On 6th April 2010 new fit note certifications will replace the current Med 3 sick notes currently filled in by GPs.

The fit note differs from its predecessor the Med 3 as it allows GPs to suggest a return to work with adjustments through the introduction of a new option: "May be fit for work taking account of the following advice". If the GP completes this option, they should also describe the functional effects of the employees condition, with the option of setting out suggested temporary arrangements which could help them back to work, such as a phased return, altered hours, amended duties or workplace adaptations.

If an employer is not able to facilitate a change or adjustment, the GP’s advice on the statement will be evidence that an individual is not fit for work.

Employers that work with occupational health practitioners may disagree with the GP’s advice. But if the employee’s condition constitutes a disability under the Disability Discrimination Act the employer will have a duty to make reasonable adjustments in any event. Employers duties under the Disability Discrimination Act remain unaffected and will continue to apply.

The new fit note will not give doctors the option to deem a patient “fit for work”. The doctor will indicate on the note whether or not they need to assess their patient’s fitness for work again, making the need for a ‘fit for work’ option unnecessary. A ‘fit for work’ statement is not generally needed for employer liability insurance reasons, and it is the employer’s responsibility to carry out a risk assessment when an employee returns to work to ensure there is minimal risk to the employee and others in the workplace.

The fit notes have already been subject to criticism on the grounds that GPs have not been sufficiently trained in occupational health to make an informed assessment of the employees work-related capabilities.

According to recent research, only one in 20 GPs follow government advice on sick leave, with employees often being signed off for far longer than the time recommended, and an enormous disparity between GPs in the amount of time signed off for the same conditions. Most GPs felt that patients and GPs have equal influence on the length of the period covered by the sickness certificate.

Many are sceptical about the willingness of GPs to change their practice, especially as doctors are being cautioned against giving anything other than the most general advice on medical fit notes.

It is unlikely that the new fit notes will make much difference in practical terms, so employers wishing to tackle sickness absence at work should continue to:
• encourage dialogue between the employer and employee;
• make it clear that they want to try to get the employee back to work;
• give support including, where appropriate, adjustments such as a phased return, to help the employee get back to work;
• consider referral for an independent assessment from a specialist doctor or occupational health expert where appropriate; and
• provide appropriate training for line managers.

Peninsula clients who receive a fit note stating that an employee may be fit should contact our 24 Hour Advice Service on 0844 892 2772 to discuss their options.