Statement of fitness for work (fit note)
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Law relating to this document
Leading statutory authority
Social Security Administration Act 1992
Equality Act 2010
Social Security (Medical Evidence) Regulations 1976 (SI 1976/615)
Statutory Sick Pay (General) Regulations 1982 (SI 1982/894)
Social Security (Medical Evidence) and Statutory Sick Pay (Medical Evidence) (Amendment) Regulations 2010 (SI 2010/137)
Fit note: guidance for employers
Fit note: guidance for general practitioners
From 6 April 2010, a new "fit note" replaces the traditional sick note certificate. The fit note is designed to encourage employers, employees and doctors to move away from a rigid system of employees being either fit or unfit to work and towards a more flexible approach placing the emphasis on what employees are able to do at work, thus helping sick employees to return to work as soon as they are able.
As well as declaring that an employee is unfit for work, a doctor can also state on the fit note that an employee "may be fit for work taking account of the following advice". There is space below this option on the fit note for the doctor to give suggestions for changes that could be made to the employee's duties, working environment or hours of work to enable him or her to go to work. The doctor could also recommend a phased return to work after illness so that the employee can gradually increase his or her workload.
Examples of amendments to duties include:
- removing heavy lifting from the job duties of an employee who has suffered a back injury; and
- reducing the more pressurised parts of a role (for example, removing customer-facing duties) from an employee who has been suffering from stress.
Changes to the working environment could involve:
- providing a ground-floor workstation for an employee who has difficulty getting up and down stairs because of a musculoskeletal disorder; and
- providing a special chair for an employee who has been suffering from back pain.
An employee's hours of work might be altered, for example, to allow him or her to start or finish work earlier or later to avoid the rush hour on public transport. Similarly, an employee who tires easily might be permitted to work fewer hours, at least on his or her initial return to work as part of a phased return.
From July 2012, GPs started using computer-completed fit notes. They are printed on one side of A4 paper and include the same information as handwritten fit notes.
As with the old sick note system, an employer cannot require an employee to provide a fit note until after seven calendar days of illness, for statutory sick pay purposes. The information given on the form continues to be advisory and is not binding on employers.
Fit for Work is a Government-funded service providing advice for employers, employees and GPs on matters relating to health and work. It also provides occupational health assessments on referral from the employee's GP or employer, where an employee is absent from work for at least four weeks. Where an employee has provided the employer with a return-to-work plan provided by the Fit for Work service, this can be used in place of a fit note to determine fitness for work.
Employers have a duty to make reasonable adjustments for disabled people under the Equality Act 2010. Therefore, although the fit note is not binding, an employer may need to make certain adjustments to accommodate a disabled employee.
Employers should also note that where they refuse to make adjustments or consider alternatives to facilitate the employee's return to work and the employee is dismissed as a consequence of the continued absence, an employment tribunal may find that the employer's failure renders the dismissal unfair. It is therefore worth considering alternatives and adjustments even where the employee is unlikely to be disabled within the meaning of the Equality Act 2010.