Fit note scheme is not reducing long term sickness absence, claims new study

The UK government’s fit note scheme, introduced  five years ago to help people back to work from long term sickness absence, has failed to deliver its intended reductions, according to research from manufacturing and engineering trade association EEF and Jelf Employee Benefits. The study of 345 companies claims more than two-fifths (43 per cent) of employers believe the policy had not helped employees return to work, up from 35 per cent in 2010. Employers also told the survey that the quality of GP advice on fitness for work has deteriorated, which the report’s authors claim is largely down to the fact that only around one in eight GPs in the UK have been trained in specific health and work and the Government has shown no willingness to invest in more training to bring the numbers of those qualified up to the necessary levels necessary to meet its own goals.

According to the survey 43 percent of companies say the ‘fit note’ is not helping employees return to work, up from 35 percent in 2010. This compares with 22 percent (24 percent in 2010) saying that it has resulted in earlier returns to work. Amongst a number of recommendations, the report urges government to set a fixed date by which all GPs and medical professionals will be trained in the use of the ‘fit note’.

With regard to the advice given by GPs about employees’ fitness for work in 2014, more companies disagree (47 percent) than agree (17 percent) that this advice has improved.

However, more positively, there has been a small improvement and reduction in the number of companies who did not receive ‘may be fit for work’ fit notes. Just over a quarter (26 percent) of companies report that they did not receive any ‘may be fit for work’ fit notes in 2014, compared with 35 percent in 2010.

Despite this direction, the report claims that it is discouraging for employers because just over two-fifths of employers (41 percent) have said they are able to make all the required workplace adjustments for employees with fit notes signed ‘may be fit for work’ (an increase from 38 percent in 2011). Only 8 percent of employers said they are not able to make any adjustments (a decrease from 18 percent in 2011).

In addition to greater resources for GP training and a fixed date for GPs and medical professionals to be trained in the ‘fit note’ EEF is calling for a step up in efforts to create greater interaction between GPs, employers and employees.

Without this EEF believes there is little prospect of the ‘fit note’ ever delivering genuine improvement in return-to-work performance and absence reduction.

To aid this process, EEF has developed a template for use by employers so that employees will be able to take this to consult with their GP on what the employer is able to do to aid return to work.

Key recommendations:

• Link evidence of fit-note training to GP and medical professional CPD and appraisal systems;
• Create e-communities to allow more effective interaction and communication between GPs and employers and employer occupational health services in the ‘fit note’ process;
• Provide targeted advice for SMEs who may come across a ‘fit note’ infrequently;
• Target training of line managers about awareness of the ‘fit note’ process;
• Target employee awareness and training of the ‘fit note’ process at induction;
• Analyse and publish GP performance in using the ‘fit note’ and issuing ‘may be fit for work’ fit notes;
• Modify the ‘fit note’ to include a referral to the Fit for Work Service (FWS);
• Produce clear guidance to show the interaction between the Fit for Work service and the ‘fit note’.

Commenting EEF Head of Health & Safety, Terry Woolmer, said: “We have supported the ‘fit note’ since day one and wanted it to succeed. However, the evidence is now clear five years on that it’s not delivering on helping people back to work earlier. In fact, the evidence suggests that the quality of advice being given by GPs to help people back to work is deteriorating. It can still be made to work but government now needs to put its shoulder to the wheel with greater resources. The first step must be to ensure that all GPs and hospital doctors are trained in health & work issues so they feel confident in giving proper advice. Without this as a basis there is little prospect of the ‘fit note’ ever delivering genuine improvement in return-to-work performance and absence reduction.”