medical_consultationIn 2010 I reported the introduction of fit notes as a way of focusing on making arrangements for employees to return to work rather than just being signed off without more. In 2014 the system was backed up with the launch of a Health and Work Service. However its scope has been restricted and there have been delays in implementation. Although scheduled to commence nationwide in April 2015 the scheme is currently being rolled out and appears to be limited to a telephone advice service. It requires the consent of employees/patients to participate.

In the meantime the EEF has published its Sickness Absence Survey 2015. Its conclusion is clear: “Five years on [from its introduction] – the government’s fit note isn’t working”. The comprehensive survey, conducted with 345 employers and covering 83,654 employees, is the twelfth national survey of its kind and SMEs accounted for 82% of respondents. According to the research, as at September 2014, only 5000 GPs from a pool of 40,584 had received training in health and work.

The survey revealed that 43% of employers said that the fit note had not helped employees to return to work, up from 35% shortly after the scheme was introduced in 2010. Employers also reported that the quality of GP advice on fitness for work has deteriorated.

It was noted that GPs and medical professionals are still issuing low numbers of “may be fit for work” fit notes and over a quarter of the businesses responding had not received any.

In terms of overall absence trends there is a sickness absence rate of 2.2% which equates to 5.1 sickness absence days per employee per year. However, as in previous years, over half of employees had no absence because of sickness. There was a notable increase in long-term sickness absence with the main cause being back problems and other musculo-skeletal disorders. However, for businesses with more than 500 employees the most common cause is stress and other mental ill health disorders.

Commenting on the research, Terry Woolmer, EEF head of health and safety, said:

We have supported the ‘fit note’ since day one and wanted it to succeed. However, the evidence is now clear five years on that it’s not delivering on helping people back to work earlier. In fact, the evidence suggests that the quality of advice being given by GPs to help people back to work is deteriorating.

It can still be made to work but government now needs to put its shoulder to the wheel with greater resources. The first step must be to ensure that all GPs and hospital doctors are trained in health and work issues so they feel confident in giving proper advice. Without this as a basis there is little prospect of the ‘fit note’ ever delivering genuine improvement in return-to-work performance and absence reduction.