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Fit notes for sick employees hit record high

The NHS issued 10.4 million fit notes in 2022, a record high.

In the UK, fit notes are issued by healthcare professionals to provide evidence of the advice an individual has been given about their fitness for work.

The number of fit notes issued increased by 11% between 2021 and 2022 according to data analysis by employment law firm GQ Littler.

During the pandemic it was more challenging for employees to get fit notes, and employers were more lenient about them.

However, Sophie Vanhegan, partner at GQ Littler, said bouncing back from Covid is only part of the reason for their increase.


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New legislation was introduced in July 2022 which enabled medical professionals other than GPs to provide fit notes for sick workers. Under the new guidelines, nurses, occupational therapists, pharmacists, and physiotherapists can now issue fit notes. 

Speaking to HR magazine Vanhegan said: “Now that a wider range of medical professionals can certify fit notes, it is easier for employees to obtain these. If people are waiting weeks or longer for a GP appointment, it makes it nearly impossible to get a fit note in a timely fashion. But new legislation makes fit notes much more accessible to the people who need them.”

Vanhegan also suggested an increase in illnesses as Covid restrictions eased may have contributed to the rise in sickness absences.

The challenging economic climate is also affecting employees’ mental health, she added. 

“Worrying about the current cost of living crisis can elevate levels of stress and anxiety in employees, causing them to need time away from work,” she said.

Sickness levels have risen in the UK as in 2022 the number of workers with long-term conditions hit a record 2.5 million.

Suzanne Marshall, head of clinical strategy at wellbeing consultancy GoodShape, said although fit notes provide an important function they are not a complete strategy to manage absence.

Speaking to HR magazine, she said: “While sick notes highlight the validity of an illness they do not contribute to the welfare of the employee long term. They shouldn’t be treated as a diagnostic tool in terms of the duration of absence or relied on as a mechanism for supporting employees once back to work. 

“Generally, fit notes give employers little insight to the health of their employee, which precludes effective support being offered upon their return to the workplace. This can be particularly problematic for longer-term health issues, where the employee might benefit from additional support at work.”

Marshall suggested employers gather data and build policy around any ill-health patterns they find.

She said: “Gathering accurate data is crucial for employers to implement effective wellbeing policies and processes. Absence data can help flag up patterns of ill-health and areas of concern so they can take targeted steps to make things better.”

Early intervention and clear signposting can shorten absence times, she said: “Intervening early makes a huge difference too, especially for absence reasons with long average durations, like mental health and musculoskeletal issues. 

“Similarly, having systems in place to signpost your people to specialist support, such as occupational health or employee assistance programmes (EAPs) can quicken recovery times, make for safer returns to work, and increase uptake of historically under-engaged services,” she said.

The data was gathered by the NHS between 1 April 2019 and 31 March 2022 then analysed by GQ Littler.