Publish date

31 October 2023

Getting the most out of the fit note: Guidance for employers

The Department for Work and Pensions has recently published updated guidance for employers and line-managers on ‘getting the most out of the fit note’. We consider what has changed and provide a reminder of some key things to remember about fit notes.

The Department for Work and Pensions has implemented several changes to the fit note in the last couple of years. In 2022 a new version of the fit note was introduced to replace the previous requirement of a signature in ink with the name and profession of the issuer. This means that employees are able to receive fit notes via digital mediums.  Also in 2022 the scope of professionals that could issue sick notes was widened to include nurses, occupational therapists, pharmacists and physiotherapists, in addition to doctors.

The most recent updates to the guidance give employers access to numerous resources, including:

  • A checklist for employers to highlight key points to support conversations between the employer and employee following the issue of a sick note
  • A detailed breakdown of the form itself, assisting employers in understanding the information that is needed and ensuring that key dates are not missed
  • An FAQ feature with case studies comprising situations whereby an employee is deemed as ‘may be fit for work’, a classification that has historically brought much confusion and uncertainty to both the employer and employee.

The general rules of the fit note

The updated guidance offers a useful reminder as to the underlying legal framework regarding fit notes.

  • Employees can only be given a fit note if a healthcare professional considers their fitness for work to be impaired. If an employee is considered fit for work, a fit note will not be issued
  • Employees have the right to self-certify for the first 7 calendar days of their sickness absence, including weekends and bank holidays
  • On some occasions an employer may request an employee’s medical records from the healthcare professional for the purpose of supporting the employee. However, an employer must be sure to seek the permission of their employee before requesting these. It is essential that employers keep all sensitive information confidential and ensure that this information is only shared with those who absolutely need access to it such as Human Resources.

‘Not fit for work’ or ‘may be fit for work’

An employee may be deemed ‘not fit for work’ or ‘may be fit for work’ on the fit note. A key emphasis of the updated guidance is to remind employers of what adjustments they may consider where an employee has been signed off as ‘may be fit for work’. Such adjustments may be used effectively to facilitate the employee’s return to work.

The fit note may include details from the medical professional regarding how the employee’s condition affects their performance at work. Employers are able to utilise these in discussions with employees regarding making their return to work more comfortable and sustainable.

The updated guidance goes further in explaining the adjustments that employers may make in that whilst employers are not obliged to follow the suggestions on the fit note, it may help to facilitate creative discussions and suggestions to assist employees returning to work.

It is worth remembering though that employers are not obliged to follow the recommendations made where they cannot be accommodated.  But employers should bear in mind that if the employee has a disability, the employer will be under a duty to make reasonable adjustments to alleviate any disadvantage suffered as a result of the disability, this will apply to consideration of recommendations on the fit note, and so they should not be dismissed lightly.

Following the Pandemic and in the midst of the current economic and healthcare crisis, long-term sickness stands at a record high. Employers are experiencing numerous repeated absences and are tasked with supporting those employees facing economic inactivity due to long-term sickness. The updated guidance aims to encourage employers to take a pragmatic approach to fit notes, ensuring that employees are empowered to remain in and return to work.


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