News Analysis: The impending replacement of sick notes with fit notes

With the arrival of fit notes to replace sick notes in April, employers will have to rethink their arrangements for dealing with staff absence, says Ben Jones

A major change in the way sickness absence is handled comes into force on 6 April. From that date, fit notes will replace doctors’ sick notes, as outlined by the national director for health and work, Dame Carol Black, in her 2008 review of the health of Britain’s working age population, Working for a healthier tomorrow. Fit notes are intended to cut the cost of staff absence for employers and could benefit the UK economy by £240 million over the next 10 years, according to the Department for Work and Pensions.

Unlike traditional sick notes, fit notes involve a doctor advising whether an employee is fit for work and recommending, subject to an employer’s agreement, temporary changes that could be made to accommodate them, such as reduced working hours. Katharine Moxham, spokesperson for industry body Group Risk Development (Grid), said the introduction of fit notes indicates a change in thinking at government level. “The state is saying ‘we will help you, but you have to help yourself’. They are focusing on someone’s ability to do something and note their disability to do it.”

Peter Barnard, registrar at the Grimsby Institute of Further and Higher Education, said helping staff return to work should be seen as an ongoing managed process, rather than simply a medical one. “For the last couple of years, we have been helping managers and employees return to work by holding discussions with those who are absent and discussing what it would be like for them to return to work,” he said. “We then ensure proper support arrangements are in place, for example if they need a taxi to be laid on, or if the staff member cannot work above the ground floor because they have a plaster [cast] on a leg.”

But Barnard is concerned that giving GPs more power to decide whether or not someone can return to work may slow down that process. “I would be disappointed if the extra involvement of GPs slowed the process down, rather than sped it up,” he said.

Barnard is currently preparing to brief managers at the institute about fit notes and has endeavoured to build up relationships with GPs through the local primary care trust.

Giving employers the opportunity to make adjustments to enable staff to return to work in some capacity may see them become more creative than before in what they offer employees, for example, in terms of flexible working arrangements.

If changes are made so that employees can return to work sooner than they might have otherwise, this could impact on benefits such as group income protection. But Dr Doug Wright, principal clinical consultant at healthcare provider Aviva, said the mechanics of healthcare insurance policies would not need to be altered. “I do not think policy wordings will need to change, but there is an opportunity for providers to offer medium-term services, because short-term absences are often covered by HR policy and those with long-term absence are often left alone.”

However, fit notes could muddy the waters for employers in terms of their responsibilities to employees. Samantha Davis, head of employment law at Adams and Remers, said: “The note very much puts the onus on the employer and it could put them in quite a difficult legal position.

“Companies will need to make sure they carry out risk assessments and make any amendments that are needed after taking the note into account. Employers that do not make the necessary amendments could leave themselves open to personal injury claims.”

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