• Alex Davies
  • 5 August 2015

Is the Fit Note still fit for Practice?

The GP fit note was introduced in April 2010 to a very mixed reaction. The concept was fairly straight forward: to allow better communication and choice for patients, GPs and employers.

Previously GPs had one option where people were ailing for any reason, which was to provide a medical certificate keeping the patient from work for a specific period. The fit note introduced further options, and a chance for GPs and employers to communicate with each other, even if still with some restrictions.

The fit note now enables GPs to recommend adaptions such as changes in working hours or phased returns and allows a return to work tailored to the patient’s specific needs. The goal: to allow patients to work without affecting their health.

Five years on though, has it worked?

IOSH – the chartered body for health and safety professionals and the world’s largest professional health and safety organisation – commissioned the University of Nottingham as rehabilitation research experts to conduct a study.

This research collated data from patients, GPs and employers and broadly identified that the fit note is not being used as it was intended.

Overall this appears to be due to a general lack of understanding between GPs, patients and employers, with a result of more patients being unable to work creating a huge burden on all parties involved.

According to Heidi Thompson, HR Consultant for International Workplace: “This is perhaps not that surprising. GPs have limited time with patients and are tasked with a complex question: could this patient work and if so on what basis? This requires GPs to understand in just a short consultation the different complexities of each patient’s role, company and individual abilities”.

Heidi notes: “This study highlights that the fit notes play a vital role in tackling absence, but without a clear practice in terms of completion and application, the benefits will be lost in many cases”.

As a result the study provides a total of 67 recommendations for the improvements needed. These include an exemplar ‘ideal’ fit note from the perspective of employers, employees and GPs; the ability for employers to contact GPs for queries; and specific training for employers and GPs on the administration of the fit notes.

Heidi’s comments are echoed by Jane White, Head of Research and Information Services at IOSH: “Our research has shown that the GP fit note has the potential to do much more and play a pivotal role in helping people stay in work or get back to work as soon as they can.

“We are keen to see changes to the fit note and processes which will lead to practical and significant improvements for all involved and this research and the recommendations pave the way to help us do that.”

The summary and full research reports are available to download online.

Getting the best from the fit note - full research report (PDF, 1.50 MB) Getting the best from the fit note - summary report (PDF, 1.33 MB)