Doctors, Employers and Workers Unite: Britain’s Fit Note Rules ‘Broken’

Britain’s sick note system is under mounting pressure after hundreds of GPs admitted they rarely refuse requests to sign patients off work for mental health reasons — fuelling concerns that a process designed to support recovery may instead be keeping people out of work longer than necessary.

Hundreds of GPs have told the BBC they have never refused to sign a patient off work for mental health issues.

BBC News sent a questionnaire to more than 5,000 GPs in England asking if they had ever denied a fit note - often called a sick note - to someone who had requested one because of their mental health.

Of the 752 GPs who replied, 540 said they had never refused such a request, while 162 told us they had turned at least one down. A smaller number - 50 - said they would prefer not to say.

Some revealed how frustrated they were with the current system, saying the provision of fit notes should not be part of GPs’ jobs.

Sadly, it’s not just GPs who are fed up with the fit note system. Employees themselves, in the main, prefer to be at work and would like more support to get back to work quicker. This doesn’t just apply to employees with mental health issues but those with physical ailments as well. Employers want people back to work quicker because these are valuable employees who drive the success of business and keep businesses growing and creating jobs. The economy needs people to be in work rather than off sick because it increases productivity, allow businesses to grow and gives the Treasure the money it needs to fund public services including the NHS.

Last year, a government-commissioned a report looking into the role of employers in health and disability said that fit notes were “often problematic”. The Keep Britain Working review found that GPs often don’t have the time, or the occupational health training, to work out who is and isn’t able to be at work. The report said, as many reports before it have said, the longer a patient is off sick, the less likely they are to return to work. If someone is absent for 4-6 weeks, there’s a 96% chance of them going back, but if they’re off for a year that chance drops to 50/50. If an employee is off sick in the short-term it costs employers around £13,000 on average and around £21,000 on average per employer who is off sick long term. The report said the current fit note system needs reforming and that it is testing new approaches.

Last year I wrote a report for Metlife the insurer on Early Intervention in absence management, which includes employers, with insurance policies covering absence, getting the help of health professionals to work with absent employees much earlier when they go off sick, to help them to return quicker. That doesn’t mean returning to work before they’re ready but with the right support people who want to be in work are equipped and support back sooner. You can read the report here.

Photo by National Cancer Institute on Unsplash

This is part of the answer the Government, employers, the economy and employees are looking for.