With the CIPD’s September 2023 Health and Wellbeing at Work survey reporting the highest level of employee sickness absence in over a decade (7.8 days per employee), the topic of employee absence continues to be at the top of the agenda for employers.

The Department for Work and Pensions (DWP) has recently issued new guidance on statements of fitness for work (generally known as “fit notes”) – this article explains what this means in terms of employer best practice and the broader policy agenda.  

What are fit notes?  Quick recap  

A fit note is used to record details of how an employee’s health condition affects their ability to work. They were introduced across England, Wales and Scotland in April 2010 and are the normal method for employees to provide evidence of sickness to employers.

Although fit notes have been a familiar document for HR in the last few years, they have recently undergone more than one overhaul: over the last 18 months, new digital fit notes were introduced, which allowed the form to be issued using GP IT systems without the need for a wet ink signature; then more recently the DWP updated its policy to enable nurses, occupational therapists, pharmacists and physiotherapists to certify fit notes, in addition to GPs.

What is the new guidance?

Although there has been no change to the overall policy or rules on the use of fit notes, the DWP has updated the guidance it issues for patients and employees, employers and line managers, and healthcare professionals.

The guidance includes extra detail regarding the completion of the forms and is now supplemented by six case studies which illustrate how fit notes should be used to help employers manage employee absences and support employees to return to work.

In addition, there is a new checklist for employers which is designed to support discussions between the employer and the employee following the employee being issued with a fit note.

The benefits of a pro-active approach to sickness absence

The new guidance is best viewed as part of the government’s wider aim of reducing economic inactivity.  It is clear from the updates to the guidance that the government is encouraging employers to take a more active role in managing employee sickness absence.  The new guidance is expected to be just one of several measures aimed at helping employers combat sickness absence and further significant changes are anticipated in this area.  The Government is also considering how it can legislate to increase occupational health coverage, for example by introducing tax incentives to employers.

As the fit note guidance highlights, there are clear benefits to a more pro-active approach to managing absences, namely:

  • saving employers money;
  • minimising disruption; and
  • helping recovery and wellbeing through work.

Practical tips

We recommend that employers and HR professionals refer to the case studies and checklist set out in the guidance after receiving a fit note. It may be that the situation you are dealing with is similar to one of the case studies or that the checklist answers a query you have.

Employers should also consider the following practical steps:

  • Request fit notes promptly. You should ask for a fit note from your employee if their absence due to illness lasts for more than 7 calendar days, including weekends.  Before this point, the employee can self-certify. 
  • Remember that, for the time being, you may receive forms using the old template with a wet ink signature or in the digital format that was introduced last year. You should expect to receive more digital fit notes as IT systems are updated.
  • Review all sections of the fit note form carefully and always check whether your employee has been assessed as “may be fit for work”. If this is the case, you should discuss possible accommodations with your employee to help them stay in or return to work. This could include a phased return to work, altered hours, amended duties or workplace alterations.
  • Look out for any advice that the doctor or other healthcare professional has included in the comment boxes.  
  • Many absences will be related to a disability from which the employee suffers, in which case there is a duty on the employer under the Equality Act 2010 to make reasonable adjustments. This does not mean that employers are obliged to follow the healthcare professional’s suggestions, but they should form part of any discussion of potential adjustments. 
  • Fit notes are likely to contain a relatively limited range of information regarding the employee’s illness or injury, and it may be hard to ascertain whether it constitutes a disability within the meaning given in the Equality Act.  Occupational health referrals can provide additional detail and guidance on this issue and on the prognosis more generally, particularly if the instructions are clear and considered.  
  • Maintain regular dialogue with your employee throughout the period of absence. Refer to the ACAS advice page for best practice in this area. Always try to agree how often the contact should be, the means of communication and the point of contact within your organisation. Try to get a sense of if or when the employee feels ready to return to work or review any plans you have for reasonable adjustments where applicable.   
  • Remember there is no requirement for employees to be signed back to work by a healthcare professional. The guidance makes it clear that employees can return to work at any time, even if this is before their fit note expires.

Contact us

If you have any questions about these issues in relation to your own organisation, please contact a member of the team or speak to your usual Fox Williams contact.


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