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Fit notes fail to cure sick-note Britain say employment experts

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Neither doctors nor employers really know what to do with the new 'fit notes' and, as a result, they are failing to cure sick-note Britain, according to legal experts.

On April 6, "fit notes" officially replaced the traditional "sick notes". But Jim Lister, head of employment at Manchester law firm Pannone, says the fit note regime is not being embraced by GPs, and many employers are claiming they are simply not fit for purpose.

Fit notes were launched to encourage people, who are well enough, to return to work before they receive Employment and Support Allowance (ESA) on incapacity grounds.

The notes are designed to provide employers with greater information on an employee's medical condition and suitability for work.

The notes have two boxes which allow GPs to certify one of two options: "not fit for work" or "may be fit for work taking into account of the following advice". 

The notes then list four common types of adjustments which employers can introduce to assist a return to work: "phased return to work" "amended duties" "altered hours" and "workplace adaptations".

For example, if an employee was absent because of stress, the doctor could recommend a "phased return to work" or "altered hours". Similarly, a welder may not be able to carry out his or her original duties, but could perhaps work in the warehouse.

But, according to Lister, GPs often fail to understand the nature of the workplace and working practices, and employers do not understand what they are suppose to do with extra information they have been given.

He said: "On the day fit notes were introduced, we had one client who received two notes where they GP had recommended adjustments to the working environment. But the recommendations weren't particularly helpful as the doctor didn't appear to have much understanding of the workplace.

"The problem is that GPs are not trained in occupational health, have no knowledge of the workplace or the employer's working practices and will find it impossible to make a proper assessment in the five to 10 minutes they have to conduct a consultation.

"Indeed, one medical defence union warned GPs to be cautious in their approach to completing the notes as it is unclear whether a GP would be liable if they encourage an early return to work which causes the patient's condition to deteriorate.

"It seems that the new fit note regime has, so far, received a lukewarm reaction from both GPs and employers. There will need to be a settling in period, but on the plus side fit notes encourage everyone concerned to think about reasonable adjustments at a much earlier stage of the sickness process and may eventually achieve their aim of getting people back to work sooner."