Fit Notes
With effect from 6 April 2010, the Medical Statement (the so-called ‘Sick Note’) was replaced with a Statement of Fitness for Work (‘Fit Note’) (see documents) for Social Security and Statutory Sick Pay purposes.
The Fit Note offers GPs the option to indicate either that the employee is unfit for work, or that s/he might be able to return to work with some support; and to suggest ways to facilitate a return to work, i.e. a phased return to work, altered hours, amended duties, or workplace adaptations. GPs can also provide further information about the employee’s condition and how it might affect the work s/he is able to do.
In many cases, the advice provided on the Fit Note will be straightforward.
In others, further discussion with the employee may be necessary to facilitate a return to work, or specific advice may be required from Personnel Services and/or the University Occupational Health Service before a return to work can be agreed by the department.
The Fit Note is not binding on the employer: unless and until the department has agreed that the employee may return, and any necessary support is in place, the employee will remain on sick leave.
See further background information.
- Summary of the new scheme
- Insurance
- Sick pay and record-keeping
- Return to work interviews
- Further information
Summary of the new scheme
The following information and advice is based on the guidance issued by the Department of Work and Pensions (http://www.dwp.gov.uk/fitnote/)
An example of the new Fit Note Sample fit note 
(1,469kb). A Fit Note can be issued by a GP on the basis of a face-to-face or a telephone consultation, or a report from another healthcare professional. During the first six months of sickness, a Fit Note can be issued for a maximum of three months.
The Fit Note contains two options
- unfit for work
- may be fit for work taking account of the advice given
The form will indicate the period of time for which this assessment is valid, and whether or not the GP needs to assess the employee’s fitness again at the end of this period. If the statement does not refer to a subsequent consultation date, the employee will normally be expected to resume their usual full duties at the end of the statement period. In either case, fitness to resume normal duties will usually be signalled by the absence of further statement since there will no longer by the option for GPs to provide a statement that an individual is ‘fit for work’. If the employee is returning to a role that has specific hazards, for example work at heights, driving or heavy manual handling (this list is not exhaustive), and the department is concerned that health issues might still affect their ability to return safely to their full duties, advice should be sought from the UOHS.
The Fit Note will continue to be used as evidence as to why an employee cannot attend for work owing to illness or injury for Social Security and Statutory Sick Pay purposes. A statement is not required until after the seventh calendar day of sickness.
If the GP indicates that the individual 'may be fit for work taking account of the following advice', tick boxes on the Fit Note will indicate the nature of that support, e.g. phased return to work, flexible working, amended duties, and/or workplace adaptations. The GP may also indicate how the employee’s condition might affect their ability at work (i.e. the ‘functional effects’ of the condition).
Further information on adjustments to facilitate a return to work may be found on the Occupational Health web site and in the Occupational Health guidance 
(109kb) .
The Fit Note constitutes advice from a doctor to his or her patient. In many cases, such advice is not informed by detailed knowledge of the work undertaken by the employee, or his or her work environment. The advice is not binding to the employer, who has responsibility for deciding whether or not to accommodate any changes suggested to facilitate a return to work. The employing department should discuss the doctor’s comments with the employee, and seek advice from Personnel Services and/ or Occupational Health where necessary. Any adaptations or adjustments required should be reasonable and proportionate, and decisions about what can be accommodated should include a risk assessment of the effect of the changes on the employee and others in the workplace. If a return to work is possible, the department should agree any temporary changes to the job or hours and what support will be provided and for how long. This should be recorded in writing; and there is an optional Return to work discussion proforma (45kb) for recording discussions in ‘return to work’ interviews.
There may be occasions where it is not practicable to accommodate the adjustments, in which case the Fit Note should be used as if it had advised ‘not fit for work’. In such cases, and in all cases where the ill-health may have a work-related cause, it will be particularly important to seek advice from Occupational Health and/or Personnel Services before reaching a final decision and discussing this with the employee.
Fit Notes do not affect the University’s current obligations in relation to the Equality Act (previously Disability Discrimination Act)
Insurance
Where the GP has certified that the employee is not fit for work, as at present, individuals will not be covered by the University’s insurance and should not be permitted to carry out work for the University. Where a doctor has certified that an individual “may be fit for work taking account of the following advice”, the individual will be covered for insurance purposes as long as the medical (GP or UOHS) advice is followed. In cases where an individual’s recovery allows them to return to full duties earlier than indicated by the GP it will be important that clear agreement is reached with the individual, and that this is recorded.
Sick pay and record-keeping
The University’s occupational sick pay scheme (outlined in Section 4.1.2 of the staff handbooks) gives guidance as to appropriate periods of full and half pay during sick leave, but leaves some discretion to department in relation to the management of individual cases.
It is essential to maintain accurate records of sickness absence for the purposes of calculating entitlement to occupational and/or statutory sick pay. Any arrangements for a phased return to work (RTW) should be recorded and monitored. In order that comprehensive records can be maintained, any time that the individual is absent from work should be accurately recorded as sickness absence on the individual’s personal record (so, for example, a full-time employee working mornings only while they were not fully fit would be recorded as taking 2.5 days’ sick leave over the week).
As general guidance, in straightforward cases (for example, a phased return to work following a short illness, or minor operation), those engaged on a phased return to work should be paid at their normal rate of pay during the phased return period or four weeks, whichever is the shorter. In respect of any further agreed extension of phased return beyond four weeks, salary will be pro rata to the hours worked with the remaining time counting against normal sick pay entitlement. Extended or repeated phased RTW programmes should not be undertaken without discussion with Occupational Health Service and/or Personnel Services.
Return to work interviews
Many departments already carry out return to work interviews for members of staff returning after sickness absence. Where an employee is returning under the terms of a Fit Note, a return to work interview/meeting should be held, and a record of the meeting kept. A Return to work discussion proforma (45kb) is provided.
Further information
A Summary of actions (54kb) to be taken on receipt of a Fit Note.