Scheme to trial scrapping fit notes to get people back to work

Key developments are emerging from the global stage. Scheme to trial scrapping fit notes to get people back to work23 minutes ago Share Save Add as preferred on GoogleBecky MortonGetty ImagesGP fit notes declaring people unable to work will be replaced with support to help them stay in their job, under a government pilot scheme. GPs in two areas of England will refer patients for support alongside fit notes, while two others will stop issuing fit notes entirely. The government said the current system was "broken", with too many people signed off work with no help for them to return.

The move is part of efforts to tackle the growing number of people who are out of work due to poor health. There is concern about the impact this has on the economy, as well as contributing to increased benefit payments and pressure on the NHS. More than 11 million fit notes are issued every year, with the numbers increasing since the Covid pandemic.

The Details

Fit notes are approved when someone is unwell or cannot work for more than seven days. They advise on how the patients' health problems impact on their ability to work - and can help to access certain benefits and sick pay. A patient can be declared "not fit for work" or "maybe fit for work" with some adjustments, but the government says more than nine-in-10 sign people off work entirely.

Earlier this year, hundreds of GPs told the they had never refused to sign a patient off work for mental health issues. Many also raised concerns that issuing fit notes should not be part of a GP's job. Hundreds of GPs tell they have never refused a fit note for mental health concernsWhat needs to change to get more people working?

The four pilot schemes, lasting up to a year, cover up to 100,000 appointments and are backed by £3m of funding. They aim to test different approaches to find the best way of tackling the increase in fit notes. In Birmingham and Solihull, as well as Coventry and Warwickshire, GPs will initially issue a fit note where needed but patients will also be referred to support services.

What Experts Say

In Cornwall and the Isles of Scilly, along with Lancashire and South Cumbria, GPs will refer patients directly to support services, without issuing a fit note. The pilots will test whether support should be led by healthcare professionals or non-clinical staff, such as work coaches and social prescribers, where community groups or activities are recommended to patients to improve their health. They will also involve conversations with employers about adjustments to help people return to work.

The pilots will be delivered through existing NHS WorkWell sites, which connect patients with services such as physiotherapy and counselling. It comes after a review earlier this year on how to get people back into work recommended a new approach to fit notes. The review, led by former John Lewis chairman Sir Charlie Mayfield, found the system was "not working as intended", with most GPs lacking the training and time to assess someone's ability to work.

The development has drawn wide international attention, with diplomatic circles watching closely.