The Government has announced a series of pilot schemes aimed at overhauling the fit note system in England, with trials designed to reduce pressure on GPs and improve support for people off work due to illness.
The reforms will be tested through four existing NHS WorkWell sites and could eventually lead to wider legislative changes to how fit notes are issued and managed.
Currently, around 11 million fit notes are issued each year, with more than 90% stating that a patient is ‘not fit for work’. The Government says the existing system often functions as a basic administrative process without providing tailored support to help people remain in employment or return to work safely.
The new pilots, which are expected to cover up to 100,000 appointments over a year, will test alternative approaches focused on personalised ‘stay in work’ and “return to work” plans.
Under some models, patients will continue to receive an initial fit note from a GP before being referred to support services. Other models will remove the need for a GP-issued fit note altogether, with patients instead referred directly to specialist support teams made up of clinical and non-clinical staff.
Support services will include work and health coaching, social prescribing and discussions between employees, employers and healthcare professionals to explore workplace adjustments and maintain contact during periods of absence.
The trials follow recommendations made in the Keep Britain Working Review, led by former John Lewis & Partners chairman Sir Charlie Mayfield, which concluded that the current fit note system was no longer operating as intended and could act as a barrier to communication between workers and employers.
Alongside the launch of the pilots, the Government also published findings from its Fit Note Call for Evidence. The report found that only 29% of primary care healthcare professionals viewed issuing fit notes as a good use of GP time, while around 60% of employers said the current process did not effectively support workers’ health and employment needs.
The pilots, backed by £3 million in first-year funding, will begin in July across four areas:
- Birmingham and Solihull
- Coventry and Warwickshire
- Cornwall and the Isles of Scilly
- Lancashire and South Cumbria
Each area will test a slightly different model to assess which approach is most effective at supporting workers while reducing administrative burdens on GP services.
Dr Steve Taylor GP Co-Lead Doctors Association UK said: ‘We agree that the current system of fit-notes isn’t working well for patients, GPs and employers. It often lacks the nuance to deal with specific work situations and reasons that people have for not being able to work their full or part of their role.
‘We hope these pilots will give the opportunity to explore a different way for people to engage with the periods of ill health and ways to make work more accessible and achievable. This recognises that GPs aren’t always best equipped to understand the options for work and we hope that active engagement between patients, GPs, employers and this new service will provide a better experience for everyone.
‘It is important that no one is forced to work who cannot, but it is also important that those who can, should be encouraged and given options to work. This could be a great improvement and we look forward to seeing the outcomes from these four pilots.’
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