Tag: Fit Note

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Disability Employment Law Employment Rights Act 1996 Health Conditions Mental Health Reasonable Adjustments Return to Work Sick Pay

Changes and guidance on fit notes for employers and line managers

View of the City of London at sunset

The government has just published changes to its fit note guidance for employers and line managers. It even included a handy checklist so that employers can avoid painfully drudging through the lengthy (4,462-word) document. The checklist includes the necessary steps and information that employers should have at their disposal when an employee has been issued a fit note.

Firstly though, what is a fit note? It’s a note from a certified healthcare professional who has determined after consultation with an employee, whether or not they ‘may be fit for work’ or are ‘not fit for work’. A fit note allows employers to discuss with their employees any health conditions that may prevent them from undertaking their work as usual. It also gives employers the chance to have an interactive discussion with their employees to establish tailored measures suited to both parties going forward.

The changes to this guidance as of 2022 state that where these fit notes had previously been required to have a signature of ink, they are now moving forward (as we all are) to accepting just the name and profession of the issuer. This enables the fit notes to be received and sent digitally. The DWP also expanded their accepted list of healthcare professionals who can certify the notes to include nurses, occupational therapists, pharmacists, and physiotherapists. It should be noted that although digital notes are embedded in primary care settings (GP), they are not yet in secondary care settings (hospitals), and so a pre-printed note may still be used by employees recently discharged from hospital.

There are a number of general rules that surround fit notes, so I’ll just outline the important ones to familiarise yourself.

In the first 7 days of sickness, employees can self-certify. If your organisation requires medical evidence within this time, any costs incurred by the employee for accessing a healthcare professional will be yours to cover eg:- where there has been a pattern of absence say on a Monday and Friday and you tell the employee that any further absence on these days will require a fit note.

The length of a fit note can cover a maximum of 3 months at a time during the first 6 months of sickness. Any specific time decided will be determined by the clinical judgement of the healthcare professional.

Private (non-NHS) healthcare professionals can produce reports like a fit note which can be considered. Private medical certificates or the Allied Healthcare Professionals Work Report can be accepted with no further need to obtain a further note.

Fit notes can come in a variety of ways, whether that be computer-generated and printed out, or sent digitally to your employee. Digital fit notes will include a barcode so that they can be scanned by employers and added to sickness records.

Now onto the fitness for work assessment and what that means for employers. The healthcare professional will state whether the employee is fit for work or not, and the length of time that any adaptions are required/the amount of time the employee is unable to work for. If they ‘may be fit to work’, the healthcare professional will give general recommendations on adjustments to be made for the employee to work safely or return to work entirely. These recommendations are not binding and if the recommendations cannot be implemented given the nature of work, the fit note can then be used as evidence for sick procedures.

General adaptions you may choose to explore as an employer include:

  • Phased return to work

  • Altered hours

  • Amended duties

  • Workplace adaptions

While at first glance these fit notes may appear to be potentially obstructive, by supporting your employee to stay or return to work you may actually avoid absence costs and minimise disruption for your organisation. Having an open discussion with your employee about adjustments will serve to create a more trusting work relationship that can only benefit both parties!

Martha Regan
Refreshing Law

 

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Anna Denton-Jones Disability Employment Law Employment Rights Act 1996 Equality Act 2010 Health Conditions Mental Health Return to Work Sick Pay

Revised — Fit notes

View of the City of London at sunset

You may be aware that the categories of people who are able to sign a Fit Note for the purposes of Statutory Sick Pay and other Social Security claims has been broadened with effect from 1 July 2022, so that pharmacists, physiotherapists, registered nurses and occupational therapists are now all able to sign Statements of Fitness for Work.

The old rules that such paperwork needed to be ‘wet’ signed by the GP have also been removed so it is now possible for the electronic generation of this paperwork in order to improve the way in which medical professionals are able to issue such documents. The Fit Note is still required to be signed and include the name of the healthcare professional who authorised it to be legally valid so a version that is blank isn’t genuine.

The Department for Work and Pensions has issued guidance for healthcare professionals which is called “Getting the most out of your Fit Note”.

It is interesting reading, in particular the instructions to medics to focus on fitness for work in general rather than fitness to attend a particular occupation, which suggests that it ought to be harder for somebody to achieve a state where they are unable to work at all, compared to being unable to perform aspects of their job.

