GPs in parts of England will stop issuing some sick notes under government pilots designed to overhaul what ministers called a “broken” fit note system and reduce long-term sickness absence.
The reforms will see some workers referred to specialist support services instead of being signed off work in the usual way, with personalised plans aimed at helping people remain in employment or return sooner.
Ministers said the current system too often leaves people with a document saying they cannot work, but without practical support to recover, stay connected to their employer or discuss adjustments. The pilots will run through selected NHS WorkWell sites and major employers, covering up to 100,000 appointments over the next year.
Ministers target ‘broken’ fit note system
The Department for Work and Pensions (DWP) and the Department of Health and Social Care said around 11 million fit notes are issued each year, with more than nine in ten declaring someone “not fit for work”.
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Under the pilots, patients will either receive an initial fit note from a GP before being referred to a community health worker, or will go through the full process without an initial GP-issued note.
The separate services will be staffed by clinical and non-clinical practitioners, including social prescribers, work and health coaches and other support workers.
They will provide “stay in work” and “return to work” plans, including three-way conversations between patients, employers and trained professionals about reasonable adjustments and workplace support.
Pat McFadden, the work and pensions secretary, said the government wanted to replace a passive process with earlier practical support.
“Fit notes are too often a dead end, a piece of paper that tells people they can’t work but does nothing to help them get better,” he said.
“We’re changing that. By bringing employers, the NHS, and patients together we can help people recover faster, stay connected to their jobs, and get the economy firing on all cylinders.
“That’s what these pilots are about, and that’s what this Government is committed to, fixing what is broken.”
The pilots will take place in Birmingham and Solihull, Coventry and Warwickshire, Cornwall and the Isles of Scilly and Lancashire and South Cumbria.
Employers urged to act earlier
The reforms are likely to attract close attention from employers as businesses continue to manage rising sickness absence, long-term health conditions and pressure on productivity.
The government has increasingly linked economic inactivity to workforce shortages and weaker growth, while employers have warned that NHS waiting lists and limited access to occupational health can make it harder to support staff back into work.
Paul Shires, director at Health Shield Friendly Society, a UK health cash plan provider, told HRreview the move away from simply signing people off work could help reduce long-term absence, but only if it improved access to support.
“Moving beyond a system that simply signs people off work could help reduce long-term absence, but only if it gives people quicker access to the right support,” he said.
He said the organisation’s Britain at Work report showed health problems were already affecting work decisions for many employees.
“Research in our Britain at Work report supports this, with findings showing 34% of employees have considered reducing hours or leaving work due to a health-related issue, but 75% believe that faster access to diagnostics or treatment would help them return to work sooner, showing how important early practical intervention can be,” he said.
Shires said the proposals reflected a wider change in how employers and policymakers were approaching health at work.
“Employee wellbeing, access to healthcare and business performance are now closely linked, with 53% of employees telling us NHS waiting times or access to treatment have affected their ability to work, and 55% saying they’ve struggled to get a GP appointment,” he said.
“With indications that government policy is shifting towards keeping Britain working, employers should be considering implementing affordable wellbeing strategies that support the whole of the workforce by providing access to proactive care that addresses problems before they require time off.”
GP workload concerns
The government said the reforms were also intended to ease pressure on general practice.
A call for evidence found only 29 percent of healthcare professionals in primary care believed issuing fit notes was a good use of GP time, while six in ten employers said the current process was ineffective in supporting employees’ work and health needs.
Minister of State for Care Stephen Kinnock said NHS staff had repeatedly warned that the current process was not working for patients or clinicians.
“These pilots mark the beginning of the end for that broken system, giving people personalised support to get back into work and freeing up GPs from unnecessary admin so they can focus on what they do best: caring for their patients,” he said.
But doctors’ leaders said any changes must be properly resourced and must not add to pressures on general practice.
Professor Victoria Tzortziou Brown, president of the Royal College of General Practitioners, the professional body for family doctors in the UK, said GPs took their responsibility to issue fit notes seriously, but the current system involved significant administration.
“We are open to exploring evidence-based reforms that could help improve outcomes for patients. However, any reform of the fit note process must put the health and wellbeing of patients first, be fully resourced and avoid creating additional workload for general practice,” she said.
Disability groups also warned that the system must recognise that some people will remain unable to work.
James Taylor, director of strategy at Scope, a UK disability equality charity, said pilots could help improve the process for individuals and employers, but ministers needed to listen to disabled people.
“Disabled people face barriers at every stage of working life and are nearly twice as likely to leave work as non-disabled people,” he was quoted in The Independent as saying.
“The DWP needs to listen to the experiences of disabled people and understand the impact of any decisions that are made. They also need to recognise that some people might not be able to work.”
The government said the pilot evidence would help shape future legislation to reform the fit note system more widely.
William Furney is a Managing Editor at Black and White Trading Ltd based in Kingston upon Hull, UK. He is a prolific author and contributor at Workplace Wellbeing Professional, with over 127 published posts covering HR, employee engagement, and workplace wellbeing topics. His writing focuses on contemporary employment issues including pension schemes, employee health, financial struggles affecting workers, and broader workplace trends.
- William Furney
- William Furney
- William Furney
- William Furney
