The Department for work and pensions (DWP) and the Department for Health and Social Care (DHSC) have released a call for evidence on fit note reform. The outcome of this is to facilitate timely patient access to specialised work and health conversations and look into the current fit note process for those with long term health conditions. This forms part of a wider activity to reform the sicknote that was announced in the Autumn statement in 2023.
Quite often, people are written off work without an objective assessment of what they could do with the right support, rather than what they cannot. This call for evidence is an opportunity to seek views and experiences of the current fit note process; how it supports work and health conversations, but also the challenges and the enhancements that would better support people to start, stay, and succeed in work.
Evidence has shown that the longer an absence from work, the lower the likelihood that someone returns to work and their health often worsens.
Limitations of the current fit note
The fit note was introduced in 2010 to replace the ‘sick note’ and to ensure patients received advice about the benefits of returning to work, and employers had the information they need to make changes to facilitate an earlier return to work.
Feedback suggests that a key issue with the current fit note process is that it does not reflect the diversity of needs when considering whether someone’s health condition impacts their ability to work. This is because:
1. There is currently not enough capacity and health expertise in primary care to make an effective assessment of a patient’s ability to undertake work.
2. There is no established route to refer people to more tailored or intensive support if it is needed. Where further support is required, its availability can vary and is difficult to navigate.
This means that the current process is not meeting the needs of individuals, employers, and healthcare professionals in supporting people to start, stay, and succeed in work
Approach to change
The Government wants to develop and test a reformed fit note process in England that provides a more integrated work and employment support offer to help employers and employees to reduce sickness-related absence, and in turn, free up valuable time for healthcare professionals.
The Department for Work and Pensions (DWP) and the Department of Health and Social Care (DHSC), together as the Joint Work and Health Directorate (JWHD), are seeking views on what our current and future policy considerations should include when reforming the fit note process.
The views that are of particular interest are on how digital channels can support gathering this information and any risks and opportunities.
Reforming the fit note process in England means committing to working collaboratively with healthcare professionals, NHS bodies, and other stakeholders to develop and design a system-wide approach to this process. In addition, there needs to be an understanding and consideration of a wide range of views and lived experiences, including individuals as service users, carers and patients.