The case studies are interesting as well. Particularly the fifth one called “relationship issues at work”. It gives the example of a patient complaining that she doesn’t get on with her manager, is feeling very stressed and wants to be signed off work. The medic determines in the consultation that although the situation is upsetting for the individual, they do not have a mental health condition and that they are fit for work. The medic then explains to the individual that they can see that she is being affected by work but is not in a situation where she should be issued with a Fit Note. The patient reacts badly and tells the medic that their manager has been really horrible to her and that she is finding it difficult to cope. The medic is directed to say that they appreciate that that may well be the case but to explain that the situation is not making the patient ill. If they were ill then they would be issued with a Fit Note and the medic would be acting with their health interests in mind. Instead, the medic is encouraged to explain that this is not a medical problem but a management issue and that going off on the sick will not resolve the problem or help her to find another job if that is what she decides to do. If that conversation happened, I think all employers would be relieved.

The medic is then encouraged to discuss with the individual whether they can talk to somebody at work to help resolve their problems such as speaking to HR, a Trade Union representative or speaking to ACAS. In the case study, the patient decides to approach another colleague for advice, to check the internet and to look at ACAS materials on managing conflicts at work.

Using that example, the situations we come across in HR where this is some kind of conflict or dispute in work, should not by this analysis result in somebody being signed off from work. It will be really interesting to see to what extent the medics toughen up their approach, as we all know that the stereotype is that Drs will provide a Fit Note “on demand”.

In the question and answer section of the document, it’s interesting to see that there is a question relating to “what if my patient fears job loss, stigma or discrimination if I reveal a health condition (or its effect on their work functioning) on their Fit Note?”. The answer is as follows: “if you feel that revealing a particular diagnosis or a limitation would harm your patient’s wellbeing, compromise their position with their employer, you can enter a less precise diagnosis on the Fit Note”. We have all come across examples where a Fit Note has said something like “unwell” or “stress” rather than an actual medical condition – this is why it is always worth referring somebody to occupational health to get the full picture. It reminds us that this scenario may be behind what a medic has written and that all may not be what it seems from the face of the paperwork: further exploration is necessary.

It is interesting to note that medics are encouraged to only issue bereavement related Fit Notes if somebody is genuinely so distressed by what happened to them that they are unfit for work – where they are not actually medically unwell then they should be having compassionate leave with their employer not time off sick. Again it will be interesting to see how many medics follow this guidance.

There is also further guidance for employers and line managers: Fit note: guidance for employers and line managers. Amongst other things, this repeats the position that has been the case for some while now but which I find employers are often confused by, in relation to return to work before the end of a Fit Note. The employee can come back to work at any time, even if this is before their Fit Note expires and they do not need to go back to their healthcare professional first. If somebody is coming back and you believe it is too soon or harmful in some way, then you would need to refer to occupational health for an assessment and further guidance. Where a healthcare professional assesses somebody is fit for work, they will not be issued with a Fit Note (there are some very narrow occupations where certification has to be given).

Something else that strike me about this new guidance is the emphasis that people do not need to be 100% fit to return to work because they may well be returning to work with adjustments and need to do alternative duties. That would probably surprise employees.

Anna Denton-Jones
Refreshing Law

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Absence Anna Denton-Jones Disability Employment Law Health Conditions Return to Work Sick Pay

Extension of who can provide an employee with a Fit Note

View of the City of London at sunset

You will all be familiar with GPs providing employees with certification that they are insufficiently well to attend work on day 8 of their absence, enabling the employer to then process, for example, statutory sick pay.

Some new regulations, snappily titled “The Social Security (Medical Evidence) and Statutory Sick Pay (Medical Evidence) (Amendment) (No. 2) Regulations 2022″ amend the position to expand the category of people who can sign Fit Notes for the purposes of Statutory Sick Pay and making Social Security claims.  From 1 July 2022, registered nurses, occupational therapists, pharmacists and physiotherapists will also be able to sign the Statements.  The idea behind this is to reduce workload on GPs and as you can envisage the GP practice may pass some routine work to the practice nurse, for example.

However, employees are still going to primarily be thinking of their GP when they are thinking about evidence for their employer of them not being fit to attend work.

You will need to update managers on this development so that they appreciate that any paperwork they see with the four new categories of signature are genuine and acceptable.

Anna Denton-Jones
Refreshing Law