Is an employer obliged to comply with the advice on a fit note?
The advice given on a fit note is advice for the employee and is not binding on the employer. Most GPs are not trained in occupational health. They have a limited amount of time to see patients and often have only the patient's account of the symptoms. The government guidance for doctors (Getting the most out of the fit note: GP guidance) and employers (Getting the most out of the fit note: Guidance for employers and line managers), makes clear that fit notes are not binding on employers. It is ultimately the employer's decision how to act on the advice, taking into account its wider legal obligations.
If the employer is unable to implement the suggestions on the fit note, it should explain this to the employee and treat the fit note as if the doctor had advised that the employee is "not fit for work". The employee does not need to return to the doctor to confirm this. Alternatively, the employer could request that the employee return to the doctor for advice on alternative suggestions for adjustments. The employer could also seek specialist occupational health advice.