding employee return to work
  • More companies saying the quality of GP advice on fitness for work has deteriorated
  • Insufficient GP and medical professional training remains in use of ‘fit note’
  • GPs and medical professionals not working closely enough with employers
  • Only low numbers of “maybe fit for work”  fit notes still being issued
  • Government urged to set fixed date by which all GPs and medical professional will have been trained in use of the “fit note”

The findings come from a survey of 345 companies and reveals that far from aiding economic growth and improving productivity by getting people back to work earlier, the situation has failed to improve.

According to EEF, only around 5,000 GPs have been trained in health & work out of 40,584 (September 2014 census) while only a small sum has been spent on GP training compared to the £170m the Government is investing in the new “Fit for Work” service over five years.

In response, EEF is now urging Government to set a fixed date by which all GPs and medical professionals will be trained in the use of the “fit note”.

Commenting EEF head of health & safety, Terry Woolmer, said: “We have supported the “fit note” since day one and wanted it to succeed.

“However, the evidence is now clear five years on that it’s not delivering on helping people back to work earlier. In fact, the evidence suggests that the quality of advice being given by GPs to help people back to work is deteriorating.

“It can still be made to work but Government now needs to put its shoulder to the wheel with greater resources.

“The first step must be to ensure that all GPs and hospital doctors are trained in health & work issues so they feel confident in giving proper advice. Without this as a basis there is little prospect of the ‘fit note’ ever delivering genuine improvement in return to work performance and absence reduction.

“It’s vital that employers take their responsibility for working with employees and GPs seriously. This template will spell out clearly the adjustments they are willing to do to enable the employee to return to work in some capacity and should enable a speedier and better quality recommendation from GPs.”

Key recommendations:

  • Link evidence of fit note training to GP and medical professional CPD and appraisal systems;
  • Create e-communities to allow more effective interaction and communication between GPs and employers and employer occupational health services in the “fit note” process;
  • Provide targeted advice for SMEs who may come across a “fit note” infrequently;
  • Target training of line managers about awareness of the “fit note” process;
  • Target employee awareness and training of the “fit note” process at induction;
  • Analyse and publish GP performance in using the “fit note” and issuing “may be fit for work” fit notes;
  • Modify the “fit note” to include a referral to the Fit for Work Service (FWS);
  • Produce clear guidance to show the interaction between the Fit for Work service and the “fit note”.