Fit Note Guidance for Managers

The ‘Fit Note’; what it means for an employer

From April 6^th 2010 general practitioners (GP’s) will start to use the new Statement of Fitness for Work for Social Security and Statutory Sick Pay purposes. It replaces the Med 3 and Med 5 'Sick Notes'.

GP’s will be able to sign that the employee ‘may be fit for work’ and suggest adjustments that might assist the individual to return to work e.g. phased return to work, amended duties or hours, workplace adaptations. The advice on the statement is not binding on the employer. Its purpose is to suggest ways of facilitating an earlier safe return to work if appropriate to the benefit of employee and employer. Employers still have duties under the Disability Discrimination Act (DDA) to make all reasonable adjustments for disabled employees.

What steps should a line manager take if adjustments are suggested?
What if a manager cannot accommodate the employee's needs for adjustments?
How long should these adjustments be in place?
What are the cost issues?
What confidentiality issues may need to be considered?
What if the problem is work-related?
Examples of adjustments
What is a 'Phased Return to Work Programme' (RTW)?

What steps should a line manager take if adjustments are suggested?

Facilitating an adjusted return to work may help overcome barriers to returning. This benefits both employee and employer. As soon as a Fit Note with suggested adjustments is received, you should consider the doctor's comments and discuss these with the employee (either by phone or by person). If a return to work is possible, you should agree any temporary changes to their duties or hours and what support you will provide and for how long and this should be recorded in writing. This contact alone may encourage the individual to start to contemplate returning. If further contact is required the line manager may discuss with the employee when and how they should liaise again. During consideration of the return to work process appropriate regular contact with the employee is advisable (normally weekly).

Many common adjustments (See below e.g. shorter hours, reduced workload, and minor alteration of duties) do not require equipment but may have an impact on the operation of the department. As a manager you have a duty under the Health and Safety at Work Act to ensure that any adjustments comply with University Policies on safety and health. You must therefore balance the proposed adjustments against the operational needs of the Department as a whole, the needs of the other team members and health and safety considerations. The UOHS can advise managers at any stage of this process.

What if a manager cannot accommodate the employee's needs for adjustments?

If you cannot reasonably make the adaptations or adjustments to help a return to work, you should explain the reasons for this to the employee. You should use the statement as if the doctor had advised 'not fit for work'. The reasons should be recorded in writing and might include, but are not limited to adjustments that are:

Unlikely to enable the individual to undertake useful work
Disruptive to the operation of the department
Costly in the context of the role
Potentially a risk to the health or safety of the individual or other staff (e.g. if the work involves work with heights or moving machinery other concerns may be if the individual drives for work, undertakes lone working, or works with infectious pathogens)
Not able to be implemented before the employee regains full health

The UOHS is available to advise managers experiencing any difficulty accommodating suggested adjustments.

How long should these adjustments be in place?

Adjustments for temporary ill-health should usually last no longer than twelve weeks. (For individuals with a disability the DDA applies see University guidance).

What are the cost issues?

The costs of temporary adjustments should normally be offset by the benefit to the department of the early return of the employee. For long term adjustments under the DDA alternative sources of funding (such as Access to Work) may be available.

What confidentiality issues may need to be considered?

Personal data related to the need to implement adjustments should be stored and accessed according to the Department’s procedures for complying with the Data Protection Act 1988 (link to University Guidance).

What if the problem is work-related?

If the 'Fit Note' indicates any ill health may have been caused or made worse by work, or working arrangements (including, for example conditions such as musculoskeletal disorders or stress-related illnesses), please refer the individual to the UOHS using the management referral form. Any incident giving rise to work-related ill-health should be reported to the Safety Office using an accident/ incident form.

Examples of adjustments

The following examples are possible temporary adjustments that UOHS or GPs might advise while the employee regains strength, mobility or capacity to work. The practicability of introducing such adjustments, if requested, should be considered on a case-by-case basis and may vary between sites depending on local facilities.

Phased return to work, building up from part-time to full-time hours over an agreed and appropriate period of time (see below).
Changes to an individual’s working hours to allow travel at quieter times
Help with transport to and from work, for example organising lifts to work,
Home working (providing a safe working environment can be maintained and work carried out this way) see guidance on homeworking.
Time off during working hours for rehabilitation assessment or treatment.
A designated area for exercise / rest during the day
Moving tasks to more accessible areas e.g. closer to toilet facilities.
New or modified equipment and tools, including IT, modified keyboards etc. The OHS has a lending library of simple ergonomic equipment.
Modified workstations, furniture, and office movement patterns e.g. allowing the employee to use a footstool/ have the post brought to them
Additional training for workers to do their job.
Modified work patterns or management systems to reduce pressures
Telephone conferences to reduce travel
Buddies, mentors or supervision for workers while they regain confidence
Reallocating work within the person’s team.

What is a 'Phased Return to Work Programme' (RTW)?

Employees who have been off sick for longer than 6 weeks or who have had a significant period of ill-health (e.g. a major operation) may feel concerned about how they will cope with a return to their full work duties. A structured gradual return to full duties over a period of time may be beneficial in some cases.

A phased RTW usually takes place over no more than 6 weeks. Managers should aim to reduce, not postpone, hours or duties to avoid development of a backlog. To achieve this some duties may need to be temporarily re-assigned to someone else. The line manager and the employee should agree a timetable, duties and working arrangements that will allow them to gradually increase their hours or duties until they have returned to their full role. The staff member’s progress should be monitored on a weekly basis. As individual progress can be variable some flexibility may be necessary.

As an incentive to return to work for those on reduced pay, during the first 4 weeks ONLY of a straightforward phased RTW a staff member will be on full pay even if their pay has reduced below this because of the length of sickness absence. However all time absent from work must be recorded for sick pay purposes during this period. In respect of any further agreed extension of a phased return beyond four weeks' salary will be pro rata hours worked with the remaining time counting against normal sick pay entitlement. Extended or repeated phased RTW programs should not be undertaken without discussion with the UOHS ( see Personnel Guidance 'Introduction of Statements of Fitness for Work' regarding sick pay monitoring during a phased return to work).

There is no fixed pattern to a return to work and managers may agree any gradually increasing pattern spread over 6 weeks but one suggested example may be:

Week 1: 3 half days

Week 2: 4 half days

Week 3: 5 half days

Week 4: 1 full day and 4 half days

Week 5 : 3 full days and 2 half days

Week 6: 4 full days 1 half day

Employees should reach about 50% of their full-time hours by the end of week 3. If it is clear the the individual is not achieving this the manager should consult with their personnel officer and ensure that any absence is recorded for sick pay purposes.